Psychological Aspects

Psychological Aspects

Patients may need ongoing psychological support after surgery to assist with maintaining a new life style. There are many adjustments post-surgery.

There are various factors that contribute to a person becoming obese. Some of these are biological, others are social, and/or psychological. We could therefore say that the causes are bio psychosocial.

Each person has a unique biological, social and psychological profile and there is seldom one single cause in the development of obesity.

The full implications of genetics in regard to weight is not yet fully understood, but it tends to run in families. A study involving adults who were adopted as children proved that these individuals’ weights more resembled those of their biological parents.

One would also need to bear in mind that aside from genetic influences children of obese parents are also often introduced to faulty eating habits and may overeat. It is therefore difficult to tease out environmental and genetic causes.

Obesity is difficult to manage because of the enmeshed nature and interaction between the factors mentioned in the previous paragraph. Many people are familiar with the phrase “comfort eating” which is basically emotional eating. One could, for instance, subconsciously associate food with nurturing.

There is sufficient evidence in the literature that some people overeat in response to:

* anger/frustration

* boredom

* depression

* grief

* loneliness

The most common psychological problem associated with obesity is depression. There is an interplay between depression and obesity and they feed on each other in a cycle. For instance, many people who overeat fill an emotional void. Some people resort to high sugar foods to numb out feelings.

Comfort foods like chocolate and biscuits or starchy foods increase the body’s natural neurotransmitter, serotonin. Some people say they “zone out” when they eat. This is like an automatic response to stress where the person could dissociate and indulge without even enjoying the food. Emotional overeating protects people from psychological distress and can initially be soothing. However this is short lived and then the overeating impacts negatively on their self-esteem.

Patients may need ongoing psychological support after surgery to assist with maintaining a new life style. There are many adjustments post-surgery. Some people find that they encounter relationship difficulties in that their partners may not have been adequately prepared for the various changes, including changes to the body, lifestyle, and social interaction.

Psychological treatment would focus on identifying emotional triggers where appropriate and negotiating strategies to manage these more effectively.

The treatment would also provide an opportunity to address:

* low self-esteem

* rejection

* relationship problems

* loss

* stress

* relationship difficulties that could arise

Ultimately the Psychologist’s involvement would be supportive as bariatric surgery patients contemplate and confront significant life challenges.

The person could feel shame, disgust, rejection and isolation, and then turn back to food for comfort. This is therefore a process where the attempts to relieve a feeling actually exacerbate it. This is a complex interaction and is difficult to break, especially if the person is unaware of what these psychological triggers are.

Psychology and Bariatric Surgery Patients may be required to attend a psychological assessment. This will be conducted by a Clinical Psychologist who will advise the doctor/s if there are any issues that could impede the best surgery outcome. The assessment will basically comprise a detailed, semi-structured clinical interview and a self-report measure that will be explained in more detail at the time of consultation.