• Mayo Clinic Q and A: Work with counselor before weight-loss surgery for success

DEAR MAYO CLINIC: I have decided that I want to have bariatric surgery, but was told that I need to first go through counseling. What will those sessions involve, and does it really improve my chances of the surgery being successful?young overweight woman looking out at the ocean and thinking

ANSWER: Before you have weight-loss surgery, it’s important to understand what to expect and to prepare yourself, physically and mentally, for what’s ahead. Working with a counselor for several months prior to the procedure can help set you up for long-term success following your surgery.

“Bariatric surgery” is the broad term used to describe all types of weight-loss surgery, including gastric bypass, gastric sleeve, placement of an adjustable gastric band and a procedure known as a duodenal switch, among others. Although the techniques used in each vary, all are considered major procedures that can pose serious risks and side effects. Going through counseling beforehand can help identify if having such a significant surgery is the best choice for you.

Weight-loss surgery changes the body’s anatomy and biology in a way that helps people lose weight. But in many ways, the long-term outcome of any bariatric surgery depends less on those changes than it does on a person’s behaviors and lifestyle.

In preparation for surgery, you will work with a counselor who specializes in helping people prepare for weight-loss surgery. He or she can identify and assess risk factors that could make it hard for you to make the lifestyle changes you need to in order to lose weight and keep it off long-term.

In most cases, the sessions before surgery include a weight-loss component. In fact, many insurance companies now require a medical weight-loss program before they will approve payment for bariatric surgery.

For many people, difficulty managing weight is the result of problematic eating or activity habits, like skipping meals or evening snacking. Working with a counselor can help you change habits, decrease emotional eating, self-monitor your eating and activity patterns, and find ways to stay motivated for healthy lifestyle changes. Counseling sessions before surgery also can help improve mood, manage substance use, and teach stress management techniques so you are better equipped to handle the surgery and maintain a healthy lifestyle afterward.

Counseling sessions before bariatric surgery may be conducted one-on-one, or you may be part of a group preparing for surgery together. Many people find group sessions to be quite useful, as it gives them an opportunity to connect with others facing similar circumstances and share ideas.

Some health care organizations, including Mayo Clinic, offer follow-up counseling sessions to help keep people on track after bariatric surgery, as well as to catch any problems or complications that may arise. These sessions also provide an opportunity for you to learn more about support services and healthy living resources in your community.

Research shows that about 70 to 80 percent of those who have bariatric surgery are successful at losing weight and keeping it off five years after gastric bypass surgery. But the stress and busyness of life can sometimes make long-term weight loss difficult. Over time, you may notice that you’re slipping back into eating and lifestyle habits that are not as healthy. Staying in touch with your providers after surgery, or seeking help if you start to notice that you’re reverting to old habits, can help refocus your efforts and keep you healthy.

For many people, working with a counselor before and after bariatric surgery is extremely helpful. Talk to your health care provider about counseling options he or she would recommend. Going through this process can be an excellent way to set the stage for weight-loss success. Karen Grothe, Ph.D., Psychiatry & Psychology, Mayo Clinic, Rochester, Minn.

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