Inclusion Criteria:  Subjects who have had sleeve gastrectomy Willing to provide informed consent Agree to all study procedures and assessments.  Exclusion Criteria:  Weight greater than 450 lbs Regular use of growth hormones, oral steroids, or prescription osteoporosis medications; Known allergies to bisphosphonates Unstable gastric reflux requiring two or more additional doses per month of anti-reflux medication. Current participation in other research study Unable to provide own transportation to study visits Unable to position on scanner independently.