Bariatric surgery is becoming an increasingly used tool for the management of severe obesity in youth; however, outcomes after surgery are variable. Keeping adolescents engaged in treatment postsurgery is critical, yet little research has focused on this area. A review of the literature using Pubmed, Ebscohost, and PsycINFO and terms “bariatric surgery,” “gastric bypass,” “gastric band,” “sleeve gastrectomy,” “retention,” “attrition,” “engagement,” and “participation” was conducted. In addition, a survey to the psychologists working with adolescent bariatric surgery programs was conducted. Only 3 manuscripts met the inclusion criteria, demonstrating a significant lack of literature in this area. Age, baseline mood and eating symptoms, Body Mass Index (BMI) and parental history of bariatric surgery were some factors identified as being related to attrition. From the survey, members identified the following as the most common strategies to keep families within treatment: access to providers in between appointments, appointment reminders, and in person support groups. Little work exists focusing on retention, and follow-up for adolescent bariatric surgery patients. This is concerning given that these patients may be at high risk for negative consequences without follow up. This is a critical issue that adolescent bariatric surgery programs should commit to understand better, report findings, and systematically address.