This study will compare same day discharge and at least one night stay in the hospital after bariatric surgery. Patients undergoing bariatric surgery will be randomized (i.e. have an equal chance of either plan) to either group. The study's primary outcome is the frequency patients in the study require a visit to the emergency room within 7 days of their surgery.

This pragmatic, parallel, randomized, open-label trial aims to determine the safety and feasibility of same day discharge (SDD) for bariatric surgery including sleeve gastrectomy and gastric bypass. Investigators will investigate the frequency of 7-day emergency department visits with SDD after bariatric surgery (Aim 1). In addition, the investigators will compare total 30-day charges between participants who undergo same day discharge versus those receive post-operative hospital admission (Aim 2).

Inclusion Criteria:

• BMI ≤ 60 kg/m2
• Primary Sleeve gastrectomy or Gastric Bypass,
• Undergoing bariatric surgery at sponsor site

Exclusion Criteria:

• Type 1 Diabetes
• Myocardial Infarction
• Unstable Angina or Heart Failure
• Prior Stroke
• Solid organ transplantation
• Systemic glucocorticoid prior 28 days
• Severe Obstructive Sleep Apnea
• Uncontrolled Hypertension (Systolic > 150, Diastolic > 90)
• Untreated Hyperthyroidism
• Chronic Kidney Disease (EGFR < 60)
• Current anticoagulant use,
• Poorly controlled Type 2 diabetes (Hemoglobin A1c in last 3 months > 8.5%)
• Chronic opioid use
• Insulin dependence.
• Need for extended venous thromboembolic event prophylaxis,
• > 1 lifetime bariatric surgery (revisional or conversion bariatric surgery)
• Patient lives > 130 miles from the hospital.
• Tobacco use in last 12 months
• Desire to become pregnant or active pregnancy
• Prisoners
• Unable or unwilling to follow-up
• Unable to understand or provide consent

All participant-level data will be preserved and shared. Shared data will be deidentified prior to sharing. Clinicaltrials.gov will document recruitment progress and final results. Study protocols will be shared with publications as supplementary data and made available upon request. All participant consent document will be collected and stored electronically utilizing the REDCap study data repository. The REDCap data warehouse will also contain the study data dictionary. Study protocols have also been published on the ClinicalTrials.gov and any protocol amendments will be reflected on the ClinicalTrials.gov study page. The investigators will utilize the Research Electronic Data Capture (REDCap) data warehouse maintained locally at Vanderbilt for all data collection. Upon study completion and prior to closing the REDCap data warehouse for this study, the investigators will archive all data after removing patient identifiers in the Open Science Framework data repository.

Per institutional policy, data will be maintained in the local REDCap data repository for 6 years after closure of the study. Following this period, data will be deidentified and uploaded to the OSF repository, which has funding for at least 50 years of data storage.

Data will be made available upon request after completion of appropriate institutional review board approval and data use agreement obtainment.