The current standard of care dictates that all patients who are contemplating weight loss surgery must undergo psychological evaluation before their surgery. We will arrange for a pre-surgical consultation with an experienced clinical psychologist who has had extensive clinical experience in evaluating and treating patients with binge eating or compulsive eating disorders.

With presurgical psychological screening, we can have a general sense of who is more likely to do well and who might do poorly, but we cannot predict this with any certainty. Someone with a history of severe depression, anxiety, or psychosis, or addiction to alcohol or drugs is an especially poor candidate.

It is also wise to be evaluated by dietitian before the surgery, especially to determine if you have an eating disorder.

Binge eating and compulsive eating are the most common eating disorders and play a major part in poor outcomes following weight loss surgery. Binge eaters or compulsive overeaters eat in an addictive-like way for emotional reasons, to distract themselves from anxiety, to push angry feelings down, or to anesthetize themselves to depression. Just as many compulsive eaters can defeat diets, the nature of their eating disorder can defeat the purpose of the surgery. Binge eating serves a powerful psychological function for those who do it, and, in some cases, the need for it will not disappear once surgery is performed. Weight loss surgery makes it more difficult to eat large quantities in this way, but it does not make it impossible and it does not make the compulsion to eat disappear. This is why some patients will regain much of the weight they may have lost initially.

For some compulsive eaters, bariatric surgery does feel like magic. It is a tool that helps them to eat less, feel satisfied with less, and lose weight and maintain the loss. When put to the test, they discover that they have more ability to withstand the impulse to binge than they ever thought, and this itself boosts their self-esteem, improves their health, and empowers them. They are the fortunate ones.