While surgery may be able to facilitate weight loss by creating anatomical changes, the patient’s long-term behaviours remain incredibly important in ensuring that the gains achieved are consolidated and maintained. Even motivated and educated patients can struggle with this process and sometimes need help from a trained psychologist who specialises in obesity issues to succeed. There are many reasons why a patient may encounter such difficulties such as a history of disordered eating behaviours or poor coping strategies among many others. Specialised help is essential if any of these challenges are encountered and early identification and intervention, ideally before surgery ensures the best outcomes.