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There is currently an increasing role for bariatric surgery in the treatment of obesity. However, not all patients experience a successful outcome in terms of weight loss achieved. Failure to attain sufficient weight loss or weight regain may be attributed to numerous factors. It is essential to adequately evaluate these patients to determine if they have behavioral issues that might be responsible for their weight loss failure. If a structural cause is identified it might be necessary to revise the primary operation with an aim to produce further weight loss.