Choosing Bariatric Surgery for Weight Loss.

Weight loss transformations are everywhere, from celebrity makeovers on social media to a growing number of posts about new weight loss medications like GLP-1 drugs.

In spite of these recent trends, for many people, bariatric surgery remains a powerful and life-changing option for achieving lasting results.

What often surprises patients, however, is that before they can move forward with bariatric surgery, they’re required to complete a pre-op psychological assessment.

This step can sound intimidating at first. Some imagine it means digging deep into their past or sharing every personal challenge. In reality, the process is much simpler, and far less stressful, than most expect, but it is absolutely essential.

In this article, we’ll explain why the psychological assessment is such an important part of preparing for a bariatric surgery.

Why the Psychological Assessment is Important

One of the main reasons for a pre-op psychological assessment is to identify whether a patient may need extra emotional or behavioral support after surgery. Bariatric surgery isn’t just linked to weight loss. It is a major surgery that can impact multiple facets of a patient’s life, and it is crucial to recognize how it can affect individuals.

The Positive Psychological Effects of Bariatric Surgery

Research consistently shows that bariatric surgery is linked to many positive mental health outcomes. For instance, a 2025 meta-analysis of 79 studies found that individuals often experience improvements in symptoms of depression and anxiety following surgery (van Reekum et al., 2025). Similarly, another large-scale review found that many patients reported reduced depressive symptoms two years post-surgery (Law et al., 2023).

The Negative Risks Associated with Bariatric Surgery

However, both reviews also emphasized an important caveat: while many people feel better psychologically, a small but meaningful subset experience increased risks of suicide and substance use disorders after surgery (Law et al., 2023; van Reekum et al., 2025).

Further studies support these findings. For example, a 2023 analysis found that people who underwent bariatric surgery had a significantly higher rate of suicide attempts compared to those who did not (Hung et al., 2023). Likewise, a 2021 study reported that individuals who received bariatric surgery were twice as likely to engage in self-harm or suicide attempts compared to non-surgical groups (Konttinen et al., 2021).

Why this Matters.

These findings highlight why pre-op psychological assessments are so important. Bariatric surgery brings major physical, emotional, and social changes to a person’s life. A psychological evaluation helps ensure that patients are mentally prepared for those changes, have access to ongoing support, and can maintain both their physical and emotional well-being throughout recovery.

References

Hung, A., Maciejewski, M. L., Berkowitz, T. S. Z., Arterburn, D. E., Mitchell, J. E., Bradley, K. A., Kimbrel, N. A., & Smith, V. A. (2023). Bariatric Surgery and Suicide Risk in Patients With Obesity. Annals of surgery, 278(4), e760–e765. https://doi.org/10.1097/SLA.0000000000005825

Konttinen, H., Sjöholm, K., Jacobson, P., Svensson, P. A., Carlsson, L. M. S., & Peltonen, M. (2021). Prediction of suicide and nonfatal self-harm after bariatric surgery: A risk score based on sociodemographic factors, lifestyle behavior, and mental health: A nonrandomized controlled trial. Annals of surgery, 274(2), 339–345. https://doi.org/10.1097/SLA.0000000000003742

Law, S., Dong, S., Zhou, F., Zheng, D., Wang, C., & Dong, Z. (2023). Bariatric surgery and mental health outcomes: An umbrella review. Frontiers in Endocrinology, 14, 1283621. https://doi.org/10.3389/fendo.2023.1283621

van Reekum, E. A., Darcy, M., Drage, J., Xu, J., Ng, K., Forestell, B., Santesso, N., Joundi, R. A., Wong, J., Doumouras, A., Taylor, V. H., Yusuf, S., & Van Lieshout, R. (2025). Psychiatric and cognitive functioning after metabolic and bariatric surgery: A systematic review and meta-analysis. Obesity reviews: An Official Journal of the International Association for the Study of Obesity, 26(11), e13968. https://doi.org/10.1111/obr.13968