Should people with a mental illness have gastric sleeve?

[kinipela24]

Hi,
I am 32 years old from Los Angeles. I am seriously considering having the gastric sleeve done (hopefully this summer in June). I am very nervous. There are so many unknowns because everyone is different. I have been reading the posts, watching a lot of youtube videos and have spoken to the one person I know who has had it. She was in her 60's when she had it and there was minimal pain for her and no complications. I am considering having it in Mexico (please don't judge). I have already been talking with the coordinator for Dr. Corvala who is among the top 10 surgeons in the world for bariatric surgery. I have an HMO and if I were approved it may take a year and I would not get to choose my surgeon; it would be limited. I see a therapist once a week, have a psychiatrist, and am currently on medication to stabilize my moods. I am fully functioning with a stable career. I have also called my insurance company to make sure I wont be denied if complications arise.

I have bipolar type II but have only had one manic episode that I know of and I mostly deal with the depression side of it and some anxiety. I have searched for information about people with bipolar disorder and having this procedure. There is not a lot out there. I am 5'5 and almost 300 lbs and prediabetic. I am tired of being an obese person but I am also scared of the mental and emotional impact the surgery may have and issues with malabsorption of the medication and weight gain etc. My two options are stay like this and possibly gain more weight or have the surgery. I have lost over 70 lbs twice in my life "naturally" only to gain it back. I have never been this big but I also don't want to end up an emotional mess. I was so excited about the surgery but now I am down. Please any advice words of wisdom and/or support would be truly appreciated. This is the first time I ever posted in a forum. Thank you for reading and sorry for the length. It was cathartic to get that out.

[Christie13]

Honestly I would seek advice from your surgeon, psychiatrist, and therapist for these answers. There may be people on here who know but it is such an important issue I would definitely be seeking answers from the professionals. I hope you get your answers and can safely be sleeved. Good luck Jennifer.

[kinipela24]

Thank you Christie13. I 100% agree with you. I guess I was wondering if there were other people who suffered from a mental illness and have had the surgery could weight in with their experiences but for some reason they are hard to find. Thanks again for your input

[Sandra3]

Hi Jennifer!

Welcome to the forum.
I think with your weight and health issues, you could be approved for the sleeve and find it really helpful for long term weight loss.
When you reach the point of being morbidly obese, like I was too for 20 years, diets don't work. It's my experience but also all data I could find about diet confirm it.

But I think that since you are followed by a psychiatrist you should ask him/her advice too.
Mexico is not the issue here, I did think about it too, there's good doctors who have experience. Many people in here have been to Mexico.
The issue is mental issues and the sleeve.
During my approval process I had to meet with the psychiatrist twice. He told me that getting the sleeve could trigger depression episodes for some people and that for depressed patients (already sick before bariatric surgery) there's a higher rate of suicide.
A study came out last year about it (I think it was Canadian). I don't have depression issues myself (but I have so many other health issues..) but the psychiatrist made me promise to come back to him in case I was not feeling good post-op, if I had dark thoughts. He also said that for people who have food addiction, sometimes they replace it post-op with alcohol. So there's several cases where they have to be extra careful with patients dealing with depression pre-op.
I never felt depressed, even if the first month was not easy physically, my head was fine. But I can understand how it could be difficult when already having chemical unbalanced in the brain. Because I was extremely tired at some point, dealing with dehydration several times. I guessed for a depressed sleever it could make things worth.
About malabsorbtion, I do have issues with my vitamin level, but I also had IBS pre-op. My other medications (asthma, PPI ) worked fine. But again we are all different.

So after it's hard to know if you were depressed before being obese, or you become obese and then got depressed. But my two cents would be to make sure to have your psychiatrist's approval before starting the process even if you do it in Mexico. Because of course in Mexico you will be able to get the surgery without all the paper work, six months controlled diet etc...and pick your surgeon (big plus here) but you will need support when you come back home.

Making the final decision to get the surgery took me a very long time too. I also had doubts like everyone. Take your time, there's no rush. But the most important is to make sure that if you decide to go for the surgery you will have support.
Losing weight, that much weight in such a short time is challenging for most people. Having a new body, getting more attention, finding a "new space" in life. There's many sides to it. The fact that you question your decision is a good indication that you are on the right path.

Good luck and take care.

[ACE]

I was diagnosed after my sleeve with conversion disorder they believe it was due to the fact that i used to stress eat but after sleeve cannot do that so now i convert my stress into physical symptoms. Its a form of PTSD and is considered mental illness but I feel the sleeve has contributed in the best way to my life because now i feel like a person not a blob that cant move. I am healthy now and active I have a life where i used to sit and do nothing because just the effort of getting up was so much work i was winded. Mental illness is a part of why many of us get to the extreme weight we get to to need the sleeve so its all a matter of what will make you happy and healthy in the end. if you truly believe you need to get healthy for your body and your own happiness then do it. if you think it wont work then it probably wont help and therapy is still a huge part of the process no matter if you choose to do it or not. Almost all doctors have you get a psych eval to see if you are going to be able to handle the changes in your life after sleeve but they dont address the issues that are the underlying thing contributing to the weight gain and inability to lose it any other way that is something you have to seek therapy for after surgery to get it to change. I do EMDR therapy and it is great for me.

[kinipela24]

Wow what a great place I found. Thank you so much for the kind, informative and well thought out reply. I have an appointment with my psychiatrist March 13th and I will write down all my questions. My surgery in Mexico is approved but pending on a letter from my psychiatrist thinking it is a good thing for me. I'm single and I want to be healthy and start my life again. I hope this works. My friend said she would come with me to Mexico and even spend the night in the hospital.

[Tamera2]

I just wanted to Welcome you, I safely had surgery in Mexico, hopefully you can work with your doctors in the states that help you with your medical things and then bring the surgeon you choose into the loop and form a plan that will hopefully allow you to have the life changing surgery. I was considered high risk so I worked with my specialist and my surgeon worked with my doctor to figure out how to treat my medical stuff. I wish you all the best and hope everything can come together for you. Good Luck Jennifer

[Shirl]

Hi,
I am 32 years old from Los Angeles. I am seriously considering having the gastric sleeve done (hopefully this summer in June). I am very nervous. There are so many unknowns because everyone is different. I have been reading the posts, watching a lot of youtube videos and have spoken to the one person I know who has had it. She was in her 60's when she had it and there was minimal pain for her and no complications. I am considering having it in Mexico (please don't judge). I have already been talking with the coordinator for Dr. Corvala who is among the top 10 surgeons in the world for bariatric surgery. I have an HMO and if I were approved it may take a year and I would not get to choose my surgeon; it would be limited. I see a therapist once a week, have a psychiatrist, and am currently on medication to stabilize my moods. I am fully functioning with a stable career. I have also called my insurance company to make sure I wont be denied if complications arise.

I have bipolar type II but have only had one manic episode that I know of and I mostly deal with the depression side of it and some anxiety. I have searched for information about people with bipolar disorder and having this procedure. There is not a lot out there. I am 5'5 and almost 300 lbs and prediabetic. I am tired of being an obese person but I am also scared of the mental and emotional impact the surgery may have and issues with malabsorption of the medication and weight gain etc. My two options are stay like this and possibly gain more weight or have the surgery. I have lost over 70 lbs twice in my life "naturally" only to gain it back. I have never been this big but I also don't want to end up an emotional mess. I was so excited about the surgery but now I am down. Please any advice words of wisdom and/or support would be truly appreciated. This is the first time I ever posted in a forum. Thank you for reading and sorry for the length. It was cathartic to get that out.

Hi Jennifer, and welcome to the forum.

I cannot offer much on the insurance side of the conversation, or on taking meds for your psych condition, but I came across this study that you might find helpful and share with your psychiatrist if you decide to go through with gastric sleeve surgery. Depending on the meds you take or anyone for that matter, on whether they are dissolved (absorbed?) through stomach acid (which we sleeved folks have little of) or alkalized through the intestines (which would be no problem for us sleeved folks) should be discussed with prescribing physicians.

I just had a root canal redone and the pain meds, which are pretty gnarly according to my son, were not doing anything for me. I was having better luck with Tylenol extra strength because they are rapid release gels, but I am taking one 500mg like one to two hours. The last two nights I have woken up with severe pain. My oral surgeon said pain would last for about a week to ten days. After reading the article, it made sense why the narco wasn't working. I decided to dissolve in a bit of water before taking one tonight, and it seems to be kicking in.

Here is the article for your consideration:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026560/

[Luna354]

My only suggestion would be to talk to your psychiatrist. Are there liquid versions of your meds that are an option? I wasn't allowed to take pills for 1 month post op.

Good luck & welcome to the forum. There's so much good helpful information here.

[Sandra3]

Here is the article for your consideration:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026560/

Thanks for the article Shirl!

Those tooth pains are the worth! Hopefully you'll see the end of it soon!
For acetominophen I usually take 1gr 4X per day max. If I don't take 1gr it just doesn't help at all. My cousin (pharmacist) also told me that being over 50kg I needed a higher dosage or it wouldn't work...

[got2get]

Hi Jennifer,

I too have Bipolar Mood Disorder. I have mostly depressive episodes and the occasional hypo-manic phase. I am 51 and had my surgery in July 2015. I was worried about becoming more depressed afterwards and kept in close contact with my psychiatrist. I experienced extreme pain the first 30 days and could barely move due to a special stitching procedure my doctor used at Johns Hopkins. Once the pain subsided then the depression started. I REALLY missed food and being able to eat. This was a very difficult time for me and lasted about 3 months before I got used to not being able to eat when I felt depressed.

Then just after my 6 month post-surgery mark the weight loss completely stopped. I had lost 50 pounds exactly. The good news is that I have kept the weight off and not bounced back up. I no longer take meds for diabetes. No manic or depressive episodes have occurred. But the bad news is that my Lupus and Fibromyalgia have kicked into high gear and I am in daily pain from them.

Bottom line is that I am glad I had the surgery. Glad that I lost the 50 pounds. Glad that I have a "built-in" mechanism for keeping my meals small. But I am sad that I cannot lose any more weight without resorting to a Gastric Bypass surgery which I refuse to even consider. I think if you keep in touch with your psychiatrist closely during the first 6 months and maybe even talk to your counselor during that same time, I think you'll do great. I don't want to discourage you but I did want you to hear the truth that the surgery doesn't always work the way it should. I was supposed to lose at least 100 lbs that first year! But so many people have much better results than I did...I wish you good luck!! Please feel free to message me if you would like to talk more!!

[Xxjanexx]

Hi jennifer
I have bi-polar and it was my psyc doctor that suggested i had the sleeve done! As my meds made me starving hungry all the time,yes tried different meds but TBH they didnt make much different...it was a bit of catch 22 i needed my meds but i was super obese. The hospital where i had my sleeve done was fantasic they did every test possible to make sure it would be safe for me to have the sleeve.
The only thing my bariatric nurse was concerned about was when id get very low and the i dont care stage how would i manage my food intake as you no the low could last from a few days to a few months...i can honestly say in 3 years ive only hit rock bottom once all i wanted was chocolate and put on 2pound in the 3 wks i was in the black hole....now im almost out off it im back on it and dont want chocolate at all!!
Here in the uk they would not consider even doing the op unless your classed as super obese.
I would talk to your consultant who manages your bi polar to get a bit of feedback from them....yes i do still get hungry but as i cant get much in and making healthier choices i dont have a problem

[Christie13]

I love our group and how honest and open everyone is! You guys are all so amazing!

[kinipela24]

Thank you all so much! I appreciate it more than you know. Well I will be honest, my psychologist (not psychiatrist) doesn't think I am ready. I have an apointment to see my psychiatrist (he is the one that I would need the approval from). He doesn't know anything yet. My best friend is a therapist and knows me very well and thinks that I can handle it. I just wish my therapist was on board. She said if I can show that I can be conscience and eat healthy and exercise beforehand. She might feel differently. I'm nearly 300 lbs...I don't see any other choice but to do the surgery. I want to change my life. I don't want my bipolar episodes to get in the way of that. Sorry if I am whining. Again, your replies mean the world!

[kinipela24]

Hi jennifer
I have bi-polar and it was my psyc doctor that suggested i had the sleeve done! As my meds made me starving hungry all the time,yes tried different meds but TBH they didnt make much different...it was a bit of catch 22 i needed my meds but i was super obese. The hospital where i had my sleeve done was fantasic they did every test possible to make sure it would be safe for me to have the sleeve.
The only thing my bariatric nurse was concerned about was when id get very low and the i dont care stage how would i manage my food intake as you no the low could last from a few days to a few months...i can honestly say in 3 years ive only hit rock bottom once all i wanted was chocolate and put on 2pound in the 3 wks i was in the black hole....now im almost out off it im back on it and dont want chocolate at all!!
Here in the uk they would not consider even doing the op unless your classed as super obese.
I would talk to your consultant who manages your bi polar to get a bit of feedback from them....yes i do still get hungry but as i cant get much in and making healthier choices i dont have a problem

It is so nice to hear that overall it was a vey positive experience for you. I am also a very emotional person and I have a low tolerance for pain. I need to grow up! Again, I am glad you made the best decision for you and it has clearly paid off. Congratulations!