Behavioral Care Flashcards

A patient six months post-sleeve gastrectomy reports eating small amounts of food continuously throughout the day when stressed. Which maladaptive eating pattern does this describe?

Answer: Grazing

Grazing is the repeated consumption of small amounts of food over extended periods, a common post-surgical maladaptive pattern often triggered by emotion.

In motivational interviewing with a bariatric patient ambivalent about exercise, which counselor response best exemplifies reflective listening?

Answer: "It sounds like part of you wants to be more active, but you're worried about joint pain."

Reflective listening mirrors the patient's own ambivalence without judgment, a core motivational interviewing skill.

Which behavioral strategy involves a patient recording everything they eat, along with hunger levels and emotions, to identify eating triggers?

Answer: Self-monitoring

Self-monitoring through food and mood journals is a foundational behavioral technique for building awareness of eating triggers.

A bariatric counselor notices a post-operative patient has replaced compulsive eating with excessive alcohol use. This phenomenon is best described as:

Answer: Addiction transfer

Addiction transfer (cross-addiction) occurs when one compulsive behavior is substituted for another, and alcohol risk is elevated after bariatric surgery.

Which cognitive distortion is a patient displaying when they say, "I ate one cookie, so my whole diet is ruined and I might as well quit"?

Answer: All-or-nothing thinking

All-or-nothing (dichotomous) thinking frames a single lapse as total failure, a distortion strongly linked to diet abandonment.

According to the Transtheoretical Model, a patient who says "I plan to start preparing healthier meals within the next month and have bought a cookbook" is in which stage of change?

Answer: Preparation

The preparation stage involves intending to act within roughly 30 days and taking small concrete steps toward change.

Stimulus control as a weight-management technique would most directly involve which of the following?

Answer: Removing high-calorie snack foods from visible kitchen counters

Stimulus control modifies the environment to reduce cues that trigger unwanted eating behavior.

A patient reports consuming most of their daily calories after dinner and waking at night to eat. Which condition should the bariatric counselor screen for?

Answer: Night eating syndrome

Night eating syndrome is characterized by evening hyperphagia and nocturnal awakenings to eat, and it can undermine surgical outcomes.

Which screening instrument is most commonly used to identify binge eating behavior in bariatric surgery candidates?

Answer: Binge Eating Scale (BES)

The Binge Eating Scale is a validated self-report tool widely used in pre-surgical psychological evaluations to assess binge severity.

During a pre-surgical evaluation, a patient states they expect surgery to fix their marriage and depression. The counselor's best initial response is to:

Answer: Explore and gently correct unrealistic expectations about surgical outcomes

Unrealistic expectations predict post-operative dissatisfaction, so counselors should address them directly during evaluation.

A patient two years post-bypass has regained 15 pounds and avoids follow-up appointments out of shame. Which counseling approach is most appropriate?

Answer: Normalize the regain, reduce shame, and re-engage the patient in behavioral strategies

Shame drives avoidance, so a nonjudgmental, re-engagement approach is most effective for addressing post-surgical weight regain.

Which of the following best distinguishes emotional hunger from physical hunger when teaching patients hunger awareness?

Answer: Emotional hunger tends to come on suddenly and craves specific comfort foods

Emotional hunger is typically sudden, urgent, and specific to comfort foods, whereas physical hunger builds gradually and accepts a range of foods.

A counselor helps a patient plan for a holiday buffet by rehearsing portion choices and identifying an exit strategy for food pushers. This technique is known as:

Answer: Relapse prevention planning

Relapse prevention involves anticipating high-risk situations and rehearsing coping strategies in advance.

Which factor in a pre-surgical psychological evaluation is generally considered a contraindication requiring stabilization before bariatric surgery?

Answer: Active, untreated psychosis

Active untreated psychosis impairs informed consent and post-operative adherence, so stabilization is required before surgery.

A patient says, "I know I should stop drinking soda, but it's the only thing that gets me through my shift." In motivational interviewing terms, this statement contains:

Answer: Both change talk and sustain talk

The statement mixes change talk ("I should stop") with sustain talk ("it gets me through"), reflecting classic ambivalence.

Which post-operative behavior most strongly suggests a patient is "eating around" their surgery?

Answer: Drinking high-calorie milkshakes because solid food causes fullness

Consuming calorie-dense liquids bypasses the restrictive mechanism of surgery and is a classic form of eating around the pouch.

A bariatric counselor teaching mindful eating would most likely instruct a patient to:

Answer: Eat slowly without distractions, noticing taste, texture, and fullness cues

Mindful eating emphasizes slow, distraction-free eating with attention to sensory experience and satiety signals.

Body image dissatisfaction after massive weight loss is most commonly linked to which post-surgical issue?

Answer: Excess loose skin

Redundant skin after rapid weight loss frequently causes ongoing body image distress even when weight goals are met.

A patient describes vomiting intentionally after overeating "to protect the pouch." The counselor should recognize this as:

Answer: A compensatory behavior warranting eating disorder assessment

Intentional post-meal vomiting is a compensatory purging behavior that requires clinical eating disorder evaluation regardless of the stated rationale.

Which social factor is most predictive of better long-term behavioral adherence after bariatric surgery?

Answer: Consistent attendance at support groups and follow-up visits

Ongoing engagement with support groups and follow-up care is consistently associated with better weight maintenance and adherence.