Background <p>The preoperative effect of mindful eating on the choice of surgical or non-surgical treatment in obesity treatment has not yet been sufficiently investigated. This study aimed to investigate the relationship between mindful eating behaviors and the preference for bariatric surgery among individuals with obesity.</p> Methods <p>A case-control design was employed involving 42 patients who chose bariatric surgery and 84 patients who preferred non-surgical treatment. Participants completed the Mindful Eating Questionnaire (MEQ), and sociodemographic and clinical data were collected. Group differences were analyzed, and logistic regression identified independent predictors of surgical preference.</p> Results <p>The mean score of the conscious eating subscale was significantly lower in the bariatric surgery group compared to the control group (<i>p</i> = 0.004), although total MEQ scores did not differ significantly (<i>p</i> = 0.053). Logistic regression analysis revealed that lower conscious eating scores (OR: 0.35 [0.17–0.74]), being single (OR: 3.39 [1.01–11.39]), and higher BMI (OR: 1.19 [1.08–1.32]) were independent predictors of bariatric surgery preference.</p> Conclusion <p>Our findings highlight the role of preoperative conscious eating behaviors in obesity treatment choices and suggest mindful eating interventions could aid decision-making, but further trials are needed to confirm their impact.</p>