Expert Answers

Courtney Holbrook, Ph. D

Courtney Holbrook, Ph. D

Director, Center Bariatric Psychology

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Q: 1
I have been obese my whole life, which is one of the causes of my depression. I am currently taking anti-depressants. Will I need them after my surgery?  
A: 1
Depression is common in obese people and many of our patients are prescribed antidepressant medication. It is important to remember that for the immediate 6-8 week post-operative period, weight loss surgery patients will not be able to swallow pills. For this reason, prior to surgery any patient taking antidepressant medications will need to check with their prescribing physician and determine if their medications can be crushed or should be prescribed in liquid form. Also, any timed release, slow release or sustained release medications will not work the same after gastric bypass surgery and will need to be changed to multiple doses of regular release medication. I recommend you make this change before surgery so you are used to taking the medication several times during the day.

Shortly after weight loss surgery, many patients report feeling better both physically and mentally than they have in years. For some people, depression diminishes as they realize the benefits of weight loss. However, it is not uncommon for patients to encounter challenges as they adjust to their post-operative life. We want you to be prepared emotionally to cope with these issues and therefore, recommend that you continue taking your antidepressant medication as prescribed for at least 6 months post-operatively. If you believe you are doing well after this point and want to consider discontinuing your antidepressant medication, talk this over with your prescribing physician and follow his or her recommendations. You should never stop taking antidepressant medication on your own. This should always be done under a doctor’s supervision.

Q: 2
Is there anything I can do to prepare mentally for my bariatric surgery?
A: 2
Prior to weight loss surgery, many patients are focused on the medical aspects of their surgery and recovery. This is understandable, but as they move beyond the recovery phase of surgery many patients begin to realize how much their surgery and associated weight loss impacts them emotionally and the extent to which their psychological functioning plays a role in their long-term success.

The best way to prepare yourself mentally for this surgery is to learn as much as you can pre-operatively. There are several steps you can take to do this. I recommend you make a list or write yourself a letter in which you detail the reasons for pursuing weight loss surgery and the expected benefits of weight loss. This will help you clarify your goals and expectations. It will help you measure your success and serve as a reminder of your pre-surgery life if you are tempted to resume behaviors inconsistent with maintaining weight loss.

It is also important to talk with those individuals who will be sharing your weight loss journey, as they have their own expectations and concerns. Encouraging communication can help clarify what you will need from each other. Remember, although you are having surgery, your new habits and weight loss will directly impact those closest to you. Making sure you are on the same page can be very helpful in the long term.

Talk to as many former patients as you can about their experiences. You can never be too well informed. You will find that most people are eager to share their weight loss journey. Talking with people who have had weight loss surgery will help you form a support network of people who can understand your concerns and successes from first-hand experience.

Prior to surgery, I encourage you to practice the behaviors that will leadto long-term weight loss success. You will find that some of these are easy and others are more difficult. Learn as much as you can about nutrition. Make changes in your eating habits consistent with behaviors you will engage in after surgery: Reduce intake of sweets, snacks, pre-packaged and fast food. Prepare nutritious meals at home. Chew food thoroughly, and eat slowly, making each meal last approximately 30 minutes. Practice not drinking liquids with your meals or for at least an hour afterwards. Find alternatives to eating if you use food to cope with emotions or situations. If possible, begin engaging in light exercise. Weight loss surgery provides you with an amazing tool, but you are responsible for using it properly, and the more you practice these behaviors, the better prepared you will be to do so.

Finally, I recommend you attend CBS Pre-Operative Readiness Groups. These meet on the second Wednesday of every month from 5:30 – 7:00 pm in the St. Vincent DePaul Room in St. Vincent Charity Medical Center . These classes were specifically developed to educate pre-operative patients on psychological and medical aspects of post-operative life. They are a good opportunity to learn, ask questions and meet other patients. You are also welcome to attend our Post-Operative Support Groups. These meet on the fourth Thursday of the month, also in the St. Vincent DePaul room from 6:30-7:30 pm. If you are unable to attend our groups, we can provide you with a list of satellite support groups which are CBS-affiliated, patient-led groups that meet in various locations in Northeast Ohio.

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