Since April 26, 2001, the Ministerial Order 628/GM (Portaria 628/GM) issued by the Brazilian Ministry of Health, regulated that the Psychologist should compose the multidisciplinary team of bariatric surgery. Nowadays, excellence teams in bariatric and metabolic surgery recognize the importance of psychological treatment prior to and after the surgical approach.
The role of the psychologist in the bariatric surgery team is to understand the dynamics of the patient through his history of obesity, his life experiences and traumatic situations, the repercussions that obesity brings on his life, fantasies about surgery, medical record of depression and other psychiatric disorders, and the use of alcohol and drugs.
Through the understanding and analysis of the information, the Psychologist assists and prepares the patient for surgery, evaluating which psychological factors may contribute to the success or failure of the surgical treatment, as well as making clear the reality of the immediate and late post-operative period. It is not about psychotherapy. There is no possibility that in a few sessions we will deepen questions of a lifetime.
The psychologically well-prepared patient for performing bariatric surgery is the one that presents understanding, motivation, and availability to adhere to the treatment, together with all the multidisciplinary team, in the pre- and post-operative period. It is not up to the Psychologist to judge the need for surgery, but rather to assess whether this patient can take responsibility for a procedure that will change his whole life-style and, to guide him through in this.
Post-operative psychological follow-up is extremely important due to possible changes in mood, the way the patient sees the world and the way the patient is seen, interpersonal and affective relationships, distortion of body image, eating habits and dysfunctional behaviors. Furthermore, we address the new needs and responsibilities, encouraging the patient to face new possibilities of pleasure to be explored from the change of habits implied by the surgery.
After surgery, the patient is asked to return to the appointments with 30, 60, 180 and 360 days. From the second year on, the appointments will occur every 06 months or one year, according to the guidance of the Psychologist.