Pre and Post-Bariatric Surgery Behavior Modification / Therapy

Before making the decision to have weight loss surgery, patients have typically tried many other ways to lose weight. After patients make the decision to undergo surgery, they are quite excited and ready to embark on a new journey to a healthier life. Regardless, even after weight loss surgery, patients still require hard work and life-long behavioral change in order to successfully lose and maintain weight. This is because their unhealthy habits have evolved over many years and therefore may not just disappear overnight.

Surgeons give patients a diet that they must stick to before and after surgery, which will help them with their weight loss and prevent future weight re-gain. It is recommended that patients learn new habits including:

  • Changing their food and eating habits
  • Eating smaller portions
  • Not drinking and eating at the same time
  • Increasing their exercise
  • Chewing slowly
  • Not eating for emotional reasons
  • Limiting certain foods: alcohol, sugar foods, high fat foods, carbohydrates, carbonation, etc.

Weight loss surgery can result in significant weight loss and an improvement in other obesity related medical conditions. Dr. Shapiro works with patients post-operatively to help them achieve success. While most patients are very happy with their surgical experience, some patients do need pre- and /or post-operative support to help them with the necessary long-term changes.

You may want to consider therapy after weight loss surgery if you are:

  • having a hard time sticking to the recommendations.
  • not feeling happy and healthy or are experiencing depression or anxiety.
  • having body image concerns.
  • having family concerns at home (e.g., meal issues, food in the house, need support regarding exercise).
  • isolating yourself from friends and family rather than going to social events.
  • drinking too much alcohol instead of eating.
  • not sure if you have the skills to be on your own for this new world of eating.

You may also want to consider therapy before weight loss surgery.

Dr. Shapiro also works with patients before their weight loss surgery to help them become emotionally and psychologically prepared for surgery. She helps them learn their triggers to their unhealthy eating and begin to make small changes so that they are more prepared after surgery.

Why should I work with Dr. Shapiro?

Dr. Shapiro is the top bariatric psychologist in San Diego. She specializes in Eating Disorders and Obesity and is passionate about people who struggle with their weight. She has trained at the most esteemed obesity centers including Duke University’s Weight Loss Surgery Center, Duke University Eating Disorder Program, Structure House LLC, The University of North Carolina at Chapel Hill Eating Disorder Program. She has trained psychiatry residents and psychology graduate students on how to treat obesity and bariatric surgery patients and she has authored several chapters and medical journal articles on both eating disorders and obesity.

When choosing a psychologist, it is important to select one that is experienced in the area that you want help in managing. If you feel depressed, you’d want to see a depression specialist. If you have cancer, you’d visit an oncologist. If you have a rash, you’d likely go to a dermatologist.

Dr. Shapiro only specializes in eating disorders and obesity. She has spent her entire career focusing on this area and her practice is dedicated to disordered eating. She is sensitive to the emotional issues of obesity. Rather than know a little bit about a lot of areas, she knows a whole lot about disordered eating!

How will Dr. Shapiro work with me?

Individual Therapy: Dr. Shapiro will first meet with you and get to know you. She will gather information about your eating, activity, social history (family, work, relationship, upbringing), the role that food and body played in your family, etc. She will then work with you to collaboratively put together a treatment plan to address your own individual needs. Dr. Shapiro is compassionate and trusting and patients feel that they can genuinely open up to her to talk about anything – things that they have a hard time discussing with their friends and family. And, aside from listening, she is also able to help them resolve the issues with which they are struggling.

During sessions, Dr. Shapiro will help you identify and change your own personal relationship with food. While this can include a history of what triggered your initial weight gain or unhealthy eating patterns, the focus is not on the past but rather it is on the present and what is maintaining this behavior. This includes discussing the emotional and behavioral reasons for eating and learning different ways of managing these situations.

After surgery – you may physically not eat or be able to eat, but you may psychologically want to eat. Dr. Shapiro will help you change this relationship with food.

Dr. Shapiro works with bariatric surgery patients to help them make small dietary, physical activity, and general behavioral goals that they can stick with to achieve long lasting benefits. These are SMART goals –Specific, Measurable, Attainable, Realistic, and Timely.

Typically, Dr. Shapiro meets with patients weekly (but is flexible upon the needs of each patient). As treatment progresses patients transition to every other week, and then monthly, until they graduate from treatment. The ultimate goal is for patients to manage their eating and weight alone without Dr. Shapiro’s assistance.

Common Topics for Bariatric Surgery Patients Include:

  • Sticking to the Recommended Diet
  • Learning to Make Small Changes and Stick to Them
  • Lifestyle Activity and Exercise
  • Mood and Food (emotional eating) – Get to know the strong relationship between your feelings and eating.
  • Binge Eating
  • Restaurant Eating and How to Still Have Fun
  • Meal Planning
  • Managing Cravings
  • Mindful Eating – Slow Down
  • Triggers (Reasons for) Eating
  • Body Changes and Body Image
  • Discussing Surgery with Friends and Family – Pre-op
  • Discussing Surgery with Friends and Family – Post-op and noticing rapid weight loss
  • Goal Setting
  • Time Management to Exercise
  • Weight Maintenance for Long Term Success.…..and more

Brief Phone Coaching:

Dr. Shapiro offers brief coaching over the phone for weight loss surgery patients to help them stay on track. These are 25-30 minute sessions.

Phone sessions may be a good option if you:

  • Live too far from a therapist who specializes in bariatric psychology, eating disorders, or obesity.
  • Live too far for support groups and / or can not attend support groups.
  • Need a little bit more than support groups but not as much as weekly therapy.
  • Need someone to help you stick to your goals.
  • Need someone to help you manage triggers to cravings or reasons for wanting to eat so that you don’t give in to them.

These calls can be set up on a weekly, every other week, monthly, or on an as needed basis. Insurance programs do not cover phone sessions.