BACKGROUND: African-American (AA) women have higher rates of obesity and obesity-related diseases but are less likely than other women to undergo bariatric surgery or have success with conventional weight loss methods. OBJECTIVE: To explore obese AA women’s perceptions regarding barriers to weight loss and bariatric surgery. DESIGN: Focus groups to stimulate interactive dialogueabout beliefs and attitudes concerning weight management. PARTICIPANTS AND APPROACH: We partnered with acommunity organization to recruit women who were AA, were ≥18 years old, and had a body mass index (BMI) of ≥30 kg/m2. We audiotaped the 90-minute focus groups and used content analysis for generating and coding recurring themes. RESULTS: In our sample of 41 participants, the mean age was 48.8 years and mean BMI was 36.3. Most participants were unmarried, had some postsecondary education, and reported good or fair health. About 85% knew someone who had undergone bariatric surgery. Qualitative analysis of 6 focus group sessions revealed that the most common barriers to weight loss were lack of time and access to resources; issues regarding selfcontrol and extrinsic control; and identification with a larger body size. Common barriers to bariatric surgery were fears and concerns about treatment effects and perceptions that surgery was too extreme or was a method of last resort. CONCLUSIONS: Only through the elimination of barriers can AA women receive the care needed to eliminate excess weight and prevent obesity-related morbidity and mortality.