Nearly one fourth of all Americans are obese or morbidly obese. In fact, the number of morbidly obese persons has been increasing over time and this trend is expected to continue. Not surprisingly, many physicians are considering specializing in bariatrics and opening new practices. From a business standpoint, the decision to open a bariatric practice should be based on whether or not the enterprise can achieve an acceptable rate of profit. The application of economic tools in conjunction with techniques of operations management can increase the likelihood that this decision will be optimal. Clearly, the central question of whether to take on a project such as opening a specialized practice is: Do the benefits outweigh the costs? The guidelines presented here focus on identifying factors that lead to value enhancement; the bariatric physician should consider these when making decisions about the business side of his or her practice.