"What's important is psychology." ~ J. Carville

Next up – psychology – July 27.

I was scheduled for a two hour visit. First I took an online assessment. They give you an hour to do that because it’s several hundred questions. Well, it took me like 10 minutes. First, I work with psychological assessments all the time. I am very familiar with them. Second, I am a speed-reader. I don’t see/read one word at a time. I see/read the whole sentence, sometimes the whole paragraph or screen, at a time. When I went back to the desk to tell the secretary I was done, I think she thought I blew it off. She made several comments about how quickly I finished. Whatever, lady, get it over it. But then that meant I had to sit in the waiting room for a long time until it was time to see the psychologist. The BMI waiting room is very interesting. Very. The chairs are HUGE. Everything in the place is huge. It took me awhile to figure that out. All of the furniture is “fat-friendly.” And, it’s a great place to people watch. Young, old, all different sizes, some in wheelchairs, some on oxygen, professionals, retired, all different colors, accompanied by sundry different people. I would catch myself making up stories about them, who they were, where they were from, why they were here… Then Dr. Julie Merrell came to get me for my psychology appointment.

Apparently, psychology is what keeps many interested people from getting approved for surgery.  Weight loss surgery is a life-altering, stressful process. Changes occur both emotionally and physically. This is why a behavioral health evaluation is a requirement – many habits, behaviors, thoughts, and emotions can affect the success of weight loss surgery. The online assessment and the face-to-face interview with the psychologist are meant to assess eating habits, weight history, stress factors, coping patterns, and lifestyle behaviors to determine the patient’s likelihood of success after surgery.

I didn’t like Dr. Merrell during my first visit. She was too thin. What kind of sense does it make to have an extraordinarily thin woman counseling fat people who want to have weight loss surgery? My friend and I would joke that she needed a “two piece and a biscuit.” I also didn’t like her because she pointed out exactly what I needed to change about my eating habits. Ugh. Who wants to hear that?! She quickly identified that I have out of control eating patterns that I need to change, such as binge eating. She asked me to go to a group called BEST (Binge Eating Strategies and Tools) Start. I did not want to go. Hear me clearly: I DID NOT WANT TO GO. It was inconvenient. There were no evening or weekend meeting times. It was only offered at the downtown campus. It was four sessions, just as school was starting and, most importantly, I didn’t think I needed to go. BUT, the psychologist is one of the three people (surgeon, psychologist, dietitian), who must sign off on your file to get approval both from the hospital and from the insurance company, sooooooo… off to the BEST Start group I went. Every Tuesday. In September. From 3:00 to 4:30. Ugh. I hated it. Then, I loved it. I learned how to slow down when I eat. I learned how to eat with purpose and intention. I learned how to reduce my portion sizes. We discussed emotional eating, out of control eating patterns, support groups after surgery, and so much more.

I returned to Dr. Merrell on September 26, after my last BEST Start session, and I liked her much more this time, even though she was still too skinny. She was very pleased with the progress I had made and the reports about me that the group leader had provided. She signed off on my file. Two signatures down, one to go…the dietitian.