This extension request describes a 4-month funded extension for the K23 awardee who is in her final year of funding (5K23HL135394-05). The recipient experienced an 8-month research interruption due to lab closures and clinical research restrictions on Boston University Medical Campus due to the COVID- 19 pandemic. Further COVID-19 disruptions extended this research interruption by an additional 19- weeks. However, with the current COVID-19 situation improving in the Boston area, the applicant?s research program is operating at maximum capacity and will generate sound scientific data for the outcomes in Aims 1 and 2 within the original funding period. The 4-month funded extension is essential for this early stage investigator to develop more complete and scientifically robust answers to the outcomes proposed in Aim 3 that are currently trending toward significance. Briefly, Aim 3 examines the effect of surgical weight loss on insulin resistance, micro- and macrovascular functions, fat tissue histopathology and adipose tissue characteristics by CT imaging. During the 8-month COVID-19 shut down, 35% of the enrolled participants became ineligible for their 6-month post bariatric surgical return visit. Thus, the combination of her current recruiting efforts and the additional 4-months extension of salary support will not only provide time but the resources to complete the studies that are likely to provide novel and clinically important information regarding mechanisms of obesity-related vascular disease in severely obese individuals.