CBC Managing Post-Operative Adjustments Questions and Answers

Question 1

A patient, 9 months post-RYGB, reports that her spouse frequently brings home her old favorite high-calorie foods and encourages her to "just have a little." This is causing significant marital stress and making adherence difficult. What is the most likely underlying dynamic the counselor should explore with the patient?

Accepted Answer

The spouse may be expressing love in a way that is no longer compatible with the patient's new lifestyle.

Answer

Significant lifestyle changes after bariatric surgery can disrupt relationship dynamics. A partner's established behaviors, such as showing affection with food, may no longer be helpful or appropriate. This is not always intentional sabotage but rather a failure to adapt to new relationship patterns, which can undermine the patient's efforts.

Question 2

A patient who is one year post-op mentions they have started drinking a few glasses of wine every night to unwind, a significant increase from their pre-surgery habits. Which phenomenon should the counselor be most concerned about?

Accepted Answer

Addiction transfer

Answer

Addiction transfer, also called cross-addiction, is a known risk after bariatric surgery where a person replaces the compulsive behavior of overeating with another compulsive behavior, such as alcohol use, shopping, or gambling. This is particularly dangerous with alcohol due to altered metabolism post-surgery.

Question 3

Which of the following is the most common body image concern expressed by patients 12-18 months after bariatric surgery, even after achieving significant weight loss?

Accepted Answer

Distress and dissatisfaction with excess or redundant skin.

Answer

After massive weight loss, excess or redundant skin is an extremely common physical and psychological issue. It can negatively impact body image, cause physical discomfort, and act as a persistent reminder of the patient's former size, preventing them from fully appreciating their new body.

Question 4

A patient, 14 months post-sleeve gastrectomy, is distraught because their weight loss has completely stalled for two months. They state, "It was so easy at first, I thought this would be a magic fix. Now it's just hard." What is the best initial approach for the counselor?

Accepted Answer

Normalize the experience as the end of the "honeymoon phase" and explore their feelings of disappointment.

Answer

The first year post-surgery is often called the "honeymoon phase" due to rapid, seemingly effortless weight loss. When this inevitably slows or stops, patients can feel disillusioned. A counselor's primary role is to first validate and normalize this emotional experience, helping the patient reframe expectations for the long-term maintenance phase.

Question 5

When counseling a post-operative bariatric patient on how to manage social events centered around food, such as holiday dinners or restaurant outings, what is a key proactive strategy to recommend?

Accepted Answer

Eat a small, protein-rich meal or snack before the event.

Answer

Arriving at a food-centric event extremely hungry makes it difficult to adhere to post-operative dietary guidelines. Eating a small, protein-dense meal or snack beforehand is a proactive behavioral strategy that reduces hunger, allowing the patient to make more mindful choices and focus on the social aspects of the gathering rather than the food.

(CBC) Certified Bariatric Counselor Practice Test

(CBC) Certified Bariatric Counselor Practice Test

CBC Managing Post-Operative Adjustments Questions and Answers