This case report presents a 37-year-old male patient with a history of bariatric surgery, bipolar disorder, and alcohol use disorder. Despite maintaining social and occupational functionality, the patient exhibits a marked pattern of alexithymia, denial, and passive-aggressive resistance to treatment. We explore the clinical evolution, therapeutic challenges, and psychodynamic underpinnings of what we define as “alexithymic addiction,” with possible connections to the psychosomatic framework of the Paris School and the Lacanian notion of foreclosure. Special attention is paid to the psychiatric implications of bariatric surgery and the need for emotionally ventilating therapeutic modalities