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Background: We sought to determine if adolescent patients with super-obesity (body mass index, BMI >50 kg/m2) have different outcomes in weight loss and obesity-related co-morbidity (ORC) resolution when compared to patients with a BMI <49.9kg/m2. Methods: We identified patients aged 15-21 years who underwent bariatric surgery from 2011 to 2016. Patients were stratified according to the preoperative BMI into BMI greater than 50 kg/m2 (group A) compared to those with BMIs between 30 and 49.9 kg/m2 (group B). Mean change in percent weight loss and rate of ORC resolution were measured. Results: One hundred twenty patients were included, with 21 patients in group A and 99 patients in group B. Patients in group A had a BMI of 56.09 kg/m2, while group B had a BMI of 42.61 kg/m2. Group A's percent weight loss of 30% (45.5 kg) and 41% (62.3 kg), at 1- and 2-year follow-up, respectively. Group B's percent weight loss was 28% (34.7 kg) and 32% (38.8 kg), at 1- and 2-year follow-up, respectively (p < 0.05). There was no difference in ORC resolution rates. Conclusions: We found that group A had greater percent weight loss at 1 and 2 years compared to patients in group B. No significant differences were found in ORC resolution.