Objective The purpose of this study was to examine whether subgroups could be identified among a sample of adolescents presenting for bariatric surgery. Methods Participants were 125 severely obese adolescents enrolled in a bariatric surgery program referred for a psychiatric evaluation. A latent class analysis was conducted with self-report and clinician-rated measures of depressive symptoms, total problems by the Youth Self-Report Scale, anxiety severity, eating pathology, psychiatric diagnoses, quality of life, and family functioning. Results A 3-class model yielded the best overall fit to the data. Adolescents in the “eating pathology” class demonstrated high levels of both eating disordered and other psychopathology. The second class, or “low psychopathology” class exhibited the fewest psychosocial problems, whereas adolescents in the third class were intermediate on measures of psychopathology, which is consistent with “non-specific psychopathology.” Conclusions The latent class analysis identified homogeneous subgroups with different levels of psychopathology among a heterogeneous sample of severely obese adolescents. The identification of clinically relevant subgroups in this study offers an important initial means for examining psychopathology among adolescent bariatric surgery candidates and suggests a number of avenues for future research.