Recently the National Heart, Lung, and Blood Institute (NHLBI) released an executive summary of the 2011 NHLBI Bariatric Surgery Workshop that was held in January. Experts in bariatric surgery, cardiovascular disease, sleep disordered breathing, clinical trials, guideline development, and insurance coverage concurred with the need for randomized controlled trials as an important next step in developing a strong evidence base for bariatric surgery. They identified patients at high risk for cardiovascular disease as a priority population for clinical trials in bariatric surgery, while also identifying patients with sleep disordered breathing as an important sub-population to include. The workshop group also determined that shorter length trials should focus on recognized surrogate or intermediate markers such as changes in sleep disordered breathing as measured by the apnea-hypopnea index.