BackgroundOnly a small proportion of eligible individuals undergo bariatric surgery. The purpose was to examine attrition to surgery and whether psychiatric symptoms and eating behaviors differentially predicted attrition among men and women. MethodData was collected from a retrospective chart review of 313 patients who underwent a pre-surgical psychosocial evaluation. ResultsThe overall attrition rate was 33.5%; 42.6% of men and 31.7% of women experienced attrition. In the multivariate analysis of the entire sample, White patients (OR = 2.33, CI: 1.33, 4.08) and those without a history of binge eating (OR = 2.71, CI: 1.23, 5.97) were more likely to undergo surgery. In a multivariate analysis of women only, race and binge eating independently predicted attrition; however, no factors significantly predicted attrition among men. ConclusionsFactors identified at the pre-surgical psychosocial evaluation can identify patients at risk for attrition, and these factors may differ for men and women.