Bariatric surgery is an important and underutilized treatment for patients with obesity, and the pre-operative consultation process can be stressful. Patients can, understandably, experience a myriad of emotions ranging from excitement and frustration, or sadness and anger especially when things go awry. For some, bariatric surgery is not appropriate from a psychological, nutritional, or medical perspective. Patients may disagree with or not fully understand the recommendation against surgery from their team. The following panel includes three case presentations of patients who made complaints to the clinician's hospital system and/or state licensing board. We will review impressions from the team evaluation and recommendations for these patients, discuss ethical considerations, and share strategies to navigate these complex and stressful situations while practicing self-care.