psych eval and high bmi

I don't have my consult and evaluation until november 21, but in the mean time I'm worrying like crazy.

I have a history of depression and a few other things that are well managed. I'm concerned about the psych eval and what they will do.  Can anyone offer their experiences here?

Also, is there a too high of BMI that they will operate on?  Mine is 60 and I'm worried I will be declined by the surgeon because of that.

Any help to calm my nerves is appreciated. 

Try not to worry about the psych eval. They're not trying to disqualify you; they just want to make sure you're aware of the changes you'll need to make and that you're stable enough to make such a huge decision. I, too, have a long-standing history of depression and have taken anti-depressants for 15 years.

I don't know about the BMI question, but mine was over 53 pre-surgery and it didn't seem to faze anyone.

Good luck!

Are you absolutely certain that you want the RnY? You might see better results with a DS. That seems to work much better for folks with a higher BMI. For higher BMIs, docs sometimes like to do the DS in a two part surgery. They first perform a gastric sleeve and then when a large chunk of weight is gone, they go back in and add the malabsorptive component so it's safer.

Just make sure you look into all of your surgical options and make an informed decision.

Good luck!

I don't know who your insurance is, they all have different programs. But for Kaiser NorCal it was just a simple evaluation to make sure that I understood what I was getting myself into, had a good support system and that I would be willing to comply with all the doctors orders (supplements, protein, etc.)

Also I had a high BMI and there was no issue at all.

Good Luck and try instead to focus on starting good habits now, eliminate all the junk that you can from your diet and increase your exercise. It will help you worry less about the hoops you have to jump through.

:Danni

My BMI is over 60 and my surgery date is tentatively scheduled for 12/14. My doctor doesn't even require weightloss before the procedure. I mentioned that I was starting to drink the protein shakes now replacing 2 meals and was told I didn't have to. All they ask is that 8 days prior to surgery I eat low-cal.

My BMI was 61 si do not fear.  Assuming your psych eval isn't done by an "insenstive idiot" it should not be a problem. It's purpose is to make sure you fully understand and freely accept the requirements, procedure, possible complications etc... of what you are doing.  They are there to help, not find a way to stop you from doing this.

I had the psychiatrist that I've been seeing for many years do my psych eval.  Can you have your mental health care provider do yours?

I have a history of depression, PTSD and DID.  Multiple hospitalizations and a couple of suicide attempts (last one was about ten years before my RNY, though).  I was on several medications at the time of my WLS.  None of that preventing me from having surgery.  The surgeon just wanted to make sure my conditions were stable, that I was compliant with my treatment, and that I had continuing support and mental health care and would be followed closely by my psychiatrist and therapist after surgery.

A history of depression will not disqualify you fromn surgery.  Some forms of psychotic disorders might,  as may a history of eating disorders (beyond just overeating), but as long as you are under the care of a mental health practitioner and you are lucid and understand what havign surgery will entail from both a physical and behavioral standpoint, you should have no problem.

The actual psych evals vary from one person to another, but frequently there is some kind of depression assesment.  There may also be a personality assessment (some are short amd some are quite long).  Occasionally, there is an assessment for substance abuse or addiction tendencies.

As far as your concern about your BMI, there are some surgeons who will not do surgery if someone is extremely large, but I would think that most surgeons would not balk at a BMI of 60.  Mine was 57, and bothe surgeons I went to info sessions for did not have problem with it.   Some surgeons may want to do the surgery open, though, rather than lap because of your weight, depending on how you carry your weight.  I would suggest that you call your surgeon's office and just ask if the surgeon has a BMI (or weight) cut-off for patients that (s)he will accept.  There is no point in you paying for ANY kind of evaluation or consultation if you do not meet the surgeon's restrictions (because your insurance may give you a hassle about paying for a second one with another surgeon).

Lora

I felt the same way with my psych eval (Ive now had two thanks to the revision) . They are more looking to make sure that you are "realistic" about your goals and understand what you are going to be going through and the steps it entails. Mine also checked for a support system and helped me get into a support group. Most psych's are as happy as you are that you are taking this step to improve your quality of life.  I still see my psych on and off and call if I really need to talk for a minute. Don't look at it as a bad thing, they are part of your support system and can really help when you go through some of the life changes that losing weight entails. =) Just remember if you dont like the psych, you can always go to a different one.

Psych eval is more about making sure you understand the risk of sugery and the lifestyle changes about to come,  not about depression.  But depression will probably come up because they will want to make sure it is managed and it may mean changing dosages or types of meds after surgery.  Depression does not disqualify you from having WLS.

Read the forums about the different surgeries including DS.  If you decide it is the best for you then you may have to change surgeons.  Lots of surgeons don't perform that surgery.