Bariatric Psychology/Obesity Medicine
Weight loss surgery is a life-changing procedure that requires careful thought, considerable awareness, and adjustment. Changes occur emotionally, socially and physically. Weight loss surgery is only a tool. In order to have a successful long-term outcome, it is necessary to make a number of permanent lifestyle changes. You will need to permanently change your behaviors, eating habits and activity patterns. National bariatric surgery guidelines recommend, and thus all Wellstar Bariatric Surgery Candidates receive, a pre-surgical psychological evaluation because many habits, behaviors, thoughts and emotions can affect the success of weight loss surgery.
The pre-surgical psychological evaluation consists of a visit to a clinical health psychologist with specialization in bariatrics and includes a diagnostic interview, a battery of tests, and feedback. These evaluations assess various elements related to surgical readiness as shown by research correlated with post-surgical complications and outcomes. The health psychologist will make individualized recommendations to build upon your strengths and help you address challenges so that you can best lose weight, keep it off, and adjust well to your new lifestyle.
In addition to the pre-surgical psychological evaluation, a bariatric psychologist can work with you both before and after surgery – either individually or in a group setting to change behavioral, emotional or psychological patterns that could interfere with a good surgical outcome. For example, many patients need help from a psychologist to change eating behaviors prior to surgery. Behavioral health can also provide additional support, stress management skills, assertiveness building, emotion management (e.g., anger or depression), assistance with quitting tobacco/nicotine use, behavioral treatment of insomnia and pain, and strategies for reducing anxiety or fears associated with having the surgery. After the surgery, many individuals are helped from behavioral health follow-up to improve psychological and social adjustment to the new lifestyle.
Conditions and presentations treated in the Bariatric/Obesity Medicine Service include:
• Obesity
Cardiovascular Behavioral Medicine
When you are diagnosed with cardiac health issues, taking your medications, keeping regular appointments, and getting needed labs and tests are essential to staying well. Learning to make choices that can help you to improve or to prevent worsening of your cardiac risk factors is also important.
Cardiovascular Behavioral Medicine is a branch of behavioral medicine that helps patients with cardiovascular disease to achieve their cardiac health goals through behavioral modification, address co-occurring cardiovascular and psychiatric conditions, and chiefly, to experience improved quality of life.
Sometimes low mood, panicked or overwhelming emotions, difficulties with problem-solving or memory, frustration with making change, and chronic fatigue get in the way of our progress. The clinicians on the Cardiovascular Behavioral Medicine (CVBM) team are experts in overcoming these kinds of barriers. When a patient has made a good effort at change and is still struggling to achieve health goal success, a referral
to the CVBM outpatient service can help make possible necessary change. The CVBM team uses scientifically supported approaches to help:
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Improve mood
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Decrease anxiety and its effects on cardiovascular functioning
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Identify and overcome hurdles to making healthy lifestyle changes to reduce cardiovascular risks
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Improve sleep quality
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Lose weight and maintain weight loss when diet and exercise alone don’t seem to help
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Keep track of medications and be at your outpatient appointments
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Adjusting to a "new normal" after a cardiac event
In addition to outpatient services, the CVBM team works with Wellstar’s Advanced Heart Failure team to provide evaluation services for patients with congestive heart failure and those who are candidates for an LVAD device. The CVBM team is a part of this important inter-disciplinary team that helps these patients receive life-extending treatments.
Conditions and presentations treated in the Cardiovascular Behavioral Medicine Service might include:
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Arrhythmia
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Cardiomyopathy
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Congenital heart defects
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Congestive heart failure
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Coronary artery disease
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Hypertension
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Myocardial infarction
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Postural Orthostatic Tachycardia Syndrome (POTS)
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Valve disease
Psychogastroenterology
The Psychogastroenterology Service, a specialized behavioral health service for gastrointestinal (GI) disorders, works collaboratively with WellStar physicians and their patients to support the psychosocial needs of our patients with GI conditions. Research has established that brain-gut dysregulation contributes to many gastrointestinal disorders such as Irritable Bowel Syndrome, Inflammatory Bowel Disease, and even Dysphagia. In addition to infection and other organic factors, normal brain-gut communication is highly vulnerable to chronic stress and maladaptive coping behaviors. When intense or prolonged stress and ineffective behaviors interrupt normal brain-gut communication, patients tend to notice more frequent symptom flares and their emotional well-being and quality of life suffer. Fortunately, the brain can learn to turn down pain and reduce sensitivity to normal gut-processes. Our program offers interventions specifically designed to target psychological and behavioral factors that interrupt brain-gut pathways and lead to worsening GI symptoms or maintain them.
Conditions and presentations treated in the Psychogastroenterology Service might include:
- Irritable Bowel Syndrome (IBS)
- Inflammatory Bowel Diseases (IBD)
- Chronic Constipation
- Non-cardiac chest pain
- Pre- or post-surgical adjustment to ostomies
- Functional dyspepsia
- Dysphagia
- Globus
- Functional diarrhea
Treatment is provided by a clinical health psychologist with specialized training in working with GI conditions; treatment is short-term—usually delivered over 8-10 visits--and focuses on coping skills to improve the management of the GI condition. Several brain-gut therapies are effective for patients with functional GI issues. Cognitive-Behavioral Therapy is a short-term, evidence-based treatment approach that has been customized to help individuals living with chronic GI conditions. It is particularly effective in patients who are preoccupied with their symptoms, have significant symptom-related anxiety, or engage in rigid/avoidant behaviors to control their symptoms. Mindfulness-based stress reduction or gut-directed relaxation interventions are also incorporated to target the stress-sensitive nature of the GI tract and normalize motility.
Psychosocial Oncology
A diagnosis of cancer is a difficult emotional experience for most people. The diagnosis itself is made even more stressful by the often harsh and invasive treatments to treat the disease. Emotional challenges experienced by cancer patients range from normal worry and distress to more serious conditions like depression and anxiety disorders. The physical impact of cancer treatments also range from temporary symptoms like poor sleep and fatigue during treatment to longer-term symptoms like neuropathy. Most patients experience at least some of these symptoms along the course of their treatment and as they transition into survivorship.
WellStar Cancer Network offers a variety of options for managing symptoms that can be tailored to each patient’s needs regardless of where they are in their treatment. These treatments have been shown to help manage the stress of an already challenging experience and improve the emotional and physical health of patients.
Our behavioral health team includes a clinical health psychologist and psychiatrist that work closely with you and your medical team to care for your emotional health and quality of life. Our health psychologist works with individuals, couples, and families to address common issues faced both during and after cancer treatment, including adjustment to diagnosis, anxiety and depression, insomnia, pain management, coping with side effects, stress management, caregiver stress, and improving health behaviors to prevent cancer recurrence. Our psychiatrist provides diagnostic services and medication options for patients experiencing depression, anxiety, or other changes in mental health that may impact quality of life.
Cancers treated in the Psychosocial Oncology Service include, but are not limited to:
- Bladder
- Breast
- Colorectal
- Endometrial
- Head & neck
- Kidney
- Leukemia
- Liver & intrahepatic
- Lung & bronchus
- Melanoma
- Non-hodgkin
- Pancreatic
- Prostate
- Thyroid