Weight reduction surgery won’t
work without counselling
 Surgery
alone will not achieve long-term weight loss for the morbidly
obese, say clinical psychologist Kay Mathewson and obesity surgeon
Dr Rob Fris. Emotions, attitudes and behaviour linked with food
and eating must also be addressed.
Ms Mathewson, an obesity counsellor from the University's Centre
for Psychology Services in Auckland, and North Shore-based Dr
Fris work in a team that includes a dietician and nutritional
expert to prepare patients for surgery and life beyond it.
She wants to dispel myths and preconceptions about the plight
of seriously overweight people, and says they are often maligned
and harshly judged by others.
People she counsels may have experienced years of humiliation,
battled with their weight throughout years of unsuccessful dieting,
drug treatment, exercise regimes and hiring personal trainers.
They are often depressed, anxious and socially withdrawn because
of their obesity, can be victims of workplace discrimination
and miss out on activities most people take for granted, such
as travel, playing with their children, socialising and participating
in sport and exercise.
Ms Mathewson says many people do not realise that being morbidly
obese is a clinical condition resulting from many factors including
metabolic, genetic and psychological triggers.
It puts sufferers at risk of early death, and numerous illnesses,
including heart attack, hypertension, diabetes, infertility,
incontinence as well as sleep disorders, depression, skin problems.
Obesity surgery, which usually involves the insertion of a lap
band around the stomach restricting the amount of food that can
be eaten, is not a quick-fix solution and succeeds only if the
patient can also make changes to their lifestyle and eating habits,
Ms Mathewson and Dr Fris say.
Dr Fris says although psychological counselling is not a not
requirement, his clinic recognises that obesity is more than
a purely physical, medical matter.
“No operation can separate the stomach from the brain,” he says.
Ms Mathewson’s input is part of the pre-surgery assessment for
suitability as well as to help the person adapt to life after
surgery, so that they retain the benefits of the procedure.
“One aspect of my role is looking at what will make the surgery
a success, and helping clients achieve the best possible outcome," she
says. "We talk about potential obstacles in terms of lifestyle
and eating habits, and the role that food and dieting plays in
their lives.”
Although patients will have a smaller appetite following the
lap band surgery, Ms Mathewson discusses their emotional needs
surrounding food and other psychological issues related to their
eating habits such as body image.
Dr Fris says he would like to see more research by psychologists
on obesity to better understand behavioural and emotional triggers
for over-eating, as well as body image issues for obese people.
At the Obesity Surgery Society of Australia and New Zealand
in Perth, Australia, next month Ms Mathewson will speak about
how clinical psychologists contribute to a surgeon’s team to
achieve positive outcomes for clients.
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