Disappointed! Therapy for 6 mos before I can possibly see surgeon

on 8/21/14 10:07 am - NH

I really thought I was going to have RNY in September. I did all the tests and meetings etc. But I came up for committee review before seeing a surgeon and was told no. I am being required to see a therapist weekly for 6 months to deal with my "food issues" and "coping skills".  Yeah, don't we all have those problems?  I just feel soooooo let down because I was so excited to be on my way to health.  Has anyone else had to do this?  My hospital is in Boston.  I meet all requirements BMI over 40 plus diabetes, HBP, high chol, sleep apnea, etc etc.  And they threw in a 10-20 pound weight loss (we're told 5-10 lbs in info meeting, which I did).  Just feels like a big boulder has been put in my way.  Very depressing. 

Lisa R

on 8/21/14 11:15 am

I was right where you are now over12 years ago. I had to do the six months of therapy. I am so thankful now I did that as I am a success story and feel the therapy was worth the wait. Hang in there  and best of luck

Cicerogirl, The PhD

on 8/21/14 11:54 am - OH

Yes, most of us have some "food issues" and many of us rely -- to varying degrees -- on food as a coping skill and then need to find new ways of coping after RNY.  I can understand that you are disappointed, but there must be specific reasons that they are concerned enough about whatever "food issues" you have, and any other issues that might prevent you from being successful post-op to require the counseling.  

Did you ask them what their concerns were?  That is a legitimate question for you to ask (and for them to answer).  Ask for a copy of the psych evaluation report and/or notes. The Psychologist or Counselor who did the evaluation is requisite by law to release copies of them to you.

Most people who perform the psych evals are very sensitive to how disappointed people will be to not get psych clearance immediately, but they also know what it takes to be successful (and the consequences of NOT being successful).

Take this opportunity to get as much as you can from the therapy, and to change the unhealthy behaviors and coping skills NOW.  It will be much easier to address them now than after surgery when you also have the stress of trying to cope with following the post-op eating plan and are under physical stress from the surgery, etc.


10 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

on 8/21/14 12:51 pm

I understand where you are coming from! hang in there!


on 8/21/14 6:35 pm

Hi Lisa,

I'm really sorry to hear that they delayed your surgery because of your psych eval. I know I've been pretty upset the times my surgery got delayed (and even aborted - long story short, I had an asthma attack because of the anesthesia and they had to abort). I can't  tell you whether the psych eval was too harsh or not...these evaluations are subjective to a certain extent, and it may be that this particular reviewer was overly cautious in her recommendation. However, coming from a psychology background, I can tell you that the therapy you'll be doing certainly won't be wasted. In fact, although it feels frustrating and like a boulder has been put in your way, this may be the road to something bigger and longer lasting than just weight loss. One of the major issues of WLS is that it cannot change the psychological issues that have led us to where we are, and many people end up with severe psychological issues such as depression and anxiety because although their outside has changed, their inside issues remain the same. People struggle to adapt to a new body while having to still live with the same traumas, ineffective coping styles, inadequate locus of control, self-esteem issues, self-medicating tendencies, worldviews, and learned behaviors that got them where they were in the first place. While the weight may come off, many patients struggle with NEW issues (such as anxiety, anorexia, alcoholism, etc) because of OLD, unresolved problems. Basically, the "sh&t" just gets shifted to a new, potentially even worse problem.  

You're absolutely right though, that many of us got to where we are because of the poor eating habits and coping skills that led us to overeat - why would they pick on you? To be honest, I believe that more people, if not all, should be made to go through a few sessions of counselling (although perhaps 6 months is too long for some and too short for others). Preparing our inside for the change is just as important as preparing the outside. Ideally, this should be done within the time period that it takes to go through many of the other steps (like the social worker consult, the surgeon, the nutritionist, the nurse, the workups, etc, etc) so as to not add to the length of time you've already waited. Unfortunately, the system is not cohesive and integrated enough to seamlessly weave the different components of this big step, and delays like this are the result. I myself lost tons of time (probably more than 6 months in total) because of re-schedulings, nutritionist nitpicking, and sleep-apnea reports lost in the void. IT SUCKS, and I understand why this has gotten you down. 

I think one of your main frustrations comes from the fact that it seems like this is an obstacle in your weight-loss journey. Instead, I suggest you try to see it as PART of the journey, where you are doing important work to prepare you to deal with the big physical and psychological changes you'll be going through in the next 6 months. Try to look at it as an opportunity to work on your own psychological well-being, to become a better, more resilient, more forgiving person with better coping mechanisms.  Give therapy a chance, and you'll see that soon 6 months will be gone, and you'll be ready for the next stage. 

Perhaps, if things go well in the first few sessions, your therapist may be even inclined to recommend you go through with the surgery earlier than the full 6 months. Whatever you do, don't be discouraged now. You've worked so hard to get to this point, and were so courageous in making this important decision to go through with the surgery, so don't let delays get between you and that finish line! Stay strong, and you can always vent online in a group like this full of people who will be there for you to support you! :)



on 8/21/14 9:43 pm
RNY on 12/18/12

Yep, that's definitely disappointing.  I would feel very frustrated as well.  However, as someone whom is 20 months out from RNY, and have met and exceeded all my goals, I can tell you that coping with stress/life/food/etc., after RNY is no joke.  I didn't have any of those comorbidities and work full time, have 2 kids, but dealing with stress without using food after RNY was harder than I thought.  Seriously, everything happens for a reason.  Take this time to truly embrace whatever couseling you can get.  You are going to need it.  I wish I had some!


on 8/21/14 10:43 pm - FL
RNY on 08/07/13

As others have said- as you get lighter the emotional baggage gets heavier.  Prior to surgery, I started seeing a therapist by choice.  I wanted to stack the deck in my favor, so to speak.  I remember my first session when I told her I don't really have any issues, I just eat too damn much. Now, after 12 months- I am amazed she didn't burst out laughing at me.  Boy oh boy, I've got issues.  I know you are disappointed, but understand that your bariatric team WANTS you to have surgery- but they want stack the deck in YOUR favor to give you the best chance at success.  Chin up, six months will pass before you know it and you will be even better prepared.

on 8/22/14 4:59 am - MN
RNY on 11/26/12

'Disappointing' and 'depressing' are two good words to describe how I felt, too, when insurance required six months worth of WLS prep.  Those months flew by in a flash and was used as valuable time to prepare for the life-changing event.  Here's hoping that big boulder in your way turns out to be a big golden nugget, instead :)

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