We require patients to begin a diet and exercise program that allows them to lose 10% of their weight pre-operatively for three reasons: Patients who undergo weight loss before surgery have fewer complications during and after surgery. This allows patients to truly understand the lifestyle changes that will occur after surgery and therefore make an informed consent about the diet and exercise programs that they will have to be on for the rest of their lives. This allows us to identify the patients who are truly motivated and therefore who will be most successful following surgery. Most important, we'll work with you to develop a weight-loss program to achieve the 10% reduction goal.