Weight Loss Therapists in Kensington, MD

Photo of Donald Pelles - Hypnosis Silver Spring, PhD, CHT
Hypnosis Silver Spring
PhD, CHT
Verified Verified
Kensington, MD 20895
I have recently been using the Virtual Gastric Band process for weight loss with great success - a non-surgical technique which hypnotically "shrinks" your stomach, to retrain you to be satisfied with smaller amounts of food.
People settle, for things in their lives they don’t really like, that they feel powerless to change. I work with both the conscious and unconscious aspects, sometimes indirectly, in ways that engender changes on both of these levels. I enable and empower my clients to open up to new directions and possibilities, to new ways of feeling, doing, and being.
I have recently been using the Virtual Gastric Band process for weight loss with great success - a non-surgical technique which hypnotically "shrinks" your stomach, to retrain you to be satisfied with smaller amounts of food.
People settle, for things in their lives they don’t really like, that they feel powerless to change. I work with both the conscious and unconscious aspects, sometimes indirectly, in ways that engender changes on both of these levels. I enable and empower my clients to open up to new directions and possibilities, to new ways of feeling, doing, and being.
(240) 219-6115 View (240) 219-6115
Photo of Joan Weill, LCSW-C, Clinical Social Work/Therapist
Joan Weill
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Kensington, MD 20895  (Online Only)
I help people with weight loss & eating disorders achieve lasting success & healthy weight for 15+ years.
If you are struggling with depression, anxiety, weight loss, eating issues and other addictions, I can help. With years of experience and many successful outcomes helping clients work through depression & anxiety, achieve weight loss and recovery from eating disorders, addictions, trauma, grief & loss, I welcome you and the opportunity to help you achieve results! With a caring approach & many effective interventions for adults & adolescents coping with personal stresses in work, school, relationships, divorce, custody & family issues, sexuality, I provide a safe environment to work through issues. I believe in you & your potential!
I help people with weight loss & eating disorders achieve lasting success & healthy weight for 15+ years.
If you are struggling with depression, anxiety, weight loss, eating issues and other addictions, I can help. With years of experience and many successful outcomes helping clients work through depression & anxiety, achieve weight loss and recovery from eating disorders, addictions, trauma, grief & loss, I welcome you and the opportunity to help you achieve results! With a caring approach & many effective interventions for adults & adolescents coping with personal stresses in work, school, relationships, divorce, custody & family issues, sexuality, I provide a safe environment to work through issues. I believe in you & your potential!
(240) 650-8240 View (240) 650-8240
Photo of Monique Wilson, MSW, LCSW-C, LCSW, Clinical Social Work/Therapist
Monique Wilson
Clinical Social Work/Therapist, MSW, LCSW-C, LCSW
Verified Verified
2 Endorsed
Kensington, MD 20895  (Online Only)
Are negative thoughts, anxiety or depression stealing your peace of mind? Are you constantly overthinking or thinking the worst? Do you tend to really be hard on yourself? Has stress and worrying taken over your life? Are your relationships causing you pain and strife? If you answered yes to any of these questions, please know that you no longer have to suffer through this alone. I would like to help you work through these challenges. Having a therapist to talk to who is non-judgmental and caring can be exactly what you need to decrease your frustrations, lift your spirits and help you find the peace of mind that you crave.
Are negative thoughts, anxiety or depression stealing your peace of mind? Are you constantly overthinking or thinking the worst? Do you tend to really be hard on yourself? Has stress and worrying taken over your life? Are your relationships causing you pain and strife? If you answered yes to any of these questions, please know that you no longer have to suffer through this alone. I would like to help you work through these challenges. Having a therapist to talk to who is non-judgmental and caring can be exactly what you need to decrease your frustrations, lift your spirits and help you find the peace of mind that you crave.
(301) 812-3246 View (301) 812-3246
Photo of Barrie Krellen Gochman, LCSW-C, Clinical Social Work/Therapist
Barrie Krellen Gochman
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Kensington, MD 20895
I have over 30 years of clinical experience as an LCSW-C providing individual psychotherapy to adolescents and adults. In addition, I have 2 years of post graduate training from the Washington School of Psychiatry. My theoretical orientation is primarily psychodynamic, but I also utilize cognitive/behavioral theory and other theoretical models, depending on my client's needs.
I have over 30 years of clinical experience as an LCSW-C providing individual psychotherapy to adolescents and adults. In addition, I have 2 years of post graduate training from the Washington School of Psychiatry. My theoretical orientation is primarily psychodynamic, but I also utilize cognitive/behavioral theory and other theoretical models, depending on my client's needs.
(301) 852-7376 View (301) 852-7376
Photo of Vickye Hayter, MS, RN, LCMFT, Marriage & Family Therapist
Vickye Hayter
Marriage & Family Therapist, MS, RN, LCMFT
Verified Verified
1 Endorsed
Kensington, MD 20895
Often we wait until we have exhausted every measure before we seek professional help. You can start on your journey to healing, reconciliation, peace, and joy today. I believe that in times of adversity and struggle, we have the greatest potential for growth. It is often hard to see clearly how the difficulties we face will lead to positive changes, so instead we lose our way and get stuck in places of frustration, despair, and resentment. The change process is a journey-sometimes long and at times short. It is a process that gives us the opportunity to discover new ways of approaching our circumstances.
Often we wait until we have exhausted every measure before we seek professional help. You can start on your journey to healing, reconciliation, peace, and joy today. I believe that in times of adversity and struggle, we have the greatest potential for growth. It is often hard to see clearly how the difficulties we face will lead to positive changes, so instead we lose our way and get stuck in places of frustration, despair, and resentment. The change process is a journey-sometimes long and at times short. It is a process that gives us the opportunity to discover new ways of approaching our circumstances.
(301) 327-2320 View (301) 327-2320
Photo of John Dende, LCPC
John Dende
Licensed Clinical Professional Counselor, LCPC
Verified Verified
Kensington, MD 20895
People seek me out when they or their family members are in psychological or emotional pain, stress or crisis. Your kids aren't behaving and you want help for them; the career, relationship/marriage is falling apart; you feel depressed and hopeless, or lost; lack confidence, feel angry or someone tells you that you need "anger management"; you might feel shame and humiliation; unfulfilled with your life; dealing with loss and grief; psychological or sexual traumas; phobias and fears. I specialize in treating people who feel "stuck" and want expert help. Let me help.
People seek me out when they or their family members are in psychological or emotional pain, stress or crisis. Your kids aren't behaving and you want help for them; the career, relationship/marriage is falling apart; you feel depressed and hopeless, or lost; lack confidence, feel angry or someone tells you that you need "anger management"; you might feel shame and humiliation; unfulfilled with your life; dealing with loss and grief; psychological or sexual traumas; phobias and fears. I specialize in treating people who feel "stuck" and want expert help. Let me help.
(240) 393-4207 View (240) 393-4207
Photo of Gloria Carpenter, PhD, Psychologist
Gloria Carpenter
Psychologist, PhD
Verified Verified
5 Endorsed
Kensington, MD 20895
Teletherapy Available! Difficulties coping with change, loss, or relationships? Is trauma preventing your progress? I am a Certified Gottman Therapist and a Certified Clinical Trauma Professional with training in relational therapy, grief, identity issues, infertility, sexual addictions & dysfunctions, and couple therapy to bring about success and promote active healing. This is especially effective for adults struggling with identity crises, anxiety & mood disorders, and co-dependent relationships. Moreover, other therapists and EMT personnel benefit from therapy with me.
Teletherapy Available! Difficulties coping with change, loss, or relationships? Is trauma preventing your progress? I am a Certified Gottman Therapist and a Certified Clinical Trauma Professional with training in relational therapy, grief, identity issues, infertility, sexual addictions & dysfunctions, and couple therapy to bring about success and promote active healing. This is especially effective for adults struggling with identity crises, anxiety & mood disorders, and co-dependent relationships. Moreover, other therapists and EMT personnel benefit from therapy with me.
(240) 292-9404 View (240) 292-9404
Photo of Jennifer R. Schwartz, LCSW-C, MSW, Clinical Social Work/Therapist
Jennifer R. Schwartz
Clinical Social Work/Therapist, LCSW-C, MSW
Verified Verified
Kensington, MD 20895
My passion is working with people who are confronted with challenges at home, school, or the workplace; or are having difficulty maintaining or creating meaningful relationships.  I will offer you a safe, judgment free, and accepting environment.  No two people experience hardship the same way.  Together, we can find the solution that works best for you. I have many years of experience working with individuals in schools, parents and children with child welfare involvement, and families dealing with separation and divorce.
My passion is working with people who are confronted with challenges at home, school, or the workplace; or are having difficulty maintaining or creating meaningful relationships.  I will offer you a safe, judgment free, and accepting environment.  No two people experience hardship the same way.  Together, we can find the solution that works best for you. I have many years of experience working with individuals in schools, parents and children with child welfare involvement, and families dealing with separation and divorce.
(240) 607-5060 View (240) 607-5060

More Therapists Nearby

Photo of Lindsey Berisha, PhD, Psychologist
Lindsey Berisha
Psychologist, PhD
Verified Verified
1 Endorsed
Bethesda, MD 20814
I specialize in providing evidence-based interventions for depression, anxiety, stress, weight, and insomnia, as well counseling for individuals both before and after weight loss surgery. Making and maintaining changes in your life can be incredibly difficult. Whether you are hoping to make a change in your life or struggling to adapt to life’s unexpected changes, therapy can provide support, insight, and new tools and techniques for handling life’s challenges. I am a warm and collaborative clinician who strives to help clients to better understand themselves and learn skills for improving their lives.
I specialize in providing evidence-based interventions for depression, anxiety, stress, weight, and insomnia, as well counseling for individuals both before and after weight loss surgery. Making and maintaining changes in your life can be incredibly difficult. Whether you are hoping to make a change in your life or struggling to adapt to life’s unexpected changes, therapy can provide support, insight, and new tools and techniques for handling life’s challenges. I am a warm and collaborative clinician who strives to help clients to better understand themselves and learn skills for improving their lives.
(703) 935-5674 View (703) 935-5674
Photo of Dr. Lisa Germeroth, PhD, Psychologist
Dr. Lisa Germeroth
Psychologist, PhD
Verified Verified
2 Endorsed
Bethesda, MD 20814  (Online Only)
Dr. Germeroth specializes in eating and weight related concerns (emotional eating, overeating, binge eating, weight management, weight loss surgery support), anxiety disorders (generalized anxiety, OCD, trichotillomania, excoriation), depression, and insomnia. Dr. Germeroth’s background in health behavior research strongly informs her clinical work, which is focused on providing evidence-based treatment personalized to each client’s unique needs. Dr. Germeroth primarily uses Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), Exposure Response Prevention (ERP), and Habit Reversal Training (HRT).
Dr. Germeroth specializes in eating and weight related concerns (emotional eating, overeating, binge eating, weight management, weight loss surgery support), anxiety disorders (generalized anxiety, OCD, trichotillomania, excoriation), depression, and insomnia. Dr. Germeroth’s background in health behavior research strongly informs her clinical work, which is focused on providing evidence-based treatment personalized to each client’s unique needs. Dr. Germeroth primarily uses Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), Exposure Response Prevention (ERP), and Habit Reversal Training (HRT).
(571) 200-8867 View (571) 200-8867
Photo of Stewart A Zelman, PhD, Psychologist
Stewart A Zelman
Psychologist, PhD
Verified Verified
Bethesda, MD 20817  (Online Only)
Online programs for weight loss, and focused solutions to help you overcome all obstacles in your life.
I work with clients who want to finally change their psychology and manage their lives more effectively. This work can help you manage your obesity, depression and anxiety. Based on your needs and goals, we can improve your relationships,ability to create and achieve your goals. If you are struggling with finally lose weight, we have developed an assessment, WALT and tools to help you stop struggling. By improving your ability to manage your mind and emotions, improve your motivation and body image we can help you lose the weight. We use specific treatment modalities which create goal achievement in a solution focused atmosphere.
Online programs for weight loss, and focused solutions to help you overcome all obstacles in your life.
I work with clients who want to finally change their psychology and manage their lives more effectively. This work can help you manage your obesity, depression and anxiety. Based on your needs and goals, we can improve your relationships,ability to create and achieve your goals. If you are struggling with finally lose weight, we have developed an assessment, WALT and tools to help you stop struggling. By improving your ability to manage your mind and emotions, improve your motivation and body image we can help you lose the weight. We use specific treatment modalities which create goal achievement in a solution focused atmosphere.
(301) 485-6914 View (301) 485-6914
Photo of Robin Mize, LCMFT, Marriage & Family Therapist
Robin Mize
Marriage & Family Therapist, LCMFT
Verified Verified
Silver Spring, MD 20910
Therapy can give you a new perspective on your life, and provide the tools and insight to make positive changes. I work with adults of all ages to become more grounded and centered in a life they feel passionate about, and to find emotional balance and well-being in themselves and their relationships. Same sex couples welcome.
Therapy can give you a new perspective on your life, and provide the tools and insight to make positive changes. I work with adults of all ages to become more grounded and centered in a life they feel passionate about, and to find emotional balance and well-being in themselves and their relationships. Same sex couples welcome.
(301) 852-7817 View (301) 852-7817
Photo of Katie Giganti, LCSW-C, Clinical Social Work/Therapist
Katie Giganti
Clinical Social Work/Therapist, LCSW-C
Verified Verified
Rockville, MD 20852  (Online Only)
Virtual openings beginning in September. Hi, I'm Katie! Do you struggle with high stress or feeling down, but not sure how to feel better? Daily challenges, emotional burdens, and past experiences can leave you feeling drained and stuck in a rut. I specialize in helping women who want to exit the vicious cycle & feel themselves again. I can help you identify triggers, set goals and maintain them. I use techniques known as "CBT," or Cognitive Behavioral Therapy (using the way you think to improve mood or stress) and distress tolerance skills so that you build that resiliency muscle- just like an athletic trainer would in a gym.
Virtual openings beginning in September. Hi, I'm Katie! Do you struggle with high stress or feeling down, but not sure how to feel better? Daily challenges, emotional burdens, and past experiences can leave you feeling drained and stuck in a rut. I specialize in helping women who want to exit the vicious cycle & feel themselves again. I can help you identify triggers, set goals and maintain them. I use techniques known as "CBT," or Cognitive Behavioral Therapy (using the way you think to improve mood or stress) and distress tolerance skills so that you build that resiliency muscle- just like an athletic trainer would in a gym.
(301) 945-8097 View (301) 945-8097
Photo of Sapna Doshi, PhD, Psychologist
Sapna Doshi
Psychologist, PhD
Verified Verified
20 Endorsed
Bethesda, MD 20814
Dr. Doshi specializes in the treating of eating disorders, body image concerns, behavioral weight management, pre & post bariatric counseling, insomnia, OCD, anxiety disorders, depression, and multicultural and identity-related concerns. She utilizes scientific, evidence-based approaches to inform her treatment with clients. She specializes in the use of Cognitive Behavioral Therapy (CBT), Acceptance & Commitment Therapy (ACT), and Exposure Response Prevention (ERP).
Dr. Doshi specializes in the treating of eating disorders, body image concerns, behavioral weight management, pre & post bariatric counseling, insomnia, OCD, anxiety disorders, depression, and multicultural and identity-related concerns. She utilizes scientific, evidence-based approaches to inform her treatment with clients. She specializes in the use of Cognitive Behavioral Therapy (CBT), Acceptance & Commitment Therapy (ACT), and Exposure Response Prevention (ERP).
(703) 783-9118 View (703) 783-9118
Photo of Robyn Osborn Pashby, PhD, Psychologist
Robyn Osborn Pashby
Psychologist, PhD
Verified Verified
1 Endorsed
North Bethesda, MD 20852
Are you feeling overwhelmed by the complexities of managing your physical and mental well-being? You're not alone. From navigating eating habits and weight concerns to coping with long-term medical conditions or sudden health setbacks, the journey can feel daunting. But here's the good news: we're here to help. Our team, based in Washington DC, specializes in bridging the gap between physical and mental health, and we understand what you're going through. Whether you're a patient, caregiver, or healthcare professional, we're dedicated to providing the support and guidance you need to thrive.
Are you feeling overwhelmed by the complexities of managing your physical and mental well-being? You're not alone. From navigating eating habits and weight concerns to coping with long-term medical conditions or sudden health setbacks, the journey can feel daunting. But here's the good news: we're here to help. Our team, based in Washington DC, specializes in bridging the gap between physical and mental health, and we understand what you're going through. Whether you're a patient, caregiver, or healthcare professional, we're dedicated to providing the support and guidance you need to thrive.
(202) 933-8090 View (202) 933-8090
Photo of Ryan Long, LICSW, EMDR-C, IMGCA-C, Clinical Social Work/Therapist
Ryan Long
Clinical Social Work/Therapist, LICSW, EMDR-C, IMGCA-C
Verified Verified
5 Endorsed
Bethesda, MD 20814
I specialize in working with adolescents and young adults. As a former high school coach and counselor, I provide a unique approach that is both authentic and encouraging in nature. I work best with clients that are open-minded and adaptable as well as introspective and contemplative. Sense of humor plays an essential role in developing the rapport I have with my clients. Once that is established, I make sure to carefully listen to each individual's unique story, assist in planning ahead for challenges, channel strengths, and collaboratively track progress together.
I specialize in working with adolescents and young adults. As a former high school coach and counselor, I provide a unique approach that is both authentic and encouraging in nature. I work best with clients that are open-minded and adaptable as well as introspective and contemplative. Sense of humor plays an essential role in developing the rapport I have with my clients. Once that is established, I make sure to carefully listen to each individual's unique story, assist in planning ahead for challenges, channel strengths, and collaboratively track progress together.
(202) 838-5376 View (202) 838-5376
Photo of Donald J Palmer, PhD, Psychologist
Donald J Palmer
Psychologist, PhD
Verified Verified
Bethesda, MD 20814
Hello. If you are considering psychotherapy, a good "fit" with your psychologist is essential. I have been a practicing clinical psychologist for over forty years. During that time, I have also been a psychology professor at Montgomery College. My theoretical orientation is a pragmatic blend of cognitive, humanistic, psychodynamic and behavioral, but I am also a firm believer in the value of positive psychology. I try not to diagnose people, but rather work with the entire individual, especially with their strengths. I am not the "silent, blank-screen" kind of therapist.
Hello. If you are considering psychotherapy, a good "fit" with your psychologist is essential. I have been a practicing clinical psychologist for over forty years. During that time, I have also been a psychology professor at Montgomery College. My theoretical orientation is a pragmatic blend of cognitive, humanistic, psychodynamic and behavioral, but I am also a firm believer in the value of positive psychology. I try not to diagnose people, but rather work with the entire individual, especially with their strengths. I am not the "silent, blank-screen" kind of therapist.
(240) 685-9559 View (240) 685-9559
Photo of Devon C King, PhD, Psychologist
Devon C King
Psychologist, PhD
Verified Verified
7 Endorsed
Bethesda, MD 20814
I have tremendous respect for people who make the difficult decision to enter in to psychotherapy. I work collaboratively with older children, adolescents, and adults, in individual, couples, and family therapy. My goal is to explore collaboratively the troubles that have led them to seek treatment at this time. I try to provide a safe, non-judgemental environment, where one can develop insight to better understand and ultimately change behavioral and relational patterns that get in the way of happiness and fulfillment. I have extensive experience working with depression, anxiety, and trauma, as well as relationship difficulties and life transitions.
I have tremendous respect for people who make the difficult decision to enter in to psychotherapy. I work collaboratively with older children, adolescents, and adults, in individual, couples, and family therapy. My goal is to explore collaboratively the troubles that have led them to seek treatment at this time. I try to provide a safe, non-judgemental environment, where one can develop insight to better understand and ultimately change behavioral and relational patterns that get in the way of happiness and fulfillment. I have extensive experience working with depression, anxiety, and trauma, as well as relationship difficulties and life transitions.
(240) 262-4455 View (240) 262-4455
Photo of Samuel W Cooper, MSW, LMSW, Clinical Social Work/Therapist
Samuel W Cooper
Clinical Social Work/Therapist, MSW, LMSW
Verified Verified
1 Endorsed
Bethesda, MD 20814
Samuel Cooper (he/him/they) is a Licensed Master Social Worker, meditation teacher, and yogi. He practices from a trauma-sensitive foundation of pancultural spirituality and eclectic theory, and believes that therapy must be creative, fluid, and collaborative in order to meet the unique and changing needs of each client. No matter how big or small the issues we face, no matter how deep or wide the questions we ask, he believes that each of us contains the power to move towards insight, growth, authenticity, and healing. Sam’s work is ultimately dedicated to the flourishing of all beings.
Samuel Cooper (he/him/they) is a Licensed Master Social Worker, meditation teacher, and yogi. He practices from a trauma-sensitive foundation of pancultural spirituality and eclectic theory, and believes that therapy must be creative, fluid, and collaborative in order to meet the unique and changing needs of each client. No matter how big or small the issues we face, no matter how deep or wide the questions we ask, he believes that each of us contains the power to move towards insight, growth, authenticity, and healing. Sam’s work is ultimately dedicated to the flourishing of all beings.
(301) 358-4675 View (301) 358-4675
Photo of Jennifer Hamady, MA, NCC, LCPC, Counselor
Jennifer Hamady
Counselor, MA, NCC, LCPC
Verified Verified
Chevy Chase, MD 20815  (Online Only)
Welcome! I am a state licensed and nationally board-certified therapist specializing in self-expression, creativity, relationships, communication and anxiety issues. I also focus on confidence and self-worth, sense of purpose and career transitions, and work with a range of clients including creatives, executives, couples and others interested in achieving joy, peace and meaning in their professional and personal lives. I am the author of three books on the psychology of performance, write regularly for Psychology Today on matters of creative expression, and present workshops, lectures and master classes on the same.
Welcome! I am a state licensed and nationally board-certified therapist specializing in self-expression, creativity, relationships, communication and anxiety issues. I also focus on confidence and self-worth, sense of purpose and career transitions, and work with a range of clients including creatives, executives, couples and others interested in achieving joy, peace and meaning in their professional and personal lives. I am the author of three books on the psychology of performance, write regularly for Psychology Today on matters of creative expression, and present workshops, lectures and master classes on the same.
(240) 913-8708 View (240) 913-8708
Weight Loss Therapists

What is the relationship between weight management and mental health?

Mental health can be significantly influenced by one's physical health, so overall improvements in one's quality of life as a result of improved physical functioning from weight loss can have an overall positive impact on an individual's mental health and allow them to engage more readily in everyday activities. In addition, many strategies used to manage weight, such as exercise and maintaining a healthy diet, are also associated with reducing the symptoms of common mental health conditions, such as anxiety or depression. Individuals may also benefit from the improved self-esteem and self-efficacy that can come with successful weight management.

What is the psychological approach to losing weight?

While there are no specific therapy modalities specifically for weight loss, common psychological therapies can be highly effective in helping clients make lasting lifestyle changes. This may be called the "psychological approach" to weight loss because it does not rely on physical interventions, such as medication or weight loss surgery, to help clients lose weight. Weight loss counseling can be used in addition to or instead of such physical interventions. Some clients simply seek therapy to address the challenges that may accompany weight loss in general, including negative thoughts surrounding their body, disordered eating patterns, or difficulty completing daily tasks as a result of their weight challenges. In such cases, therapists will often utilize behavioral coaching or Cognitive Behavioral Therapy techniques to help clients understand how their thoughts may be influencing their diet and physical activity patterns.

What type of therapy is commonly used in weight loss counseling?

Weight loss counseling often involves a combination of therapy and psychoeducation. Common techniques used by weight loss counselors include journaling, thought diaries, and other Cognitive Behavioral Therapy strategies that encourage clients to consider how their feelings about their weight loss impact their mental health. Weight loss counselors may also teach clients mindfulness exercises, which can be used by clients during and after eating to be more aware of physical cues from their body surrounding eating. Some clients looking for weight loss therapy may also benefit from group therapy approaches, which utilize the power of social connection and accountability to help clients adhere to their weight loss plan.

Is therapy recommended for individuals undergoing bariatric surgery?

While therapy is not a requirement for individuals undergoing bariatric surgery, many individuals undergoing weight loss surgery may benefit from seeing a counselor. Prior to surgery, counselors can help clients decide whether surgical weight loss is a good fit for them and assist in surgery preparation. Post-surgery, counselors can assist clients with the psychological component of maintaining their weight loss, as well as help clients navigate any postoperative pain. Throughout the surgical process, therapists can help clients process body-image challenges that may come with dramatic changes in weight, as well as manage symptoms of anxiety or depression that may accompany the major life changes bariatric surgery can bring.