Tennessee’s TennCare may not want to pay for nutritional counseling, but the National Institute of Health requires some psychological counseling prior to any bariatric surgery. This counseling includes a psychological evaluation, often with a standardized objective test, as well as interviews to determine a patient’s preparedness for the life change required by weight loss surgery and information about those changes. One reason behind this requirement is that gastric bypass surgery cannot be reversed. It also requires major behavioral change to be successful; if a patient is not compliant with all behavior changes he or she can become very ill – I have even been told about the possibility of death. These are severe consequences for not following doctors orders implicitly.
Yet, the behavior change required is also severe. As a therapist, I see asking that kind of change from someone as setting them up for failure or disappointment because so much change is extremely stressful and mentally and emotionally taxing. I would caution any of my clients attempting such overnight life change, and counsel them on forgiving themselves when they do not stick to their plan. Eating more than planned one day may be a disappointment for someone committed to weight loss, but it can have devastating effects for someone who has had gastric bypass surgery.