The role of behavioral health in bariatric surgery

The current chapter aims to review the literature on behavioral health and psychosocial correlates within bariatric surgery. Psychosocial evaluation is an established component of the presurgical clearance process for bariatric surgery patients, and behavioral health providers play an essential role in screening and preparing patients for surgery. This chapter reviews the role of behavioral health practitioners in presurgical assessment, the psychiatric vulnerability of bariatric surgery candidates, and the current practices and components of a behavioral health evaluation. Postsurgical involvement of behavioral health providers is not as well defined; however, a growing body of research that describes associations between psychiatric and behavioral risk factors and postoperative outcomes is reviewed. The chapter also summarizes perioperative and postoperative issues that should be considered by the behavioral health specialist, including behavioral and psychosocial adjustments that occur after surgery, and important psychiatric issues that can emerge, including postsurgical suicide and alcohol abuse risk, changes in pharmacokinetic properties of psychiatric medications, and the development of postoperative eating pathology and body image concerns. This research supports the importance of ongoing involvement of qualified and specialized behavioral health providers across the surgical process.