Purpose of Review <p>This review explores the intricate and bidirectional relationship between mood disorders and obesity, focusing on the psychiatric implications of metabolic bariatric surgery and weight-loss pharmacotherapy. In particular, the review examines how these interventions impact psychiatric outcomes, identifying both benefits and risks.</p> Recent Findings <p>While metabolic bariatric surgery and incretin-based therapies improve metabolic health and, in some cases, mental well-being, they may also lead to psychiatric complications. Studies indicate increased risks of mood episodes, self-harm, and altered psychotropic drug metabolism post-surgery. Concerns have also emerged regarding glucagon like peptide-1 (GLP-1) receptor agonists and their potential link to depression and suicidality.</p> Summary <p> Weight-loss interventions require thorough psychiatric assessment prior to treatment, as well as long-term psychiatric monitoring thereafter. Future research should prioritize longitudinal studies with standardized psychiatric assessments to refine risk stratification and optimize clinical outcomes. A multidisciplinary approach integrating endocrinology, psychiatry, and behavioral sciences is essential for improving both physical and mental health outcomes.</p>