Bariatric surgery is the most effective treatment for patients with severe obesity who are pursuing weight loss and resolution of obesity-related comorbidities.1 Multiple studies, including a 2017 systematic review2 and randomized clinical trial,3 have found that bariatric surgery is also associated with improvements in quality of life. However, negative psychosocial outcomes after bariatric surgery have been reported, including an increased risk of self-harm4,5 and substance use.6