BACKGROUND: Polycystic ovary syndrome (PCOS) commonly co-occurs with obesity, medical comorbidities, and psychiatric symptoms. Bariatric surgery is an effective treatment for co-occurring obesity and PCOS. While the incidence of PCOS declines substantially after bariatric surgery, the condition is still present for a subset of women. Examining characteristics and clinical outcomes of those with and without PCOS post-surgery may underscore potential risk factors or intervention targets. METHODS: Individuals up to four years after bariatric surgery were invited to participate in this cross-sectional survey study, which included validated measures of depression, anxiety, eating disorder pathology, and quality of life. Post-surgical weight outcomes, medical comorbidities, and mental health treatment engagement were also assessed. Regression analyses were performed to examine differences in outcomes between those with and without a PCOS diagnosis after bariatric surgery. RESULTS: Of the 657 female (sex assigned at birth) participants who underwent bariatric surgery, 7% (n = 46) reported having a current diagnosis of PCOS. All females identified as women. Women with PCOS were significantly younger (p <
0.001) and were more likely to endorse migraines (p <
0.007) and loss of control (LOC) eating episodes (<
0.001) since undergoing surgery. Additionally, 47.8% of women with PCOS endorsed clinically significant anxiety, compared to 25.7% of women without PCOS (p = 0.03). There were no differences in other demographic, psychiatric, or medical characteristics. CONCLUSION: Despite the low prevalence of PCOS diagnoses in the four years after bariatric surgery, this subpopulation may be particularly susceptible to migraines, disinhibited eating behavior, and anxiety, although weight and cardiometabolic outcomes were comparable to those without a diagnosis of PCOS post-surgically.