A team approach is necessary for the optimal care of the patient with morbid obesity. Prior to the initial clinic visit, the patient must provide evidence of a medically supervised diet, counseling and referral from a primary care physician, and completion of a reading assignment to include a comprehensive review of bariatric surgery including the types of procedures, expected results, and possible complications or attendance at a seminar regarding the same. At the initial visit the patient is expected to attend a group session on bariatric surgery and a presentation by the nutritionalist on dietary issues preoperatively and postoperatively. In addition, the patient has individual assessment and counseling with the surgical team and the dietician. Subsequent evaluations may include, as indicated, a full psychological evaluation, specialty medical evaluation, ultrasound of the gallbladder, and a pulmonary evaluation including baseline arterial blood gases. Finally, preoperative assessment by anesthesiology is warranted.