Class three Obesity is an epidemic that affects public health. Also known as severe or morbid obesity, it is linked to preventable premature death and multiple health conditions like cardiovascular diseases, diabetes, sleep apnea, certain types of cancer, and musculoskeletal pain. Severe obesity is becoming more prevalent across all races and age groups and causes a significant increase in healthcare costs. Severe obesity impairs clients’ participation in activities of daily living, work and study, rest and sleep, and social interactions. Bariatric surgery is commonly prescribed to facilitate weight loss to reverse health risks. Unfortunately, weight regain is common among clients who fail to commit to lifestyle changes. Occupational therapists can play a vital role in bariatric rehabilitation, pre- and post-bariatric surgery, to help clients adopt a healthier lifestyle, increase energy expenditure, improve quality of life, and increase participation in meaningful occupation.