What we are talking about
Obesity is a chronic, multifactorial condition. Psychological care addresses the behavioural, emotional and relational dimensions that influence eating, physical activity and adherence to the plan defined by the health team.
In bariatric surgery, psychological support is usually part of the pathway, both before and after the procedure.
Specific experience
Osvaldo Santos was part of a multidisciplinary bariatric surgery team at Hospital da Cruz Vermelha Portuguesa, with consolidated experience in the psychological care of severe obesity.
How it can show up
- · Episodes of loss of control over eating.
- · Eating in response to emotional states.
- · Repeated cycles of restriction and weight regain.
- · Intense self-criticism and body shame.
- · Difficulty sustaining behaviour change over time.
- · Impact on social, professional and relational life.
How assessment is carried out
Through clinical interview on weight history, eating patterns, physical activity, sleep, emotional functioning and life context. In the pre-surgical context, assessment usually includes expectations about surgery, understanding of the required changes, and identification of factors that may hinder post-operative adaptation.
What intervention may involve
- · Psychological preparation for surgery and the changes it requires.
- · Work on emotional eating and loss-of-control episodes.
- · Sustainable behaviour-change strategies.
- · Intervention on body image and self-criticism.
- · Support during post-operative adaptation.
- · Coordination with the medical, surgical and nutritional team.
What to expect from a first session
The first session is mainly about understanding the current situation: what brought you here, for how long, and how it is interfering with daily life. It is also a space to gather relevant history and context, clarify needs and expectations, and make an initial assessment of whether psychotherapy is a suitable response.
Next steps are defined together at the end. If psychotherapy is not the most appropriate answer, that is said clearly and alternatives are suggested.