Background Although complications primarily affect patients, they also seem to cause repetitive trauma for surgeons. The concept of the "second victim" was introduced by Dr. A. Wu in 2000. This study aims to analyze the psychological impact of serious complications on metabolic and bariatric surgeons. Methods The target population included all metabolic and bariatric surgeons who are members of the Société Française et Francophone de Chirurgie de l'Obésité et Maladies Métaboliques (SOFFCO.MM). A questionnaire was developed by two surgeons, and refined by a group of psychologists. Results A total of 130 participants completed the questionnaire. Serious adverse effect affected surgical practice and professional confidence in 41.3% of cases, and had negative repercussions at family level in 39.7% of respondents. These complications led to feelings of guilt, anxiety and sleep disorders (53.7%, 53.7%, 44.6%). Excessive workload, a macho culture and a lack of communication within the team were the main obstacles to seeking help (60.3%, 47.1%, 40.5%). Women and young surgeons (30–40 years) were more affected by complications in their surgical practice and self-confidence (p = 0.03 and p = 0.019). Neither regular physical activity nor meditation showed any significant benefit in mitigating these effects. Conclusions This study highlights the significant psychological burden that serious complications impose on metabolic and bariatric surgeons. Due to a lack of institutional support, surgeons often manage emotional distress privately rather than professionally. Urgent action is needed to implement comprehensive support systems.