Inclusion Criteria:  BMI ≥ 35 kg/m2 Between ages 18-50 years Not pregnant Diabetic (Current use of diabetes medication or fasting glucose ≥126 mg/dL) Medical clearance to participate in a moderate-intensity exercise program  Exclusion Criteria:  Pregnant women Current smokers Currently abusing alcohol or drugs Chronic heart, liver, or kidney diseases, autoimmune diseases, or cancer Non-English speakers History of allergic reactions to lidocaine