Better Me

Your Mental Health is an Integral Part of the Bariatric Journey

Weight loss surgery, or bariatric surgery, is a transformative experience that goes beyond physical changes. 

While the surgical process plays a significant role in achieving weight loss goals, it is important to acknowledge the equal importance of your mental health throughout the process.

If you are considering bariatric surgery, it’s important to know the emotional changes you may face before and after. Working through them helps you throughout your bariatric journey.

James Evans, PsyD, a psychologist specializing in bariatric medicine with Banner – University Medicine, walks us through the positive and negative effects of bariatric surgery and how to navigate the process with confidence and resilience. 

What are common mental health concerns for people pursuing bariatric surgery?

Many people seeking bariatric surgery have struggled with long-term weight management and may have experienced many emotions, including shame, frustration and low self-esteem. 

Some people also struggle with untreated or undertreated mental health concerns, such as depression, anxiety, eating disorders and body dysmorphia

For these reasons, it’s very common for people pursuing surgery to experience psychological concerns. Establishing care with a licensed behavioral health specialist, such as a counselor or therapist, to address these concerns and receive support is recommended.

“If I identify a patient as exhibiting any of these risk factors, I want to make sure they are connected with the right supports in the community and within their support systems, so they are more likely to manage the changes that come with bariatric surgery,” Dr. Evans said. “When we treat their concerns concurrently with surgery, we can maximize the chances for success.”

What are common mental health concerns for people after bariatric surgery?

Bariatric surgery can also stir up many emotions and hormonal changes. You may even second-guess your decision. 

“No matter how much one prepares for this change, many people after surgery experience some amount of regret or ‘what have I done’ thought process,” Dr. Evans said. “This is a very normal experience, and we usually see this process lessen almost immediately. However, in a small minority, this thought process can increase, leading to feelings of guilt, shame, loss of self and fear about regaining weight.”

Other emotional changes you could experience include:

  • Grieving the loss of food 
  • Feeling sad or frustrated if your weight loss slows or stops for a time
  • Fearful that eating certain foods will cause you to gain weight
  • Feeling uncomfortable with compliments from others

Behavioral health specialists still play an important role after surgery. They can help support you and provide tools for long-term success and well-being.

Tips for navigating the bariatric journey

1. Build a supportive network

“Support is the number one coping skill someone can utilize post-bariatric surgery,” Dr. Evans said. “Support can look like many things, including your family, loved ones, co-workers, other bariatric patients, mental health experts like therapists/counselors and health care providers.”

Their encouragement and understanding can provide invaluable emotional support during both the pre-and post-operative phases. The importance of not feeling alone in the process is vital to success.

2. Seek professional guidance

Consider working with behavioral health specialists, such as therapists or counselors specializing in bariatric care. They can help you explore and manage the emotional challenges that may arise, develop coping strategies and support your overall well-being.

3. Set realistic expectations

Understand that bariatric surgery is not a quick fix but a tool that assists in weight loss. 

“If you are coming into surgery to primarily lose weight to be thin because you feel this will make you happy, then you are at a higher likelihood of developing depression post-surgery,” Dr. Evans said.

Realistic expectations and patience are key. Remember, everyone's journey is unique, and progress may vary from person to person.

4. Appreciate your body

Be kind and patient with yourself throughout the process. 

“Appreciating your body for what it can do in the here and now is essential for increasing body acceptance and overall self-esteem,” Dr. Evans said. “When you tell yourself you will appreciate your body when … this just sets up for never accepting it.”

5. Embrace lifestyle changes

Bariatric surgery is a catalyst for significant lifestyle modifications. Embrace these changes as opportunities for personal growth and improved health. 

Establish healthy eating habits, incorporate regular exercise into your routine and prioritize self-care to foster long-term success.

6. Practice mindful eating

Develop a mindful approach to eating by paying attention to physical hunger and fullness cues. Focus on savoring each bite, chewing slowly and enjoying the flavors and textures of your food. 

“Notice how certain foods make you feel,” Dr. Evans said. “If they don’t make you feel good, you will have negative thoughts about your body. If you feel better when you eat more healthfully, notice that you are giving your body the experience it wants.”

This practice can promote a healthier relationship with food and prevent overeating.

7. Address emotional eating

Emotional eating can pose challenges during the bariatric journey. Develop alternative coping mechanisms or distracting skills. 

“Instead of snacking or eating something that is not on the plan, I encourage patients to work on an activity that utilizes both their hands and their eyes,” Dr. Evans said. “This could be a puzzle, journaling, deep breathing exercises, mindful walking, cleaning or knitting.”

8. Celebrate non-scale victories

Shift your focus from solely relying on the scale to measure progress. Celebrate non-scale victories, such as improved energy levels, increased mobility, reduced medication usage or improved self-confidence. These achievements are equally significant indicators of your overall well-being and long-term success.

9. Find a movement or exercise routine

Regular exercise not only aids in weight loss but also supports your mental health. “The more you take care of your body, the more likely you will become more accepting of it and grow in self-esteem,” Dr. Evans said. 

Find activities you enjoy, such as walking, swimming, yoga or dancing. Exercise releases endorphins, reduces stress and boosts mood and self-esteem.

10. Practice self-reflection

Take time to reflect on your journey and acknowledge your personal growth. Journaling can be a valuable tool for self-reflection, helping you identify patterns, triggers and areas of improvement. Celebrate your successes and embrace the continuous journey of self-discovery.


Bariatric surgery is not solely about the procedure itself. It is a lifelong commitment to health and well-being. 

Your bariatric journey is an opportunity for profound transformation, both physically and mentally. By prioritizing your mental health and implementing these tips, you can navigate the challenges and triumphs with resilience and confidence. 

To find a Banner Health specialist near you, visit

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