Study participation by invitation. Patients will be invited to participate after completing all necessary clinical visits including lab studies, counseling, and participation in educational programs. During the pre-operative visit patients interested in participation will complete all necessary consent documentation, during surgery tissue collection will include subcutaneous & omental fat, jejunum (Gastric Bypass), gastric remnant (sleeve gastrectomy), and liver biopsy. Post surgery patient will be observed for weight loss and resolution of co-morbidities. At designated times post surgery when lab studies are ordered additional blood/urine samples will be collected and analyzed.