What is a bariatric psychological evaluation?

A bariatric psychological evaluation is a supportive assessment designed to ensure you are mentally prepared for the significant changes that come with weight-loss surgery. It is not a pass/fail exam, but rather a mental fitness check before surgery. The evaluator's goal is to identify any areas where you might need extra support, not to disqualify you from having the procedure.

Should I be honest during my bariatric psych evaluation?

Yes. Honesty is essential during a bariatric psychological evaluation. Evaluators use psychological assessments like the MMPI and MBMD, which include built-in validity scales designed to detect inconsistencies or attempts to over-report or under-report symptoms. Being open about your struggles or past behaviors — such as difficulty sticking to a diet or episodes of emotional eating — shows self-awareness and will not automatically disqualify you from surgery. It helps the psychologist create the most effective support plan for you.

How can I demonstrate commitment to lifestyle changes during the evaluation?

You can demonstrate commitment by discussing the specific bariatric procedure you're pursuing and why it's right for you, explaining your understanding of the required dietary changes and new habits, sharing plans for broader lifestyle changes such as regular exercise and mindful eating, and describing any small changes you've already begun, like reducing sugary drinks or walking daily. If you've struggled with plans in the past, be ready to explain what you'll do differently this time.

What should I bring or prepare for my bariatric psychological evaluation?

Before your appointment, prepare notes covering: a summary of your weight and diet history, including programs you've tried; any mental health history such as past diagnoses, therapy, or medications; important lifestyle factors or triggers that affect your eating or mental health; and any questions you want to ask the evaluator. If you have documentation from a therapist or psychiatrist — such as a letter confirming you are managing a condition well — you can bring that as well.

Will having a history of emotional eating or trauma disqualify me from bariatric surgery?

No. Having a history of emotional eating, mental health conditions, or past trauma does not automatically disqualify you from bariatric surgery. What matters is that you understand these challenges and have begun to address them or have a plan to do so. Being open about these issues during your evaluation allows the team to tailor resources and strategies to support you through your surgical journey.

What does the evaluator look for regarding expectations about surgery?

The psychologist will assess whether you have realistic expectations about bariatric surgery outcomes. You should understand that weight loss is not instantaneous — it typically happens rapidly in the first 6 months, then slows, and can take a year or more to reach your lowest weight. You should also be aware that surgery will not solve every life problem and that ongoing challenges like nutritional supplementation, possible loose skin, or some weight regain may occur. Framing your reasons for surgery around health and quality of life — rather than expecting a magic fix — shows the evaluator you are mentally prepared.

What happens if concerns come up during the bariatric psychological evaluation?

If concerns arise during the evaluation, they are simply identified as areas where extra preparation or support may be needed before proceeding with surgery. The process is designed to help ensure your safety and long-term success, not to judge or reject you. Any issues flagged are opportunities to get additional support so you are fully ready for the procedure.

Where can I get a bariatric psychological evaluation at Athena Care?

Athena Care offers bariatric psychological evaluations at multiple clinic locations across Tennessee, including Nashville, Franklin, Murfreesboro, Hendersonville, Clarksville, Memphis, and Knoxville. Evaluations are also available via telehealth across 35 states. You can schedule by calling or texting 877-641-1155.

What to Expect at Your First Psychiatry Appointment

Feeling nervous about your first psychiatry appointment? You’re not alone. Taking that first step to see a psychiatrist or psychiatric nurse practitioner is a brave decision, and it’s normal to feel a bit anxious. The good news is that the process is designed to be supportive, collaborative, and focused on helping you feel better.

In fact, at Athena Care’s clinics across Tennessee, our team strives to create a warm, judgment-free environment from the moment you walk in. This step-by-step walkthrough will guide you through what to expect before, during, and after your first psychiatry or medication management visit. Our goal is to help you feel prepared and at ease for this important first session.

A woman struggling with depression benefits from medication management.

Step 1: Before Your Appointment – Preparation and Paperwork

Arriving Early: Plan to arrive about 15 minutes early for your first appointment. This extra time ensures you can complete any check-in procedures or last-minute paperwork without feeling rushed. When you first come in, you’ll check in at reception and spend a few minutes in the waiting area, much like a regular doctor’s visit. Giving yourself a little cushion of time can help you catch your breath and settle in.

What to Bring: Come prepared with some essentials and information. Bringing the following items will help your provider get a complete picture of your health and avoid delays:

ID and Insurance Card: Have your photo ID and insurance information ready. The office will likely make a copy for billing purposes. If you discussed payment details ahead of time, you might already know your co-pay or fees; if not, the staff can explain them before the session starts.
List of Medications: Write down all current medications you are taking (including doses and how long you’ve been on them), as well as any past psychiatric medications you’ve tried. Don’t forget to include over-the-counter meds, vitamins, or supplements. Also note any allergies or adverse reactions to medications. This helps your psychiatrist ensure no negative interactions and consider what has or hasn’t worked for you in the past.
Medical & Mental Health History: Jot down key points about your health history. This can include any past diagnoses or hospitalizations, previous therapy or counseling, and any family history of mental health conditions. If you have records from another provider (like a therapist’s summary or previous doctor’s notes), have those handy or let your new doctor know how to get them.
Symptom Notes or Journal: It often helps to bring notes on what you’ve been experiencing. Try listing your current symptoms, when they started, and how they affect your daily life. For example, you might note “trouble sleeping for 3 months” or “anxiety attacks a few times a week impacting work.” Include any triggers you’ve noticed and things that help or worsen your symptoms. This will jog your memory during the appointment and ensure you don’t forget important details.
Questions or Concerns: If there are specific questions you want to ask the psychiatrist – such as treatment options, thoughts on therapy, or anything you’re worried about – write them down. It’s easy to forget questions in the moment, so having a list is useful. Remember, this appointment is for you, so feel free to address whatever is on your mind.

Handling Initial Paperwork: Most clinics will have some intake forms for you to complete. These may cover your contact info, insurance details, consent for treatment, and questionnaires about your medical and mental health history. Often, clinics like Athena Care will send you these forms ahead of time or make them available online so you can fill them out at home. If you complete paperwork in advance, you’ll have more time to speak with your provider during the appointment. If not, you can fill them out in the waiting room — and clinic staff can help if you have any questions.

Tip: If you’re feeling particularly anxious, consider bringing a close friend or family member for support (if you’re comfortable). Having someone with you in the waiting room – or even sitting in for part of the session – can provide moral support and help you remember information shared during the visit. This is completely optional; many people also prefer to attend alone, which is perfectly fine. Do what makes you feel most at ease.

Step 2: During the Appointment – A Collaborative, No-Pressure Conversation

Walking into the psychiatrist’s office, you can expect a one-on-one conversation in a calm, private setting. Your first psychiatry or medication management appointment will likely be longer than a typical follow-up visit. Initial psychiatric evaluations commonly last about 45 to 90 minutes (sometimes up to 2 hours). This extended time gives your provider a chance to really understand you. The psychiatrist (or psychiatric nurse practitioner/physician assistant on the team) will guide the session with questions, but it’s also a space for you to share openly.

Here’s what typically happens during that first appointment:

Review of History: The psychiatrist will have any forms or notes you provided and will review them with you. They’ll likely start by confirming the basics of your medical and mental health history — for instance, discussing past diagnoses, treatments, or any significant health issues. Don’t worry if you don’t remember every date or detail; you can work together to fill in the picture.
Discussing Your Current Concerns: Expect to talk about why you’re seeking help now. What symptoms or challenges have you been facing, and for how long? The doctor will ask you to describe what you’ve been feeling or experiencing in your own words. Be as honest and specific as you can. For example, instead of saying “I’m just not myself,” you might explain “I’ve been feeling hopeless, struggling to get out of bed most days for the past month.” This helps the provider understand the severity and impact on your life.
Questions You’ll Be Asked: To get a well-rounded picture, the psychiatrist will ask about several aspects of your life, such as: your mood and symptoms, sleep patterns, appetite, energy level, and any recent stressors. They will also ask about substance use (like alcohol or drug use), since that can affect mental health and medication choices. Family history is another topic — for instance, “Has anyone in your family had depression or anxiety?” These questions might feel personal or even a bit intrusive, but remember they are standard questions aimed at ensuring nothing important is missed. The doctor isn’t trying to pry for no reason; each question has a purpose in understanding your situation.
No Need to Fear Judgment: It’s natural to wonder, “What will they think of me if I share XYZ?” However, psychiatrists are trained to listen without judgment. You can talk about difficult or sensitive topics knowing it’s a safe space. In fact, being open and honest is very important – the more your provider knows, the better they can help you. Remember, nothing you say will shock them. They’ve heard a wide range of human experiences and their role is to help, not to judge. If you get emotional or need a moment, that’s okay too. It’s not uncommon to feel tearful or vulnerable when discussing personal issues. Your psychiatrist understands this (you might even notice a box of tissues within arm’s reach!). Take your time, and don’t hesitate to say, “I’m feeling a bit overwhelmed, can we pause for a moment?” if you need a short break. This session is for you, and it’s perfectly fine to collect yourself.
Basic Health Checks: Psychiatry is about mental health, but because psychiatrists are medical doctors, they might do some simple physical health checks as part of the visit. Don’t be surprised if they take your blood pressure, pulse, or ask about your general health. Many psychiatrists like to record baseline vitals (and sometimes weight) during the first visit. In some cases, the provider may recommend lab tests or blood work. Lab tests (for example, checking thyroid levels or vitamin deficiencies) can rule out any medical issues that could be influencing your mental health symptoms. These tests are usually routine – for instance, a thyroid imbalance can cause mood symptoms, so they might want to check that as part of a thorough evaluation. If any labs are needed, the doctor will explain why and what the process is (you might do a blood draw on-site or receive an order to visit a lab). Rest assured, there’s no “test” you have to pass during a psych evaluation; these measures just help complete the puzzle of your overall health.
Active Participation: Throughout the conversation, feel free to speak up with your own thoughts or questions. If something the psychiatrist says isn’t clear, ask for clarification. You are an active participant in this appointment, not just a patient answering questions. For example, if the doctor mentions a term or possible diagnosis you don’t understand, it’s absolutely okay to say, “Could you explain what that means?” Being engaged and collaborative helps your provider tailor the session to your needs.

Collaborative Tone: One thing we emphasize at Athena Care is that your first appointment is a collaboration. Think of it as meeting a partner in your mental health care. You’re both there with the same goal: figuring out how to help you feel better. The conversation may cover serious topics, but the tone should be supportive and collaborative. A good psychiatrist will make sure you feel heard and will invite your input when discussing what might be going on and what to do about it. You should never feel rushed or talked down to. If at any point you do, that’s important feedback – because feeling comfortable with your provider is key. (If you don’t feel that comfort or “fit,” know that it’s okay to seek a second opinion or another provider – but give the session a chance, as first-appointment nerves are common.)

Discussing a Treatment Plan: By the end of the appointment, after gathering information, the psychiatrist will typically share their initial impressions. This might include discussing a possible diagnosis (or they may say it’s too early to be sure and they want to gather more information). Then, you’ll talk about treatment options. Treatment in mental health can involve several components: medication, therapy, lifestyle changes, or often a combination. If the psychiatrist believes medication might help your symptoms, they will explain why and give you details about the specific medication(s) they recommend – how they work, common side effects, and why they think it’s a good choice in your case. Importantly, this is a two-way discussion. You will never be pressured to accept a medication on the spot if you’re not comfortable. In fact, the decision on whether to take medication is ultimately yours. A reputable provider will give you their professional recommendation, but you get to weigh in on what you’re ready for. If you have reservations, voice them. For example, you can ask, “What happens if I decide not to take medication right now?” The psychiatrist can discuss alternatives, like starting with therapy first or other non-medication strategies, if appropriate.

Many people worry, “Will I get a prescription immediately? Do I have to take meds if I see a psychiatrist?” The answer is: you may or may not start medication at the first visit, and you’re never forced to do anything. Some patients do leave the first appointment with a prescription (especially if the need is clear and the individual is on board), but others might decide to think it over, or the doctor might suggest doing some lab tests or gathering records first. There is no pressure to get “pills” right away. Psychiatrists are there to educate you about options, not to coerce you. In fact, one provider explains that if medication seems helpful, they’ll explain it and give you time to ask questions or even time to think it over – it’s not about pushing you into anything. You might hear something like, “Based on what you’ve told me, I believe an antidepressant could help. Here’s how it works and what to expect. How do you feel about trying that?” If you’re unsure, it’s absolutely fine to say you’d like to hold off or discuss other approaches. The conversation could then cover therapy referrals, lifestyle recommendations (like exercise, sleep habits, etc.), or scheduling a follow-up to revisit the decision.

Before wrapping up the session, make sure all your questions are answered. If you wrote down questions beforehand, check that list. Common questions at a first psychiatry appointment might include: “Do I have a diagnosis at this point, or are we still figuring it out?”, “What are the treatment options and what do you recommend?”, “If we start a medication, what are the possible side effects and how soon might I feel better?”, or “Will you be in communication with my therapist or primary care doctor?” Don’t hesitate to ask anything that will help you understand the plan going forward. The psychiatrist truly wants you to leave that room feeling informed and comfortable with the next steps.

Step 3: After the Appointment – Follow-Up and Next Steps

Wrapping Up the Visit: As your first appointment concludes, your provider will recap the main takeaways and outline a plan. This plan is personalized to you, but it usually covers a few key things: any immediate recommendations (such as starting a medication or scheduling a therapy appointment), any follow-up tasks (like completing lab tests or questionnaires), and the timing of your next appointment. Expect to schedule a follow-up visit before you leave. In many cases, your psychiatrist will want to see you again in a couple of weeks if you’ve started a medication, to check how you’re doing and adjust the dose if needed. If no medication was started, they may schedule a follow-up in a slightly longer timeframe or refer you to therapy and ask you to check back in later. Every situation is different, but before you walk out, you should know when you’ll speak or meet next.

If Medication Is Prescribed: Should you and the psychiatrist decide on medication, they will send it electronically to your preferred pharmacy. You’ll get instructions on how to take it (for example, “Take one pill every morning with food”). Make sure you’re clear on these instructions and any warning signs to watch for. Don’t worry about memorizing everything; the doctor or nurse often gives printed instructions or an after-visit summary. Starting a psychiatric medication is usually a gradual process – some medications might begin at a low dose and adjust later. You typically won’t feel better overnight, and your provider will let you know when you might expect to notice effects (often a few weeks for many medications). They’ll also tell you what to do if you experience side effects or have concerns before the next appointment (for instance, they may say to call the office if anything urgent comes up). Remember that you’re not alone once you leave the office – the care team is there if you have questions between appointments.

Lab Work and Referrals: If any lab tests were ordered (such as blood work), you’ll be instructed on how to complete those. Some clinics can draw blood on-site; others might give you a form to take to a lab. These tests could be done the same day or soon after. The results will usually go back to your psychiatrist, and they’ll discuss any findings with you at your next visit (or via phone if something needs quick attention). Additionally, if your treatment plan includes seeing a therapist or another specialist, the office may help coordinate that. For example, Athena Care has an array of therapists in its Tennessee clinics, so we can often schedule therapy appointments in conjunction with your psychiatric care if needed. If you already have a therapist, you might be asked to sign a release of information so that your psychiatrist and therapist can communicate and work together on your care. This kind of coordination is part of an integrated approach to mental health treatment, ensuring everyone is on the same page to help you (more on Athena Care’s team approach below).

Follow-Up Appointments: Your subsequent appointments with the psychiatric provider will likely be shorter than the first one. A typical follow-up (sometimes called a “med check” or medication management visit) might be around 15–20 minutes. In those sessions, you’ll update the doctor on how you’ve been feeling, how any medication or other interventions are working, and discuss any new issues. The provider might adjust your treatment (change the dose, switch medications, etc.) based on your report. It’s a more focused check-in, whereas the initial visit is the comprehensive one. Consistency is important – if you’re on medication, regular follow-ups ensure you’re monitored for effectiveness and side effects. As you go forward, never hesitate to share any concerns during these check-ins. If something isn’t working or you’re experiencing difficulties, your doctor wants to know so they can help resolve it.

Tip: Consider keeping a small journal or notes between appointments. Track how your mood or symptoms change, and note any side effects if you started a new medication. This doesn’t have to be extensive; even a few bullet points each day or week can reveal patterns (e.g., “Week 1 on new med – felt a bit dizzy first two days, then that went away. Sleeping slightly better.”). Bringing these notes to your follow-up can make it easier to recall how you’ve been doing. It also helps you and your psychiatrist make the most of those short visits by having clear info to discuss.

Addressing Common Worries

It’s completely normal to have what-if questions swirling in your mind. Let’s address two of the most common concerns new patients have:

“Will I be judged or stigmatized?” – No. Psychiatrists and mental health professionals are extremely conscious of the stigma around mental health, and they work hard to create a judgment-free zone. Nothing you share is “weird” or “crazy” to them – it’s information to help you. They understand that discussing personal struggles can be hard, and they respect your bravery in doing so. Also, everything you talk about is confidential (with very few exceptions for safety), so it stays between you and the provider. Think of your psychiatrist as an ally who’s heard it all and is there to help you find solutions, not to label or blame. Many patients actually feel a sense of relief after the first session, realizing that the psychiatrist is kind, understanding, and truly on their side.

“Will I get medication right away, and do I have to take it?” – The psychiatrist may or may not prescribe medication on the first visit – it depends on your unique situation. If they do recommend a medication, they will explain their reasoning and you will have a say in the decision. You are never obligated to start a medication if you’re uncomfortable. It’s okay to say, “Can I have some time to think about it?” or “I’d like to try therapy first,” and your provider will work with that. Sometimes, the first visit might end with a plan not to use medication yet – for example, the doctor might suggest getting blood tests done or trying counseling for a bit and then deciding. If a medication is started, remember that it’s not a life sentence; you will have follow-ups to discuss how it’s going, and medications can be adjusted or even discontinued with medical guidance if they’re not the right fit. The key thing is, any treatment plan is a collaboration – you should never feel forced. As one mental health professional put it, you’ll be given options and information, but “my approach is collaborative – I’ll never push you into anything you’re uncomfortable with.” Knowing that hopefully eases the fear of walking out with a prescription you didn’t want. You are in the driver’s seat of your care, with the psychiatrist navigating and advising by your side.

Athena Care’s Integrated Team Approach in Tennessee

One advantage of seeking care through Athena Care in Tennessee is our integrated approach to mental health. What does that mean for you as a patient preparing for a first visit? It means that our psychiatrists (medication providers) and therapists work together as a team to support you. If you’re already seeing a therapist (either at Athena Care or elsewhere), our psychiatric providers can coordinate with them (with your permission) to ensure everyone is aligned on your treatment plan. For example, with a simple consent form, your Athena Care psychiatrist can communicate with your therapist about your diagnosis, progress, or any medication updates. This kind of collaboration helps create a well-rounded support system for you.

Why is integrated care helpful? Because mental health treatment often works best when therapy and medication go hand-in-hand. A medication might help balance your brain chemistry, while therapy can equip you with coping skills and address life challenges – together, these approaches can complement each other. At Athena Care, we house multiple services under one roof (psychiatry, therapy, psychological assessments, etc.), so it’s easier to coordinate your care. Our clinics across Tennessee – in Nashville, Memphis, Knoxville, and beyond – are staffed with a variety of mental health professionals who frequently consult with each other. You might find that your psychiatrist will suggest therapy as part of your treatment (or vice versa, a therapist might refer you to a psychiatrist for a medication evaluation). This team-oriented philosophy is all about treating you as a whole person, not just a set of symptoms. We want your first appointment to be just the beginning of a supportive journey, where each provider you see is on the same page helping you reach your mental health goals.

(If you’re new to Athena Care and not sure where to start, our care coordinators are happy to guide you. They often help new patients figure out which services or providers might suit their needs and can answer questions about insurance, scheduling, and more.)

Final Thoughts: You’ve Got This

By now, hopefully you feel a little more comfortable with what to expect at your first psychiatry or medication management appointment. In summary, you’ll prepare by gathering some information and arriving a bit early, you’ll have a thorough but conversational evaluation with a caring professional, and you’ll leave with a plan that you and your provider created together – whether that includes medication, therapy, follow-up tests, or another approach. Along the way, you can ask questions, express concerns, and should always feel respected and heard.

Remember, seeking help is a sign of strength, not weakness. It’s okay to be nervous, but know that the first appointment is just a starting point. You don’t have to have everything figured out – that’s what your provider is there for. They will guide you step by step. Many patients walk out of their first appointment feeling a sense of relief: the unknown is now known, and they have a direction to move in.

As you get ready for your appointment, take a deep breath. You’re taking an important step toward better mental health. At Athena Care, we’re here to support you every step of the way on this journey. We look forward to welcoming you and helping you feel comfortable as you begin. You can go into your first session knowing what will happen, but also keep an open mind – this is a chance to focus entirely on you and what you need.

No matter what, you are not alone. We’re excited to help you navigate this first appointment and all the ones to come. Here’s to the start of feeling better!

If you or someone you love would benefit from talking to a mental health provider in Tennessee, call or text:

877-641-1155

One of our Care Coordinators will help you get the care you need.

Dr. William Bell, M.D.

Psychiatrist
Dr. Bell is a Board Certified Psychiatrist whose practice is dedicated to the treatment of children, adolescents and adults with a variety of psychiatric conditions.

Learn more about Dr. Bell

Mindfulness guide Meg Stein seated smiling at the camera .

Meg Stein, CFP

Editor
Meg is a certified mindfulness instructor and works at Alive and Aware Practice in Durham, NC. She has over ten years of experience as a content creator and marketing consultant, working in mental healthcare and social justice.