Background/ObjectivesDespite profound weight loss after bariatric surgery, some patients are dissatisfied with the results. Pre-surgery expectations, as well as post-surgery items of satisfaction, need to be clarified. The main objective in this study was to investigate the primary reasons to seek bariatric surgery and assess items of satisfaction 1-year post-surgery.Subjects/MethodsThis is a prospective cohort study of women (n = 50) undergoing bariatric surgery in Stockholm, Sweden. Pre-surgery assessment included reasons to seek surgery, expected weight loss, co-morbidities, and quality of life. Post-surgery assessment included items of satisfaction, weight loss, co-morbidities, and quality of life. In total, two women did not undergo surgery, and 40 women had complete data from all pre- and post-surgery assessments.ResultsMean change in body mass index (BMI) pre- and post-surgery was − 12.9 (3.7) kg/m2. At 1-year post-surgery, the mean percent of excess weight loss (%EWL) was 86.9 (26.3). Pre-surgery, the most reported reason to seek surgery was “weight loss” (47.9%), while the most reported item of satisfaction post-surgery was “improved self-esteem” (55.6%). Satisfaction with the result 1-year post-surgery was associated with the extent of %EWL. Satisfied patients (n = 32) had a mean %EWL of 94.6 (22.9), while those not satisfied (n = 8) had a mean %EWL of 59.9 (17.6).ConclusionsThe primary reason to seek bariatric surgery was weight loss. However, despite profound weight loss, improved self-esteem was the item of most satisfaction post-surgery. Our findings may be useful in the clinical setting when informing patients pre-surgery about what to expect as well as when meeting a patient post-surgery to discuss results.