Obesity increases the risk of various weight-related disorders, including esophageal reflux disease. In this chapter, we complete a focused review of GERD before and after bariatric surgery. We will discuss the prevalence and pathophysiology of reflux in bariatric surgery patients. The rationale and management of reflux before bariatric surgery will also be addressed including surgical options such as fundoplication and the various bariatric surgery procedures that can improve reflux disease. Finally, we will discuss anti-reflux treatment options after weight loss surgery, in particular conversion from sleeve gastrectomy to Roux-en-Y gastric bypass (RYGB), placement of LINX, as well as fundoplication after sleeve gastrectomy and RYGB.