Sixteen morbidly obese patients (12 females, four males) underwent the Scopinaro operation according to Gazet. Profound weight loss occurred, along with marked improvements in eating patterns, mood and psychosocial functioning which were reported retrospectively 1 year and repeated 2 years after surgery. Continued binge eating, comfort eating and 'eating sensibly/making up in private' were associated with reduced weight loss, suggesting that a therapeutic cognitive behavioral program to correct eating problems in association with the Scopinaro operation may increase weight loss. Some physical symptoms were related to increased (burping) or decreased (hunger, thirst) intake of food, but the patterns of preoperative symptoms did not predict postoperative physical symptoms or weight loss. Subjects were divided into two subgroups with (n = 8) or without (n = 8) a history of self-damaging and addictive behaviors. The aberrant behavior subgroup had more disturbed eating patterns preoperatively (higher BITE severity scores) but similar BITE scores postoperatively. Mean BMIs were similar before and after surgery. This suggested that patients with these aberrant behaviors should not be denied surgery. Half of the female patients reported early sexual abuse, and were lighter than the non-abused group. This merits further investigation.