Background: The My True Body (MTB) group intervention incorporates cognitive restructuring and social support into bariatric surgery preparation. Purpose: To identify and describe program components that support long-term behavioral modifications and influence confidence in healthy weight maintenance. Methods: Semistructured telephone interviews exploring motivations for participation, advantages, disadvantages, and differentiating characteristics of MTB were conducted among participants who completed MTB between March 2010 and December 2011. Qualitative data analysis was performed to identify emergent themes. Results: Four primary themes emerged: (1) the value of interpersonal support and shared experiences, (2) possibilities for psychological transformations, (3) MTB's philosophy as an alternative to dieting, and (4) increased capacity for healthy weight maintenance. All study participants identified at least one psychosocial benefit. Key cognitive benefits included clarified motivations for weight loss surgery and changed attitudes toward food and eating. Discussion: Support and shared experiences and adoption of MTB's philosophical orientation provide pathways to psychological transformation; such transformation appears to be prerequisite to increasing capacity for healthy weight maintenance through increased self-efficacy. Translation to Health Education Practice: Integrating psychological self-exploration, social support, and behavior modification training into presurgical education might enhance weight loss and stress management, with or without bariatric surgery, among obese individuals.