Inclusion Criteria:  Obesity (BMI>30 kg/m2). Evidence of insulin resistance as defined by hemoglobin A1c > 5.7%. Mayo Clinic patients evaluated by Dr. Rahul Pannala. Pursue an endoscopic gastroplasty at Mayo Clinic Arizona in the Gastroenterology department. Equal distribution of gender. 18 yo older of age. BMI>30 kg/m2. Nonsmoker. Taking no medication affecting glucose or lipid metabolism. No more than 5% change in body weight in the previous 6 months. Mostly sedentary (engaging in strenuous exercise (> 70% max HR) less than 3 times a week). Not be receiving corticosteroid therapy. Have no history of asthma, COPD or atopic syndrome, or autoimmune disease (Ulcerative colitis, Chron's disease, eosinophilic esophagitis, any rheumatologic disease such as lupus, rheumatoid arthritis, Sjogren syndrome).  Exclusion Criteria:  <17 years of age. BMI <30 kg/m2. Smoker. Taking medication affecting glucose or lipid metabolism. Greater than 5% change in body weight within the previous six months. Engage in strenuous exercise (>70% max HR) less than 3 times a week. Receiving corticosteroid therapy. Have a history of asthma. History of COPD or atopic syndrome. History of autoimmune disease (Ulcerative colitis, Chron's disease, eosinophilic esophagitis, any rheumatologic disease such as lupus, rheumatoid arthritis, Sjogren syndrome).