Psychological and Behavioral Evaluation

Abstract

Behavioral evaluation of candidates for bariatric surgery has been practiced since 1991 and it is generally understood that the long-term success of bariatric surgery depends on the patient’s ability to make enduring changes in lifestyle. Despite the widespread use of behavioral and mental health evaluation prior to bariatric surgery, little has been learned about significant predictors of success or struggles with weight loss. Candidates for bariatric surgery have a higher prevalence of mental health disorders, most of which are mild. However, a significant fraction need immediate attention before surgery and continued concurrent treatment following surgery. Little is known about the long-term fate of candidates for bariatric surgery whose surgery is delayed for mental health treatment. Important mental health conditions which merit further study among candidates for bariatric surgery include deficits in cognitive function, binge eating disorder, and those with a prior history of sexual abuse. There is a need to standardize the behavioral evaluation of bariatric surgery candidates with an accepted comprehensive psychological and behavioral structured clinical interview. It is apparent that mental health expertise is needed for the evaluation of candidates as well as postoperative management.