Psychological assessment and motivational interviewing of patients seeking bariatric and metabolic endoscopic therapies

Many individuals seeking bariatric surgery present with problematic eating behaviors, psychological factors or psychiatric co-morbidities that can adversely affect outcomes. The entire health care team can utilize Motivational Interviewing skills to enhance the patient's motivational level and confidence for having a healthy lifestyle. Therefore, the purpose of this review is to highlight 4 domains of functioning that are important to assess and evaluate: Eating Behaviors (binge eating disorder, food addiction, and night eating syndrome) Mood disorders (depression and anxiety), Addictive Behaviors (alcohol, cannabis, opioid, and behavioral), and motivational level for healthy eating and physical activity. This review is not meant to be all encompassing or a comprehensive review of the literature, as other psychological and psychiatric factors such as limited cognitive functioning, history of being the victim of abuse, positive aspects of being overweight, post-traumatic stress disorder, or lack of social support, are a few specific examples of other psychosocial domains that are also important to assess and evaluate in patients seeking to have weight loss surgery. Rather, these 4 domains were selected to highlight the importance of conducting a comprehensive psychiatric or psychological evaluation in patients seeking to have weight loss surgery and to provide ongoing mental health support and counseling for positive lifestyle changes.