Another day, another article in the press about bariatric surgery – the umbrella term for weight loss surgery. This prompted me to refer to the UK official NHS website for their latest guidelines on weight loss surgery: it made interesting reading. There is a lot of information about what the various surgical procedures are – gastric bypass, gastric band, sleeve gastrectomy – risks, results, “life after weight loss surgery” and so on. An NHS Psychological Assessment will determine whether: you have any mental health conditions or emotional problems that could prevent you sticking to your lifestyle plan after surgery you’ve developed unhealthy patterns of eating, such as binge eating, that could cause problems after surgery you have realistic expectations of what life will be like after surgery. Nowhere, as far as I could see from the NHS website, does it offer any advice or suggestions about addressing any of these issues prior to surgery. Under the heading “Psychosocial effects of (weight loss) surgery” , it states: “It’s also common for a person to experience a worsening of mood when their weight stabilises, typically two years after surgery. This is often because many people realise that problems that existed before surgery, such as money worries or difficulties at work, are still there.” I am not denying that bariatric surgery can, and has, helped a lot of people. But my point is that, without addressing the underlying emotional reasons / issues that cause someone to hold onto that excess weight in the first place, it is like putting a sticking plaster over a festering wound and expecting to wound to heal all by itself: it’s not going to happen. I have worked with lots of clients who have been holding onto varying amounts of excess weight. One of the these was a lovely lady who weighed around 23 stone when she came to see me. She had been through the full NHS programme leading up to bariatric surgery, and had done all that was asked of her. When the time came, she was refused surgery because she was still too obese. This is the classic Catch 22, isn’t it – someone needs surgery because they are obese, and yet because they are obese, they can’t have surgery due to the risk to their heart with the anaesthetic and stress to the system. I worked with this lady for a few months, as we peeled the layers off the emotional onion, getting closer and closer to the real person at the core. Many issues were dealt with along the way. She laughed, she cried, she¬†uncovered “stuff” that had been locked away for years and years. There is no magic wand here; she...