BACKGROUND: Overvaluation of shape and weight (OSW) is a risk factor for psychopathology in those who have undergone bariatric surgery, and overvaluation of excess skin (OES) may present similar psychological risks. Identifying potential gender and racial differences in post-surgical OSW and OES, and their associations with psychosocial outcomes, may inform more individualized assessment and treatment for those who have undergone bariatric surgery. METHODS: In this cross-sectional study, individuals up to 4 years post-bariatric surgery completed an online survey of various psychosocial outcomes. Overvaluation was examined via the shape and weight overvaluation subscale of the Eating Disorders Examination Questionnaire (EDE-Q), and a modified item was used to assess the overvaluation of excess skin. Quality of life (QOL), depression, and anxiety symptoms were also examined. Gender and racial differences in OSW and OES were examined. Correlations were obtained between OSW/OES, QOL, and psychological symptoms among gender and racial groups. RESULTS: Of 735 participants, women endorsed significantly greater OES than men (p = .008). There were no significant gender differences in OSW. White patients endorsed greater OSW than Black patients (p <
.001), and there were no racial differences in OES. OSW and OES were inversely correlated with QOL among all groups. OSW and OES were positively associated with anxiety and depressive symptoms among both racial groups and women. CONCLUSION: Women may be at greater risk for OES than men, while White patients may be at increased risk for OSW. However, OSW/OES related to poorer QOL in all groups, and greater psychological symptoms in women.