Surgical and other medical weight loss programs most often include a behavior modification component, which they sometimes tout as being a mental health component of the program. Unquestionably, behavior modification is essential for patients to maintain significant weight loss. Behavior modification alone, however, is but one part of the comprehensive mental health services from which post-ops would benefit. Individual and group therapy to address the myriad of issues and changes WLS patients encounter before, during and for years after WLS could increase successful, long-term outcomes. The obese suffer from negative self-perceptions, low self-esteem (Allon, 1982), body-image disturbances (Stunkard & Wadden, 1992), sexual problems (Assimakopoulos et al., 2006), less interpersonal contact (Bocchieri et al., 2002), and poor social skills (Carr & Friedman, 2006), depression, disordered eating, social discrimination, and poor quality of life (Fabricatore & Wadden, 2006), and abuse in childhood. Much of this can be successfully treated via counselling. CBT and interpersonal therapy are effective treatments of these issues, which are interwoven with obesity and do not go away as a result of weight loss surgery. Psychotherapy assists patients in dealing with body image issues, and can improve self-efficacy and self-esteem, which may lead to sustained efforts toward healthy behaviour necessary to maintain weight loss following a surgical weight loss procedure. Behaviour modification is essential. It is not enough. Many weight loss surgery patients need the benefits of individual and group therapy as well as classes designed to assist post-ops for years beyond surgery.