Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental health gain is likely attributed to weight loss and resultant gains in body image, self-esteem, and self-concept; however, other important factors contributing to postoperative mental health include a patient’s sense of taking control of his/her life and support from health care staff. Preoperative psychological health also plays an important role. In addition, the literature suggests similar benefit in the obese pediatric population. However, not all patients report psychological benefits after bariatric surgery. Some patients continue to struggle with weight loss, maintenance and regain, and resulting body image dissatisfaction. Severe preoperative psychopathology and patient expectation that life will dramatically change after surgery can also negatively impact psychological health after surgery. The health care team must address these issues in the perioperative period to maximize mental health gains after surgery. 1. Introduction Obesity, as defined by a body mass index (BMI) > 30？kg/m2, is a chronic disease that is increasing in prevalence in adults, adolescents, and children. It has been described by the World Health Organization as a global epidemic [1]. In addition, obesity is a significant risk factor for numerous comorbidities, including heart disease, diabetes, hypertension, dyslipidemia, stroke, atherosclerosis, and specific types of cancer [2]. It is also associated with overall increased mortality and decrease in lifespan by ten years [3]. Obese individuals have an increased risk of psychological distress, disordered eating, and impaired health-related quality of life (HRQoL). As the severity of the obesity rises, so does the severity of the medical complications and the mortality risk. This is important because extreme or morbid obesity, defined as BMI > 40？kg/m2, is one of the most rapidly growing subgroups of obesity. Weight loss of 5 to 10% has been associated with significant reductions in comorbidities and mortality [4]. These numbers can be achieved through conventional lifestyle and pharmacologic interventions for the mild to moderately obese;
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