**Abstract**

Obesity is a multifactorial, chronic, and progressive disease whose pathogenesis is tied to a strong genetic component as well as a multitude of hormonal, metabolic, psychological, cultural and behavioral factors. Understanding the role these factors play, screening for them, and managing them appropriately, is important for effective weight loss. Psychology and behavior have profound implications on a patient's willingness and ability to engage in treatment and to follow up after bariatric surgery. Dietary education, presence of clear expectations, patient adherence to recommendations, and follow-up, directly impact bariatric surgery outcomes. Understanding postsurgical outcome success and failure and identifying best clinical practices for optimizing and maintaining results after bariatric surgery continues to be a work in process.

**Keywords:** obesity, behavioral modification, dietary adherence, long-term follow-up, long-term success
