The Role of the Behavioral Health Provider in the Management of the Patient Seeking Metabolic and Bariatric Surgery

Obesity management requires a multidisciplinary team in order to properly assess and treat patients with obesity. In addition to the medical comorbidities associated with obesity, psychosocial factors could affect long-term outcomes beyond weight loss. Research on predictive psychosocial factors continues to be inconsistent, but common findings suggest that psychiatric disorders, cognitive functioning, personality factors, and eating pathology can affect both short- and long-term outcomes of metabolic and bariatric surgery. Although a comprehensive psychosocial evaluation is the standard of practice for patients seeking metabolic and bariatric surgery, practice standards have not been defined for these evaluations. This chapter aims to describe the role of the behavioral health provider, and the goals of the presurgical psychosocial evaluation and will identify and discuss general domains that should be included in the clinical interview, as well as other considerations. Information obtained during the clinical interview is key for assessing a patient’s readiness for surgery and for improving postsurgical outcomes. Thus, in addition to reviewing the role of the behavioral health provider in conducting the presurgical evaluations, this chapter will also describe their role in facilitating psychosocial interventions in the preoperative phase as well as providing long-term care for patients with postoperative issues.