Background: Long-term bariatric surgery studies are scarce. We report a 5- and 10-year follow-up after bariatric surgery with a focus on patient-centered outcomes. Methods: At the Maastricht University Medical Centre 150 participants completed mailed surveys in 2005 and 2010. Results: In 2005, average weight decreased from 134.5 to 96.2 kg, representing a mean weight loss of 28.5%. Body mass index (BMI) decreased 13.3 kg/m2, from 46.5 to 33.2, but patient-to-patient variability was high. In 2010, mean weight and BMI were unchanged when compared with 2005. Reoperation rates were 14% and 27% in 2005 and 2010, respectively, and were negatively associated with satisfaction (trend). In 2010, 40% were satisfied with their current weight, while 74% of the participants would, given current knowledge and experience, again opt for bariatric surgery 10 years earlier. Conclusions: Most subjects would reconsider a bariatric trajectory, although more than half were unsatisfied with their current weight. For patients, success of bariatric surgery seems more than weight loss. The results need to be replicated. If we can clarify the factors of (dis-)satisfaction from the patients' perspective, we can better understand how to set expectations and prevent a mismatch between patient and provider.