Bariatric surgery has experienced unprecedented growth in the United States during the last 10 years [1]. Compared with the late 1980s and early 1990s, when approximately 15,000 bariatric operations were performed each year, in 2003 more than 100,000 bariatric operations were performed in the United States. This growth in bariatric surgery, the fastest-growing major operation in the United States, can be explained by 3 factors: (1) the 4-decades-old epidemic of obesity, (2) steadily improving outcomes for several bariatric operations, and (3) the introduction of laparoscopic bariatric surgery with improved perioperative outcomes.