The prevalence of obesity, particularly morbid obesity in children and adolescents, continues to rise in the United States despite existing studies and intervention programs. Reports have shown that the obesity rate is more than 18% among 12 to 18-year-olds. Children who are morbidly obese are 5 times more likely to carry the condition into adulthood and are more likely to have shorter life expectancies of up to 14 years than their normal-weight peers. The purpose of this study was to investigate the influence of bariatric surgery and nonpharmacologic factors and their interactive effects on morbid obesity 3 years postsurgery in children and adolescents 12 to 18 years of age living in the U.S. and who have metabolic syndrome. This study was guided by the social ecological model. The research questions focused on whether bariatric surgery, diet, physical activity, age, gender, race, and their interactions influenced morbid obesity. A quantitative retrospective study design was employed with a sample size of 242. Logistic regression statistical analyses were conducted. Diet (p < .05) was a statistically significant predictor of morbid obesity; bariatric surgery (p > .05) and physical activity (p > .05) were not. The positive social change implication of this study is that it can lead to finding more effective obesity prevention or intervention programs to address the rising morbid obesity in children and adolescents and it can lead to future studies that seek to inform better obesity intervention programs.