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Addiction a Risk After Weight Loss Surgery

Mental Health Care Critical After Weight Loss Surgery

Bariatric surgery patients are screened by mental health professionals before they undergo the procedure. During this evaluation, they are advised to avoid alcohol, because it can damage the gastrointestinal tract lining. Patients must be tobacco-free for three consecutive months prior to undergoing the operation. If someone is identified as having an eating disorder such as bulimia, says Dutson, the patient is referred for longer-term therapy.

"It's possible patients aren't always forthcoming during the pre-surgery evaluation," he says. "But in my experience, by the time patients want bariatric surgery, they're in the mentality mode of, 'I need to get this taken care of.' Those circumstances push people toward honesty."

The positive body changes that follow weight loss surgery offer a psychological boost. But adjusting to the post-surgery world has its ups and downs, says Kelli Friedman, PhD, director of psychology at the Duke Center for Metabolic and Weight Loss Surgery in Durham, N.C.

"There's not a lot of scientific study on this topic, but like this study, we also think that two years after the surgery appears to be a particularly vulnerable time for patients," she says. "Many surgery centers have the presurgical psychological evaluation and offer follow-up care, but we need to do a better job at long-term follow-up care, not just a few months after surgery."

Friedman points out that a patient's alcohol metabolism changes after bariatric surgery.

"A patient who has lost a significant amount of weight after bariatric surgery may feel the effects of alcohol much quicker than they were used to," she explains. "Mental health providers need to continue working closely with these patients so we can identify who is at risk and check in on them periodically."

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