Question:
WHY DO I NEED A LETTER FROM A PSYCH?

I TAKE ZOLOFT FOR DEPRESSION, AND I WAS TOLD I NEEDED A LETTER FROM A PSYCH. BEFORE GETTING APPROVED. BUT I HAVE'NT SEEN A SHRINK IN 4 YEARS SO WHY DO I NEED A LETTER?    — DEBBIE C. (posted on July 31, 2006)


July 31, 2006
For starters, almost every insurance company requires some type of psych eval. I was already being treated by my pysch, so a letter sufficed. Others have actually had to go through tests and such. This is because WLS is a major emotional journey and not everyone should be approved for it, no offense. Shrinks need to make sure you're fully aware of what you're getting yourself into. Since you have depression, you're already at a higher risk for having emotional issues after surgery. You need to be aware of this and prepare yourself. If you don't see a shrink now, where are you getting your meds from? Whoever it is, keep in touch with them because as you lose weight your hormones are going to go haywire and your dosing may need tweaking. Plus, some doctors don't like patients to take pills for awhile; they prefer liquid. I did fine with pills 2 days post-op. Anyway, the psych eval is very important. And I guess they figure if you haven't seen a shrink in 4 years, then why are you still being treated medically? It's because you still have depression and that's a key factor in WLS. Good luck to you.
   — platypus

July 31, 2006
I agree with Sarah, it is part of the process to have a phyc eval prior to wls. They need to know if you are ready for the changes your body is going to go through & does not mean you won't get approved. It is just part of the process.
   — Marilyn C.

July 31, 2006
Sarah is correct and I was wondering the same thing -- where are you getting your scripts for Zoloft if you are being treated for depression and I'll also add --are you seeing a therapist for your depression along with taking the Zoloft. The Psych eval is mandatory by many if not all insurance companies. I go for mine this coming Monday.
   — the7thdean

July 31, 2006
WLS is a major change to your life style FOREVER. Some people, especially those that already suffer from depression are not able to handle. The way it was explained to me was, "Your love affair with food is about to end and it will never be the same", it is a lot to handle. I thought I was completely prepared for the change, but there are days where it is quite difficult to deal. The after effects of the surgery are a lot to deal with, you have no idea what it is like till it has happened. No book or support group can 100% completely prepare you for the "Change" so they want to make sure you can handle it. I just read a study that shows a large percentage of WLS patients are becoming alcoholics. They are replacing the food with liquor. Before my surgery I rarely ever ate chocolate, now I crave it all the time. I had a VBG, so I have more trouble with solid foods, but I can eat chocolate because with a vbg, you can do sugar from day 1. With a RNY it takes time to be able to handle sugar. So I have replaced the solids I can not eat with chocolate. I am actually seeing a eating disorder therapist that specializes in WLS patients to help prevent weight gain. I passed my psych exam with flying colors and I still have some difficulty. Now do you understand why you need to see a psych doctor?
   — WMKaisla

August 1, 2006
I am 9 days away from surgery and even tho I have been a very grounded and common sense person things have been crazy. I am saying good bye to the foods I loved that also made me be what I am now...0bese!!!! I am ready for my surgery in many ways but at the same time my insides are flip flopping like wild. This process is a not a normal surgery. This is the rest of life you HAVE to change surgery. This surgery is the road to a new healthier you but you need to be able to handle all the changes before and after your surgery. I had a fantastic Psycologist that left the door to ask questions further down the line and he has been a Godsend. Peace and Blessings on the future for you.
   — jstplainwyrd1956

August 1, 2006
Hiya.</p><p>I also take meds for depression, however I am in touch with my psychiatrist. It was simply a matter of asking him to write a letter for me to the surgeon stating how long we have been working together (5 years) and also that in his professional opinion, I am psychiatrically stable enough to go through surgery. He wrote it during a regularly scheduled visit and wrote it by hand on his practice's letter head. I gave it to my surgeon and also asked for a copy for my own records.</p><p>I also work with a counselor and we will be working through some of the issues that may arise from going through this surgery. I feel that it is very important for you to be able to have someone to talk with as you go through the changes that this procedure produces. There are not only physical changes, but definitely emotional ones as well. There may be a chance that your depression will worsen after the surgery and you can no longer eat the way you are used to. Please find yourself a psychiatrist or a counselor who is willing to see you and help you work through any issues that may arise. I wish you the best of luck and success!</p><p>Winnie
   — utendn

August 1, 2006
I had to do that, too. It is a normal requirement, to make sure you can handle the surgery and understand that it is not a cure and weight loss still will require effort. You just have to go.
   — Novashannon

August 1, 2006
I recently spoke to a woman who admitted she failed her initial psych review and was required to have therapy for 6 months, and then pass another evaluation, before she could get approved. She would probably be the first one to admit that had it not been for that additional counseling, she might not have succeeded in her wls journey at all (I think she said she's over a year out now and doing great), so, as others have said, it's not only a requirement for most insurances, but it's just a darn good idea. As to those who question how you are still taking Zoloft without actively being seen by a Dr, I think it may not be all that uncommon... I was able to keep refilling a prescription I had for Zoloft for a good year and 1/2 to 2 years or so without being "seen". I suspect that since there are physical repercussions when your body is used to taking Zoloft (you can't just cut someone off of a medication like that) it has to be done very gradually, so that might make it an easier pill to get refilled. I finally made my own decision to get off it (I am NOT suggesting anyone else should do that) But... not only did nobody "notice" the two years I was getting the prescription refilled w/out any corresponding office visits, but also nobody noticed when I stopped getting refills and reporting during my office visits that I was takign it (while I was taking it, I always said so). I'm thinking it had something to do with mega-sized HMOs that provide you with a different over-worked Dr for each visit... Anyway, after all that - my point is that I easily understand how you could still be getting your prescription refilled and I think it's just a lot easier to "slip through the cracks" than most people realize...
   — [Deactivated Member]

August 3, 2006
i also take zoloft and have to see someone every 3 months in order to keep taking it and when i started the process of wls i had been seeing someone and they wrote a letter , hence i didn't have to have an evaluation so i would definately talk to the doc that prescribed it for you to get it taken care of. Best of luck to you Darlene
   — babyblues62

August 3, 2006
i also take zoloft and have to see someone every 3 months in order to keep taking it and when i started the process of wls i had been seeing someone and they wrote a letter , hence i didn't have to have an evaluation so i would definately talk to the doc that prescribed it for you to get it taken care of. Best of luck to you Darlene
   — babyblues62




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