Get the free Bariatric Screening Questionnaire - med navy

This document is a questionnaire for patients considering bariatric surgery, capturing personal, medical, and dietary history to facilitate assessment by healthcare providers.

How to fill out bariatric screening questionnaire

How to fill out Bariatric Screening Questionnaire

1. Begin by reading the introduction to understand the purpose of the questionnaire.
2. Fill out your personal information, including name, age, and contact details.
3. Answer the questions regarding your medical history, including previous weight loss attempts and related health issues.
4. Provide details about your current weight, height, and BMI (Body Mass Index).
5. Complete the sections regarding your eating habits and lifestyle, including physical activity levels.
6. Answer any psychological or behavioral questions related to your relationship with food.
7. Review your answers for accuracy before submitting.
8. Sign and date the questionnaire if required.

Who needs Bariatric Screening Questionnaire?

1. Individuals seeking weight loss surgery.
2. Patients who have a BMI over a certain threshold (often 30 or 35).
3. People who have been referred by a healthcare professional for obesity management.
4. Those experiencing obesity-related health conditions, such as diabetes or hypertension.
5. Individuals looking to understand their eligibility for bariatric programs.

People Also Ask about

Can you fail a psychological evaluation for bariatric surgery?

Here are 13 things you should never say to a therapist: Telling Lies & Half-Truths. Leaving Out Important Details. Testing Your Therapist. Apologizing for Feelings You Express in Therapy. “I Didn't Do My Homework” Detailing Every Minute Detail of Your Day. Just Stating the Facts. Asking Them What You Should Do.

What is the 20/20/20 rule after bariatric surgery?

You can use the '20:20:20 rule' to help you with this: 20 chews for each mouthful. 20 seconds between each mouthful. 20 minutes for the meal.

What questions does a psychiatrist ask for bariatric surgery?

The core parts of the clinical interview include reasons for seeking surgery, weight and diet history, current eating behaviors, understanding of the surgery and its associated lifestyle changes, social supports and history, and psychiatric symptoms (current and past).

What questions are asked during a psych evaluation?

In a Weight-Loss Surgery Psychological Evaluation, there's no passing or failing. The evaluation is a tool to determine if a patient is ready and suitable for weight-loss surgery and recovery. Its main aim is to improve the patient's results and identify potential challenges during their weight-loss journey.

What is the 30/30 rule for bariatric surgery?

Bariatric Surgery | OSF HealthCare. The “30-minute rule”: After surgery, you have a smaller stomach, so you should not drink any liquids for 30 minutes before a meal, during the meal, and for 30 minutes after a meal. Not drinking prevents you from feeling full too quickly before you've finished eating your protein.

What kind of questions do they ask for a bariatric psych evaluation?

This means the psychologist will ask many questions about you and your history, including: Current and past behaviors related to eating and exercise. Previous attempts to lose weight. Any mental health history. Childhood experiences, including any trauma. Current and past alcohol and drug use.

What disqualifies you for bariatric surgery?

You are under 18 years of age. You have an infection anywhere in your body or one that could contaminate the surgical area. You are on chronic, long-term steroid treatment. You cannot or do not want to follow the dietary rules that come with this procedure.

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What is Bariatric Screening Questionnaire?

The Bariatric Screening Questionnaire is a tool used to assess a patient's eligibility for weight loss surgery by evaluating their medical history, psychological state, and understanding of the procedure.

Who is required to file Bariatric Screening Questionnaire?

Individuals considering bariatric surgery, as well as their healthcare providers, are typically required to fill out the Bariatric Screening Questionnaire to ensure that all necessary health factors are considered before proceeding.

How to fill out Bariatric Screening Questionnaire?

To fill out the Bariatric Screening Questionnaire, patients should answer all questions honestly based on their medical history, lifestyle, and psychological readiness for surgery. It may be beneficial to consult with a healthcare provider for assistance.

What is the purpose of Bariatric Screening Questionnaire?

The purpose of the Bariatric Screening Questionnaire is to identify candidates who are suitable for weight loss surgery by gathering detailed information regarding their health status, medical conditions, and readiness for the surgery.

What information must be reported on Bariatric Screening Questionnaire?

Information required on the Bariatric Screening Questionnaire typically includes personal health history, previous weight loss attempts, current medications, psychological assessments, and any comorbid conditions related to obesity.