Biofeedback-Assisted Relaxation, Exposure, and Cognitive-Behavioral Treatment of Gastric Bypass Surgery Related Anxiety

An unusual case of a “food phobia,” which developed more than a year after the patient underwent a gastric bypass procedure, is described. A brief description of the normal digestive process and Roux-en-Y procedure is presented followed by a discussion of common surgical outcome, the patient’s presenting difficulties, assessment data, case conceptualization, and course of treatment. The case was challenging because, as with all clinical health psychology cases, it is often difficult to tease out the physical and psychological aspects of the problem. It was also difficult to establish an exposure hierarchy due to the satiation effect of food. Progress was made, however, by applying known principles of behavior change to this novel complaint. The case demonstrates the utility of a comprehensive functional analysis as well as the impact of incorporating the patient’s strengths into the treatment plan.