This study aims to determine the relationship between lipid kinetics changes and blood immunosuppressive cells by metabolic surgery in two patient cohorts.

For an eligible subject, all the following must be answered "yes":

• Biological female sex
• Age >=35 and <=60 years (including pre- and postmenopausal)
• Self-reported white or black race
• The study will enroll approximately 50% white and 50% black subjects
• Body mass index >/=40 kg/m2
• Have a diagnosis of hyperlipidemia (high triglycerides and LDL-cholesterol) or in treatment with any medication for hyperlipidemia at enrollment
• Ability to provide written informed consent
• Allow the collection and storage of biospecimens and data for future use
• Not having yet started the pre-op liquid diet before the bariatric surgery

For an eligible subject, all the following must be answered "no":

• Have type one or type two diabetes
• Use of anti-inflammatory medications, such as glucocorticoids or non-steroidal anti-inflammatory medications, within the past 15 days
• Use of medication approved for obesity management, including, but not limited to, phentermine-topiramate (Qsymia), orlistat (Xenical), naltrexone-bupropion (Contrave), liraglutide (Saxenda), and semaglutide (Wegovy)
• History of cancer of any type
• History of chronic conditions known to cause inflammation, such as tuberculosis, autoimmune disease, and human immunodeficiency virus
• An acute history (within the past 60 days) or confirmed or suspected SARS-CoV-2 (COVID-19) infection
• Currently pregnant, breastfeeding, or planning to become pregnant within the next 52 weeks
• Currently participating in another study with competing outcomes
• Any other situation that, in the opinion of the investigator, would negatively impact subject safety or successful compliance with the protocol

The study population will include women with class III obesity who plan to undergo or have completed treatment with metabolic and bariatric surgery.