OBJECTIVES: British Columbia (BC) currently performs around 250 bariatric procedures annually.  The number of individuals eligible for bariatric surgery in BC is approximately 87,000 and is increasing at about 1.04% annually. Obese individuals are high volume users of the healthcare system and bariatric surgery has proven to be an effective intervention for weight loss and reducing the impact of obesity-related disease.  The objective of this study was to determine the budget impact of increasing the volume of bariatric procedures performed in BC to 1% of all eligible patients each year. METHODS: A budget impact model accounting only for direct health care costs was created using data from Statistics Canada, peer-reviewed literature, Canadian Institute for Health Information and case-costing and resource utilization data from several Canadian hospitals. The model assumes an inflation rate of 2% per annum on future costs. A series of one and multi-way sensitivity analyses were performed around a number of parameters using a Monte Carlo simulation to establish the influence on model outcomes. RESULTS: Bariatric surgery is an expensive procedure estimated at CAD $12,804.81. It is also associated with high pre and post-operative costs that stem from the significant support required by healthcare professionals and the cost of potential surgical complications. Comparatively, individuals not receiving surgical intervention (the standard of care) also incur a significant amount of healthcare expenditure caused by the high prevalence of multiple chronic and acute conditions within this population. The results of the budget impact analysis determine that over 10 years, an individual that undergoes bariatric surgery incurs CAD $6,260.88 less in direct provincial healthcare expenditure when compared to an individual receiving the standard of care. CONCLUSIONS: By increasing the number of bariatric procedures performed to 1% of eligible individuals each year, BC could reduce healthcare spending by CAD $4,603,250.77 over 10 years.