In the Options program, we like to think about mental health and wellness in three key areas: relationship with self, relationship with food, and relationship with others. Check out the key messages for each below.


Realistic Expectations

Power of Your Mind

Embracing Change

Positive Body Image

Getting Support


Realistic Expectations

Healthy Relationship with Food

Emotional Eating

Addiction Transfer

Getting Support


Realistic Expectations

Preparing Yourself and Others

Communication Skills and Boundary Setting

Relapse and Getting Back on Track

Getting Support
There is no shame in getting support.
Important Mental Health and Wellness Considerations
Metabolic and bariatric surgery is a tool that can support overall health and wellness. However, it is important to be aware of some important mental health and wellness considerations that surgery can impact or influence, including trauma, addiction, depression, disordered eating/eating disorders, and relationships.
Trauma
What do we mean by trauma?
We often think of trauma as a specific event, but in fact, trauma has a much broader definition. Trauma stems from a life-threatening or physically or emotionally harmful event or set of circumstances that has lasting effects on a person’s functioning and mental, physical, social, emotional, or spiritual well-being. In the United States, 61% of men and 51% of women report exposure to at least one lifetime traumatic event.
Why is recognizing trauma important?
If you have had any type of trauma in your past that may be affecting your current behavior, it can help to talk to a professional. Trauma, whether experienced in childhood, adolescence, or adulthood, can impact the success of surgery and reduce the likelihood of long-term weight loss.
Professionals can help you get past events or learn to cope so you can have long-term success and happiness after surgery.
There are many resources at Kaiser Permanente and elsewhere that can support you and help you get back on track. You are not alone.
Addiction
People who have had surgery are at increased risk for addiction transfer (also called cross addiction). This means trading one compulsive behavior for another one. Addiction can take many forms, such as alcohol, opioids or other pain management medications, and other substances or behaviors. It’s important to understand the risk factors and signs and symptoms of addiction and know how to get help.
Factors that increase the risk for addiction transfer:
- History of eating disorders, food addiction, or compulsive eating
- Family history of substance abuse
- Regular alcohol use before surgery
- History of chronic pain or overuse of narcotics for pain management
- History of trauma, especially childhood sexual abuse
- History of depression and other mood or anxiety disorders
- Lack of adequate support or feeling isolated
- Avoidance of emotions and experiences
- History of engaging in self-sabotaging behaviors (binge eating)
Signs and symptoms of addiction may include:
- Needing more of the substance or behavior to get the same effect
- Doing a behavior or using a substance longer or in higher amounts than planned
- Not being able to cut down, even when you want to
- An increase in negative consequences caused by the use or behavior (issues with self, family, friends, work, and/or legal problems)
- Others have suggested that you stop or cut down
- An increase in hiding or covering up the behavior or use
- An increase in feelings of guilt and shame
- Craving or having a strong desire or urge for the substance or behavior
- Withdrawing from important social, job-related, or recreational activities because of substance use
A Special Note on Alcohol
After surgery, the way the body tolerates alcohol changes for many reasons.
Change |
Reason |
Faster alcohol absorption | Your stomach is smaller and/or bypassed, so you will absorb alcohol much faster. |
Alcohol takes longer to process | For many reasons, alcohol may take longer to be processed by your liver and clear your system. |
No eating while drinking | Because the diet after surgery recommends that you do not eat and drink at the same time, alcohol will be absorbed faster because there is no food to slow it down in your digestive system. |
Chemical/hormonal changes from surgery | The chemical/hormonal changes that result from surgery can affect the way your body and brain process and respond to alcohol. |
Alcohol is not recommended after surgery. It’s important to get help if you’re struggling with any substance abuse before or after surgery. Learn more about resources to support your health at Kaiser Permanente.
There are many resources at Kaiser Permanente and elsewhere that can support you and help you get back on track. You are not alone.
Learn more about cross addiction and bariatric surgery:
Depression
How common is depression after surgery?
Most people who have surgery will not become clinically depressed. About one-third of patients do report some minor symptoms of depression, which we call “post-op blues” (like “baby blues” after giving birth). Post-op blues often happen in the first few weeks or months after surgery when you are still recovering and adjusting to a new way of life. You may ask yourself:
- Why did I do this?
- What was I thinking?
This is not depression, and it’s normal to feel this way. It usually goes away within a couple of months.
Depression can range from very mild to severe. It’s important to be able to recognize symptoms and ask for help if needed, both before and after surgery.
If post-op blues don’t go away or get worse, you may be having symptoms of underlying depression. If you have the following symptoms, it’s important to know that you can get support. Depression is very treatable.
Symptoms of depression:
- Sadness
- Loss of interest
- Changes in sleep
- Changes in appetite
- Social isolation
- Helplessness
- Hopelessness
- Worthlessness
- Irritability
- Low motivation
- Thoughts of suicide
- Difficulty concentrating
- Increased anger and/or frustration
If you are currently on depression medications, it’s also important to let your doctor know. Your doctor may need to adjust your medications after surgery depending on the dosage.
There are many resources at Kaiser Permanente and elsewhere that can support you and help you get back on track. You are not alone.
Disordered Eating and Eating Disorders
Having surgery does not address underlying contributors to disordered eating, which may continue to get in the way of your weight loss efforts after surgery. Therefore, it’s important to recognize symptoms of disordered eating or an eating disorder because it can have serious complications, especially when paired with surgery.
Learn more at about eating disorders at kp.org or nationaleatingdisorders.org
Recovery is possible, and help is available! Talking to a professional can help. There are many resources at Kaiser Permanente and elsewhere that can support you and help you get back on track. You are not alone.
Recognizing Relapse and Staying on Track
Things don’t always go as planned, and making a major lifestyle change is not always easy. It’s OK to slip up. Check out some quick tips for getting back on track below.
Do something that signals you’re back on track right away.
- Throw away a trigger food that you bought.
- Go for a 5-minute walk.
- Take a few deep breaths.
Anticipate tough situations.
Anticipate which part of the day is the hardest to get through without caving into a craving. Plan for how you will handle it.
Call someone from your support system.
Having a strong social support system is important. Think of someone who can be there for you in tough times.
Remind yourself of your “why.”
Keeping your focus on your “why” (what matters to you most in life) can help make obstacles easier to overcome.
Plan.
List your trigger situations and some plans for how you can cope with each one ahead of time.
Looking for More Support?
Explore more resources offered by Kaiser Permanente to help support your mental health and wellness, including support groups, workshops, coaching, self-care apps, and audio meditations.
Options Support Group:
Center for Healthy Living:
Mental Health and Wellness at Kaiser Permanente:
Self-Care Apps:
Audio Meditations: