Pharmacological and Behavioral Treatment After Bariatric Surgery

Eligibility Criteria

• * Provision of signed and dated informed consent form
• * Stated willingness to comply with all study procedures and availability for the duration of the study (up to 18 months: 6-month treatment plus 12-month follow up)
• * Have a BMI ≥30 (or BMI ≥27 with a medical comorbidity) and BMI ≤50 kg/m2
• * Have had laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy
• * Suboptimal weight outcomes after MBS
• * Be an otherwise healthy subject without uncontrolled medical problems, as determined by the study physician and medical co-investigators (physical examination, laboratory studies).
• * Have had a physical in the past year
• * Read, comprehend, and write English at a sufficient level to complete study-related materials.
• * For females of reproductive potential: use of highly effective contraception and agreement to use such a method during study participation
• * For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner
• * Has a predisposition to seizures (e.g., subject with a history or evidence of seizure disorder, febrile seizures during childhood, brain tumor, cerebrovascular disease, or significant head trauma; has a family history of idiopathic seizure disorder or is currently being treated with medications or treatment regimens that lower seizure threshold).
• * Has a history of anorexia nervosa or history of bulimia nervosa.
• * Is currently taking a medication that is a contraindication to NB medication (e.g., MAOI, opiates).
• * Is currently using other medications for weight loss.
• * Has a history of allergy or sensitivity to bupropion or naltrexone.
• * Has a co-existing psychiatric condition that requires hospitalization or more intensive treatment (such as bipolar mood disorders, psychotic illnesses, or severe depression)
• * Has untreated hypertension with a seated systolic blood pressure \> 160 mmHg, diastolic blood pressure \> 100 mmHg, or heart rate \> 100 beats/minute.
• * Has a history of congenital heart disease, cardiovascular disease, cardiac arrhythmias requiring medication, or a history of cerebrovascular pathology including stroke.
• * Has current uncontrolled hypertension.
• * Has current uncontrolled Type I or Type 2 diabetes mellitus.
• * Has untreated hypothyroidism with a TSH \> 1.5 times the upper limit of normal for the test laboratory with repeat value that also exceeds this limit.
• * Has gallbladder disease.
• * Has a history of severe renal, hepatic, neurological, chronic pulmonary disease, or any other unstable medical disorder.
• * Has a recent history of drug or alcohol dependence.
• * Is currently in active effective treatment for eating or weight loss such as behavioral weight loss of FDA-approved weight loss medications.
• * Is currently participating in another clinical study in which the subject is or will be exposed to an investigational or a non-investigational drug or device.
• * Is breast-feeding or is pregnant or is not using a reliable form of birth control.
• * Reports active suicidal or homicidal ideation.
• * Has poor eye health