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Should obesity surgery candidates have to undergo a pschological exam?

Wednesday, January 28, 2009 Posted by Travis Saunders
Photo by Frenkieb

I came across a very thought provoking article by Dr David Ashton in the Guardian online yesterday. In it, he describes how obesity surgery candidates are often required to have a psychological exam in order to be cleared for surgery - something which is not required for most other types of surgery. He denounces this as a form of prejudice against obese individuals, resulting from the popular misconception that obesity is caused by an underlying psychological illness, rather than a complex interaction of biology and environment.

Neither Peter nor I have any experience with obesity surgery ourselves, which may be one reason why I was so surprised when I came across this article. Although I was aware that obesity surgery candidates are subjected to psychological screening, I was under the impression that it was to ensure that candidates were ready for the consequences of the surgery itself, as well as the adaptation to life post-surgery. In essence, I thought that these psychological exams were meant to screen-out patients if they were unlikely to benefit from the surgery in the long-term. Some people may argue that is weight bias (or even paternalistic) but it seems to make sense. Why subject someone to the physical, emotional and financial costs of surgery if they are unlikely to benefit from it?

I know that several of our readers work in the field of obesity surgery, and we would really appreciate your input on this topic - what do you think of Dr Ashton's arguments? Do psychological exams for obesity surgery candidates makes sense, and if so, should similar psychological exams be given to candidates for other surgeries? Whether you work in this area or not, let us know what you think.

For more on Dr Ashton's work, visit his website here.

And finally, I would like to wish a very happy birthday to one of our most committed readers, "Aunt" Irene.


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4 Response to "Should obesity surgery candidates have to undergo a pschological exam?"

  1. justjuliebean Said,

    I think obesity surgery is an entirely different animal than nailing one's ankle back in place (the only surgery I've had yet). WLS can have awful effects on vitamin/mineral absorption, digestion, etc., for the rest of one's life, so it's best to make sure the individual is able to deal. I think all cosmetic surgery, including boob jobs, should have the same laws, even though most of those won't kill you, or cause malnourishment.

    Posted on January 28, 2009 at 3:40 PM

  2. Travis Saunders, MSc Said,

    that ankle surgery sounds pretty unpleasant as it is!

    I should mention that people should feel free to post anonymously if they are not comfortable posting under their own name.

    Posted on January 28, 2009 at 9:58 PM

  3. Anonymous Said,

    Hi Travis - sounds like they are comparing this life-changing surgery to elective plastic surgery al la Hollywood wannabes and its accompanying psychological issues and concerns. Ergo we can take the next step in thought processes to the one that many in the medical community are seeing obesity as a cosmetic, psychological quest for self-esteem through surgical body re-shaping (probably true in some cases) rather than the truly physiological problem it is for many. Sounds like the medical establishment is trying to trivialize the real pain some truly obese suffer both in living their day to day lives as large people. Shameful.....Angie

    Posted on January 30, 2009 at 3:39 PM

  4. Mike Orme Said,

    Not only should there be some form of psychological screening, there should also be the provision for offering psychological intervention such as CBT.

    Addressing the potential problem of self sabotage would increase the rate of successful outcomes.

    Posted on May 31, 2010 at 7:25 PM


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We are PhD students in the School of Kinesiology and Health Studies at Queen's University in Kingston, Ontario. Our research focuses on the relationships between obesity, physical activity, and health risk. This blog is our attempt to consider the many "cures" for obesity that we read about on a daily basis. Enjoy.


The opinions expressed here belong only to Peter and Travis and do not reflect the views of any organization. Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.

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