Question:
Expert Advice Needed Again! Desperate!
Okay, Please help. My insurance company requires a psych eval (supposedly) before they agree to approve or disapprove my request for WLS. I live 3 hours away from my surgeon so I asked them if I could find a PhD who is close to home. I went to him. He said he has done these before. Last Monday I went to answer 600+ questions. Today I went to talk to him. The first 1/2 hour we spent discussing money and insurance to cover his fees. Then he wanted to know If I knew what Dr. Phil thought about obesity and its underlying issues. He told me I should go buy the book. (!) He then talked for about 45 minutes about my childhood and asked me if I was ever depressed before. I said yes, twice (years ago). Once when my baby died (premature) and during my divorce. I almost cried. I have to GO BACK NEXT WEEK TO FINISH.... UUUGH!!!! He doesn't sound very supportive of this surgery does he? He shounds supportive of me coming to him every week to figure out what makes me eat food. I told him straight out I have had a love affair with food. I am Italian and life was always centered around food. WHAT SHOULD I DO???? DID I BLOW IT??? — Marcy G. (posted on December 23, 2002)
December 23, 2002
First of all. You are supposed to go for a BARIATRIC psych. evaluation and
it sounds as if this quack is giving you an MMPI. This is usually for
mental status or divorce/child custody. I will have my MA in Psychology in
a couple months so I am familiar with the tests. WE all have a love affair
with food. Thats why we are all fat! He should already know that. Ask him
why he is giving you that kind of test. The info. your insurance company is
looking for is a history of your weight and health. The MMPI uses
(measures) several different scales to see where you fall. This has
nothing to do with your weight. The scales are: depression, mania,
schizophrenia,etc. Try to find another doc. to do the eval or just ask the
idiot why he would administer a test like that. in the mean time go to my
surgical date and find my dr.s info he might know someone in illinois that
can give you another one. good luck. christine
— christine L.
December 23, 2002
Hi there,Marcy! I never had to have the psych test with my insurance, but
I thought that we are supposed to get the MMPI with the psych test,
although I have heard of some Doctors who don't do it, then again , I heard
of one woman who had to do it 3 times, because the doctor wasn't satisfied
with her answers. I know that isn't encouraging, sorry. In the
"Your Journey" part, here on the AMOS site, under "WHAT YOUR
PSYCHIATRIST NEEDS TO COVER", #16 lists the MMPI. Maybe this doc does
do that test. I'm not trying to step on any toes, I am far from a
professional, but when I was searching things out, I was anticipating the
MMPI, I just didn't have to do it. Marcy, just be honest with him, I'm
Italian also and know how much "association" we have with food
ALL our lives. For every occasion there is always food around, and our
parents were shoving it into us as children and as we grew older, we were
used to doing it ourselves. Be honest and tell him your ready to break
your affair with food. Any questions, e-mail me. Hope it helps. Vi open
RNY 9/23/02 down 80 lbs.
— Vi F.
December 23, 2002
Christine - I beg to differ. The MMPI is routinely used in conjunction to
an overall psych evaluation for WLS. In some states it is mandatory. I
took it and I have to agree it seems kind of worthless but then again my
psychiatrist knows me and what I'm about. I figured I was going to come up
with about 8 different personalities, LOL. Considering a person may be
seeing a mental health professional for the first time and that person is
supposed to determine if you really are ready for this step, I think the
test can provide some good information. Obviously is should only be a part
of the things used for determination. I guarantee you I could have fooled
any mental health professional when I first started out with depression.
Fooled the family doctor no problem. But fortunately it made me take a
hard look at things and made me realize I had some problems. I believe all
possible tools should be used to ensure a person is capable of making this
decision and truly has a handle on what life will be like and how they will
deal with the ups and downs.<p>In my opinion you did not blow it. Go
back and finish and be honest. If he comes up with problems hear him out.
Maybe a little counseling would be helpful, but do your counseling with a
counselor and not an MD. MD's just do not spend much time counseling
anymore and you will get a lot more bang for your buck with a counselor.
If you are uncomfortable with this PHD person then find someone you are
comfortable with. As far as money, if your insurance will cover WLS it
seems almost unbelievable they will not cover the psych eval and any
follow-up treatment. So call your insurance and check it out. Good Luck!
— zoedogcbr
December 23, 2002
OH man i can't believe i'm going to post to this question....When it comes
to insurances demanding an eval to see if your stable enough for this
surgery I think it's a good idea....there are MORE than one reasons we
become obese it isnt nessacarily to much food as sometimes the wrong
foods....Or the need to really satify an inner pain to help you
cope......If you have become obese from constantly eating for comfort.Then
this surgery could really mess you up if you didnt get the counseling to go
with it...just like any addiction ( mines is nicotine and choclate) if you
dont do something to help or change the addiction need then the surgery
wont help you and might even cause harm....then to if you just need to
avoid sugar or too much starch without the need for food as comfort then
go for it.......Does any of this makes sense???????/I am certifiable so
don't take this as anything other than an opinion please bbd
— BBD
December 23, 2002
Dr Friday who approves all of our surgeons patients says there are very few
reasons for rejection for WLS. Active drug or alcohol abuser, hanibal
lecter multi personality type. Depression is NORMAL in MOs. Some folks
depression goes away after surgery when its based on our poor image. The
mmpi test is to screen for the alcoholics among us. Surgery doesnt work for
them. <P> For pre ops reading this ask your surgeon for a recommended
Psych doc. If you dont you may stumble onto a anti WLS doc who will try to
save you from surgery. I had a pulmonary doc do that, its in my profile.
Use your surgeons recommended support docs to prevent this. BTW my
depression left with my weight!
— bob-haller
December 23, 2002
Marcy,
I can totally relate to your frustration. I also agree that a psych
eval is necessary but I object to the Dr. Phil reference and the general
flavor of the evaluation. When I went to my size 3 doctor (I weighted
almost 300 lbs.) i got a lecture about how difficult it was for HER to push
away from the thanksgiving table and a referal to buy the book 'fit for
life'. that was the last time they saw me in that office. I went to
another doctor for a referral and I am now amost 6 months post op and down
75 pounds. sometimes you just have to find the physician that best fits
your needs. the very best of luck to you.
Monika
— Monika W.
December 23, 2002
IMNSHO, any psych doc who quotes Dr. Phil is a quack in my book. I would
run, don't walk, somewhere else. I think you felt the same thing, and you
did NOT blow it, the shrink did!
— Leslie F.
December 23, 2002
This is such a relavant question for me. I went to a Psychologist refered
from my PCP - so that I could have that Psych Eval done prior to my
Consult. Well she denied me for surgery - she feels I need some Therapy
prior to surgery to find out why I eat and also that she feels I eat from
stress. I eat because I'm happy, sad, because I'm bored and because I'm
with lots of friends, I eat if it's a holiday and because it's just there.
I was taught bad eating habits and use food for comfort at times. My Dad
use to give me Hershey bars when I was sick and my Mother always made a big
production of holidays. So - I'm very overweight - I need this tool - I
need to lose weight. I don't need Therapy. Besides it's on a cash basis and
I already paid her $180. I have a second opinion on Jan. 6th - this time
with someone recommended thru my surgeon - who understands us better. Good
Luck - Get a Second Opinion!!
— Sally P.
December 24, 2002
I'm sorry Marcy, your no different then the rest of us when it came to
food. I agree with Leslie, and psych that quotes Dr. Phil......well..thats
just a really bad sign. Find someone else. Go with who your surgeon
recommends. Deal with the drive, it will be worth it to have someooe who is
going to look at the big picture and know what to look for related to this
surgery.
— Vicki L.
December 24, 2002
I fully agree about the "doctor" using the Dr. Phil reference.
This would not be my kind of doctor and I'd go somewhere else. Personally
I would have gone for my consult to a psychiatrist and then if he or she
recommended some counseling to a counselor. I believe that even if the
psychiatrist feels you need some counseling that if you get started before
surgery and are willing to continue some afterwards that most would approve
you. Depression definitely does go hand-in-hand with MO but in many losing
the weight does not solve the issues. It forces what is the true
underlying issues to the surface and can blow your life upside down - I
know from personal experience. For the people who's depression is strictly
weight related, and no underlying issues, they will likely get rid of their
depression. The rest of us will have tons to work through but you can get
there and have a wonderful physical and mental life. I had no clue the
things that were tied to my weight and losing it forced me to face them.
It was hell to go through but I am in such a much better place now that it
was worth it. I hope your 2nd consult goes good, but don't totally blow
off the doctor if they recommend some counseling.
— zoedogcbr
December 24, 2002
I can't disagree with most of what has been said. I did want to add that
you might tell this person that you agree that you might need to seek
further therapy, but let him know that you won't be getting it from him,
but will go to someone who specializes in eating disorders. That way, if
he just wants to get more money from you, he would probably try to talk you
into staying with him. I'm not sure that this is his motive. It may also
be that he is very ignorant of WLS and the benefits it can have, so maybe
some education is in order. Also, for anyone who had to take an MMPI, I
had a psych eval for a doctor I decided not to use, but basically the
psychologist just wanted to make sure that I had a realistic view of what
the surgery could and couldn't do for me and that I had a support system of
some kind in place.
— garw
December 24, 2002
I forgot to add this. I have been in therapy for a number of years, often
dealing with weight and eating issues. I've had 2 different therapists
tell me that I probably needed to start losing weight before therapy would
be really effective. The theory is that as long as I can numb myself with
food, I can mask the underlying issues. They both believed that once I
started losing a significant amount of weight, those issues would become
more apparent, causing me more distress making me more willing and able to
get them out in the open.
— garw
Click Here to Return