Patients and their insurers spent $4.3 billion last year for 171,000 bariatric surgeries at an average of $25,000 each, says the American Society for Bariatric Surgery. When you look at those numbers, it might be tempting to think you can rush in and begin hosting bariatric procedures. But the experts we talked to say weight-loss is a program you launch, not a surgery you add, an all-consuming endeavor that requires institution-wide backing and unwavering commitment.