Bariatric Surgery Counseling in San Antonio: The Evaluation, and Everything After It
The Evaluation: What It Is and What It Isn’t
Most people find us because a surgeon’s office said they need a psychological evaluation before surgery is approved. That’s the door. It shouldn’t be the whole visit.
The Bariatric Counseling Center provides both: the pre-surgical psychological evaluation your surgical team requires, and the ongoing counseling that determines whether the surgery actually holds five years from now. We’re in the San Antonio Medical Center area, we hold the Joint Commission’s Gold Seal of Approval awarded in 2023, and we’re the only program of our kind in Texas.
The pre-surgical psychological evaluation is a requirement, not a test you can fail through bad character. It exists because bariatric surgery changes your stomach and asks your brain to keep up — and surgical teams have learned that the patients who do well are the ones whose relationship with food got addressed too.
We conduct evaluations for pre-operative patients and provide the documentation your surgical team needs. We also see post-operative patients and, frequently, people who have never had surgery and don’t plan to. If you’re anxious that the evaluation is a gate designed to keep you out, it isn’t. It’s an assessment designed to send you in prepared. Texas patients outside San Antonio: we offer these evaluations via telehealth across the state.
After the Operation Is Where It Gets Decided
Here’s what surgeons will tell you directly. Surgery restricts how much you can eat. It does not touch why you eat.
If food has been how you handle stress, boredom, grief, or self-criticism, that machinery survives the operation completely intact. It goes quiet for a while — the restriction is real and the early weight loss is real — and then it comes looking for a new route. That’s the pattern behind post-surgical weight regain, and it’s rarely a surgical failure. It’s an untreated behavioral one.
Our Intensive Outpatient Program (IOP) treats it. Not inpatient, not residential, not a partial hospitalization program — you keep your job and your home. Most clients are with us about three months, roughly 30 sessions, two to three times per week:
- Morning: 11am–2pm, Tuesday through Friday
- Evening: 5:30pm–8:30pm, Monday through Thursday
- Saturday: 10am–1pm
The program runs on three levels: insight, change, and maintenance with discharge preparation. The clinical work uses Dialectical Behavior Therapy and Radically Open DBT, CBT and CBT-E, and Acceptance and Commitment Therapy, delivered through group, individual, and family or couples sessions. Because eating after bariatric surgery is a genuinely new skill, we teach it as one: cooking classes in our teaching kitchen, guided grocery store tours, and mindful eating practice with a Registered Dietitian beside you.
Your team includes Licensed Mental Health Professionals — Clinical Psychologists and LPCs — Registered Dietitians with eating disorder training, a Registered Nurse, and a professional chef. Our Director of Clinical Services is Dr. Sara Hamilton, PsyD, and Nancy Albus, LPC, CEDS-S serves as our Clinical Advisor. Patients often come to us looking for a bariatric psychologist specifically; the clinical psychologists on our team work with bariatric patients as a primary population, not as an occasional referral. We don’t prescribe medication, and you don’t need a formal diagnosis to start.
Insurance, Access, and Texas Telehealth
We’re in-network with Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare, Tricare, Humana, UMR, Carelon, Oscar, Imagine Health, Sana, MultiPlan, Meritain Health, ComPsych, Curative, 90 Degree Benefits, and Healthcare Highways. We accept CareCredit, and if a claim is denied we file the appeal for you at no cost.
Our center is in the San Antonio Medical Center area. Our telehealth IOP — and our psychological evaluations — serve all of Texas, with the same clinicians and the same program structure. Searching for a bariatric therapist near you? Wherever you are in Texas, BCC is within reach.
Frequently Asked Questions
What is bariatric surgery counseling?
It covers two things: the pre-surgical psychological evaluation most surgical programs require for approval, and the ongoing behavioral treatment that addresses the eating patterns surgery doesn’t change. We provide both.
Do I need a psychological evaluation before bariatric surgery?
Most surgical programs require one before approving surgery. We conduct the evaluation and provide the documentation your surgical team needs, in person in San Antonio or via telehealth anywhere in Texas.
Can you fail a bariatric psychological evaluation?
It isn’t a pass/fail test of your character. It’s an assessment of readiness, and its purpose is to send you into surgery prepared rather than to keep you out of it.
Why do I need counseling if I’m already having surgery?
Surgery changes how much you can eat. It doesn’t change why you eat. When food has been a coping tool, that pattern survives the operation — and it’s the most common driver of weight regain years later.
Do you see patients after surgery, or only before?
Both, plus many clients who’ve never had surgery and don’t intend to. Post-operative patients are a core part of our program.
Is counseling covered by insurance?
We’re in-network with 17 major carriers including BCBS, Aetna, Cigna, UnitedHealthcare, and Tricare. We accept CareCredit and file appeals at no cost if a claim is denied. Call and we’ll verify your benefits before you commit to anything.
Do you offer this outside San Antonio?
Yes. Our telehealth program delivers both the evaluations and the full IOP across Texas.
Come for the Evaluation. Ask Us About the Rest.
If your surgeon sent you here for a psychological evaluation, let’s get it scheduled — that’s straightforward, and we’ll move quickly so your surgery timeline doesn’t slip.
While we’re at it, ask us what happens after. Call the Bariatric Counseling Center and we’ll verify your benefits and give you a straight answer about what your first year post-op is likely to require.
Clinically reviewed by BCC’s licensed clinical staff —