Overview

Overview

Cleveland Clinic Weston Hospital’s Bariatric & Metabolic Institute and Section of Minimally Invasive Surgery works with patients who are in need of weight loss through bariatric surgery (commonly called weight loss surgery) and patients who have complex diseases of the upper gastrointestinal tract.

Cleveland Clinic Weston Hospital has been designated a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®). This accreditation acknowledges the hospital's commitment to providing and supporting quality improvement and safety efforts for patients undergoing metabolic and bariatric surgery.

The bariatric surgeons at Cleveland Clinic are fellowship-trained with a proven record of favorable outcomes when compared to national benchmarks.

How Do I Get Started?

How Do I Get Started?

Cleveland Clinic is with you every step of the way.

The Bariatric and Metabolic Institute at Cleveland Clinic Weston Hospital offers monthly virtual patient orientations to provide important information about the surgical weight loss options available at Cleveland Clinic Weston Hospital. Participants can interact with our registered dietitians to answer any questions or concerns.

The institute strives to educate the public on the benefits of weight loss surgery and provide nutrition information. We recognize the need for continued support as you adapt to a new lifestyle. All of our virtual patient orientations and support groups are provided at no cost. Join us at an upcoming virtual orientation to learn more about the options available to you.

Your safety is our first priority that is why the Bariatric Metabolic Institute team have made all in-person patient orientations and support groups virtual to keep us all safe during this time.

For more information or to speak with one of our registered dieticians directly, call 954.659.5872.

Virtual Patient Orientations

Registration for virtual patient orientations are now available during the following dates and times:

Virtual Patient Orientation Schedule

Patient Orientations in English

Patient orientations in English are held every week on Tuesdays and Thursdays

  • Time: 8 a.m. to 9 a.m.
  • Tuesday Virtual Patient Orientation in English: Register Now
  • Thursday Virtual Patient Orientation in English: Register Now

Patient Orientations in Spanish

Patient orientations in Spanish are held the first Tuesday of the month

  • Time: 4 p.m. to 5 p.m.
  • Tuesday Virtual Orientation in Spanish: Register Now

How to Attend a Virtual Patient Orientation

Bariatric Surgery & Nutrition Resources

The Bariatric and Metabolic Institute at Cleveland Clinic Weston Hospital offers a variety of resources for all pre and post-operative weight loss surgery patients and their families. Our registered dieticians provide general information, nutrition and emotional support focusing on valuable information pertinent to bariatric surgery, nutrition and lifestyle.

Below are pre-recorded presentations by our registered dieticians to watch at your convenience. The presentations are updated on an ongoing basis, check back for new presentations.

For more information or to speak with one of our registered dieticians directly, call 954.549.5872.

About Obesity

About Obesity

What Is Obesity?

Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk.

Today, more than 42% of the American adult population is obese. An estimated five to 10 million of those are considered morbidly obese.

Severe obesity is typically defined as being 100 pounds or more over ideal body weight or having a Body Mass Index (BMI) of 40 or higher. Patients with type 2 obesity (BMI 35 to 40) are also considered at risk and are candidates for bariatric interventions.  According to the National Institutes of Health Consensus Report, morbid severe obesity is a serious disease and must be treated as such. It is a chronic disease, meaning that its medical complications, and symptoms build slowly over an extended period of time.

Related Links

Causes Of Morbid Obesity

The underlying causes of severe obesity are not known. There are many factors that contribute to the development of obesity including genetic, hereditary, environmental, metabolic and eating disorders. There are also certain medical conditions that may result in obesity such as steroid use and hypothyroidism.

Medical Conditions

A medical condition, such as hypothyroidism, can cause weight gain. That’s why it’s important that you work with your doctor to make sure you do not have a condition that should be treated with medication and counseling.

Options For Treatment

For anyone who has considered a weight loss program, there are a number of choices. In fact, to qualify for insurance coverage for weight loss surgery, many insurers require patients to have a history of medically supervised weight loss efforts.

Most non-surgical weight loss programs are based on some combination of diet/behavior modification, medications and regular exercise. Unfortunately, even the most effective medical interventions have proven to be moderately effective for only a small percentage of patients and period of time. It is estimated that less than five percent of individuals who participate in non-surgical weight loss programs will lose a significant amount of weight and maintain that loss for a long period of time.

Am I a Candidate

Weight loss surgery is major surgery. Its growing use to treat morbid obesity is the result of three factors:

  • Our current knowledge of the significant health risks of morbid obesity
  • The relatively low risk and complications of the procedures versus not having the surgery
  • The ineffectiveness of current non-surgical approaches to produce sustained weight loss

Surgery should be viewed first and foremost as a method for alleviating debilitating, chronic disease. In most cases, the minimum qualification for consideration as a candidate for the procedure is 100 pounds above ideal body weight or those with a Body Mass Index (BMI) of 40 or greater. A bariatric procedure will be considered for patients with a BMI of 35 or higher if the patient’s physician determines that obesity-related health conditions have resulted in a medical need for weight reduction and, in the doctor’s opinion, surgery appears to be the only way to accomplish the targeted weight loss.

What is your BMI?

The Body Mass Index provides individuals a score based on their height and weight. Find out how your weight rates by checking your BMI.

Obesity-Related Health Conditions

Obesity-related health conditions are health conditions that, whether alone or in combination, can significantly reduce your life expectancy. A partial list of some of the more common conditions follows. Your doctor can provide you with a more detailed and complete list.

Type 2 Diabetes

Obese individuals develop a resistance to insulin, which regulates blood sugar levels. Over time, the resulting high blood sugar can cause serious damage to the body.

High blood pressure/heart disease

Excess body weight strains the ability of the heart to function properly. The resulting hypertension (high blood pressure) can result in strokes, as well as inflict significant heart and kidney damage.

Osteoarthritis of weight-bearing joints

The additional weight placed on joints, particularly knees and hips, results in rapid wear and tear, along with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained, resulting in disk problems, pain and decreased mobility.

Sleep apnea/respiratory problems

Fat deposits in the soft palate and neck can cause intermittent obstruction of the air passage. Because the obstruction is increased when sleeping on your back, you may find yourself waking frequently to reposition yourself. The resulting loss of sleep often causes daytime drowsiness and headaches.

Gastroesophageal reflux/heartburn

Acid belongs in the stomach and seldom causes any problem when it stays there. When acid escapes into the esophagus through a weak or overloaded valve at the top of the stomach, the result is called gastroesophageal reflux, and “heartburn” and acid indigestion is a common symptom. Approximately 10-15 percent of patients with even mild sporadic symptoms of heartburn will develop a condition called Barrett’s esophagus, which is a pre-malignant change in the membrane lining the esophagus, a cause of esophageal cancer.

Depression

People who are seriously overweight face constant challenges to their emotions due to: repeated failure with dieting, disapproval from family and friends and sneers and remarks from strangers. They often experience discrimination at work, cannot fit comfortably in theatre seats, or ride in a bus or airplane.

Infertility

The inability or diminished ability to have a child.

Urinary stress incontinence

A large, heavy abdomen and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing.

Menstrual irregularities

Morbidly obese women often experience disruptions of the menstrual cycle, including interruption of the menstrual cycle, abnormal menstrual flow and increased pain associated with the menstrual cycle.

Chronic kidney disease

It is estimated that approximately 30% of severely obese subjects have suffered kidney damage that is related to the excessive deposit of fatty tissue and that can be significantly reversed with weight loss interventions.

Fatty liver disease

Fatty liver disease also known as NASH (nonalcoholic steatohepatitis) is a common associated illness in severely obese subjects that can lead to liver cirrhosis and its associated complications including liver failure.

Cancer

The Center for Disease Control (CDC) reported in 2019, the 40% of new cancers diagnosed in the United States are linked to obesity. In females, 46% of newly diagnosed cancers including breast, uterine and ovarian cancer are linked to obesity. In men, 26% of newly diagnosed cancers are linked to obesity as well.

What We Treat

What We Treat

  • Obesity, metabolic syndrome (Gastric Bypass, Gastric Sleeve, Gastric Banding)
  • Intragastric Balloon and Revisional surgery
  • Gallstones /laparoscopic cholecystectomy
  • Paraesophageal and Diaphragmatic Hernias
  • Gastric and esophageal cancer
  • Achalasia
  • Gastroesophageal reflux disease
  • Benign and malignant tumors of the stomach, duodenum and small bowel
  • Simple, complex, and re-operative inguinal, incisional and ventral hernias
  • Solid organ laparoscopic and open surgery of the spleen and adrenal glands
  • Gastroparesis
  • Flexible endoscopy of the upper gastrointestinal tract
Surgery Options

Surgery Options

Florida Weight Loss Surgery Options

The types of weight loss surgeries available fit into two categories:

  • Restrictive procedures that decrease food intake.
  • Malabsorptive procedures that alter digestion, thus causing the food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.

Laparoscopic Adjustable Gastric Banding (Lap Band)

Laparoscopic Adjustable Gastric Banding, commonly referred to as Lap Band is a procedure that requires a surgeon to use laparoscopic techniques and instruments to place an adjustable silicon band around the upper part of the individual’s stomach. This in-turn creates a smaller restricted pouch, which becomes the new stomach and gives the feeling of being full after eating a small amount of food.

Gastric Bypass

Gastric bypass surgery is a procedure in which a small pouch is connected to the lower segment of the small intestine, making the patient’s stomach smaller. The purpose of gastric bypass surgery is to restrict the intake of food and give the individual a feeling of being full with less food. Also, bypassing part of the intestine results in decreased absorption of nutrients and alteration of the gastrointestinal hormones. The latter changes determine weight loss and have a positive influence on several of the co-morbid conditions, such as diabetes and high blood pressure. 

Gastric Sleeve Surgery

Gastric sleeve surgery involves removing a significant portion of an individual’s stomach and leaving about 25 percent to create a gastric “tube” or “sleeve” as the remainder for a new stomach. Surgical staples are used on the new stomach to keep it enclosed. The procedure results not only in a reduction of the stomach thus limiting the amount of ingested food, but also, similar to the gastric bypass, it results in a positive alteration of the gastrointestinal hormones.

Reoperative Bariatric Surgery

We perform highly complex re-interventions in patients that had failed or complicated bariatric procedures done within the Cleveland Clinic health system and outside institutions.

Choosing Surgery

Although most patients enjoy an improvement in obesity-related health conditions (such as mobility, self-image and self-esteem) after the successful results of weight loss surgery, these results should not be the overriding motivation for having the procedure. The goal is to live better, healthier and longer.

That is why you should make the decision to have weight loss surgery only after careful consideration and consultation with an experienced bariatric surgeon or a knowledgeable family physician. A qualified surgeon should answer your questions clearly and explain the exact details of the procedure, the extent of the recovery period and the reality of the follow-up care that will be required.

They may, as part of routine evaluation for weight loss surgery, require that you consult with a dietician/nutritionist and a psychiatrist/therapist. This is to help establish a clear understanding of the post-operative changes in behavior that are essential for long-term success.

Life After Surgery

The following identifies areas that will be important for patients to follow after weight loss surgery.

Nutrition

The modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Post-surgery dietary guidelines will vary by surgeon. You may hear of other patients who are given different guidelines following their weight loss surgery. It is important to remember that every surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of procedure. What is most important is that you adhere strictly to your surgeon’s recommended guidelines.

The following are some of the generally accepted dietary guidelines a weight loss surgery patient may encounter:

  • When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
  • Don’t drink fluids while eating. They will make you feel full before you have consumed enough food.
  • Omit desserts and other items with sugar listed as one of the first three ingredients.
  • Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
  • Avoid alcohol.
  • Limit snacking between meals.
  • Download Cleveland Clinic's Nutrition Manual

Going Back to Work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of weight loss surgery you had. Many patients return to full pre-surgery levels of activity within six weeks of their procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a few weeks.

Birth Control & Pregnancy

It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 12 to 18 months after weight loss surgery. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement

Long-Term Follow-Up

Although the short-term effects of weight loss surgery are well understood, there are still questions to be answered about the long-term effects on nutrition and body systems. Nutritional deficiencies that occur over the course of many years will need to be studied. Over time, you will need periodic checks for anemia (low red blood cell count) and Vitamin B12, folate and iron levels. Follow-up tests will initially be conducted every three to six months or as needed, and then every one to two years.

Staff

Staff

  • Lillian Craggs-Dino, MS, RD, LDN, CLT, PhD
    Registered dietitian, nationally known with more than 14 years of professional experience in bariatric nutrition. She is the Bariatric Institute Support Group Coordinator and has a doctorate degree in health care administration from the University of Phoenix and a master-of-science degree in dietetics and nutrition from Florida International University. She is currently the Vice President of Integrated Health for the Florida State American Society of Metabolic and Bariatric Surgery.
  • Mindy Mund, RN, CBN
    Clinical nurse and serves as the Bariatric Program Coordinator at Cleveland Clinic Florida. She facilitates the assessment, planning, organization and evaluation of the program. She has a bachelor-of-science degree in nursing from Chamberlain College of Nursing in Dowers Grove, Illinois.
  • Gina Sweat, MS, RD, LDN
    Registered dietitian at Cleveland Clinic Florida's Bariatric and Metabolic Institute where she educates patients on the nutritional and behavioral aspects of their medical conditions, including diabetes, bariatric surgery, cardiovascular disease, hypertension, obesity and renal disease. She has a bachelor-of-science degree in dietetics and nutrition from Javernia University in Bogota Columbia and Florida International University and a Master of Science degree from Florida International University.
Testimonials

Testimonials

Jose Rodriquez

Jose Rodriguez Before and After | Cleveland Clinic Florida

Procedure: Gastric Bypass
Before Weight: 375 lbs.
After Weight: 215 lbs.

“From the first seminar I went to at Cleveland Clinic Florida’s Bariatric Institute, I fell in love with everyone in the program. The surgeons and staff, the support, the entire program — everything about Cleveland Clinic Florida put me at ease.”

For over three decades, Jose Rodriquez knew his weight, sometimes topping 375 pounds, put his health at great risk of heart disease, stroke, diabetes, and other serious health conditions. He sought bariatric, or weight loss surgery, more than once. But physicians said his other health issues made surgery too risky. That changed when he moved to Miami.

“From the first seminar I went to at Cleveland Clinic Florida’s Bariatric Institute, I fell in love with everyone in the program,” he says with a wide grin. “The surgeons and staff, the support, the entire program — everything about Cleveland Clinic Florida put me at ease.” They told him they could help, and he now considers the date of his surgery: February 26, 2013, “my new birthday,” he calls it. Now three years later, the 50-year-old just completed his first-ever 5K run “without even breaking a sweat,” whereas before he couldn’t walk across a room without gasping for air.

Results like this require a lifelong commitment from both the patient and the bariatric team, says Samuel Szomstein, MD, a bariatric surgeon at Cleveland Clinic Florida. We offer a comprehensive range of services for our patients’ for life.

And the team’s experience matters. Research shows that patients have greater success with high volume surgery centers. At Cleveland Clinic Florida, our team has treated over 6,000 patients with bariatric surgery.

“For all of our patients, the rewards of this program are remarkable,” says Dr. Szomstein. “But for those who have other serious health conditions, it can be life-saving.”

Still a regular member of the bariatric support group, Mr. Rodriquez continues to steadily lose weight and has dropped from a BMI of 44 to 33. “I thank God for placing this group in my path and the team for saving my life,” he says.

Michele C. Knowles

Michelle Knowles Before and After | Cleveland Clinic Florida

Procedure: Gastric Bypass
Before Weight: 245 lbs.
After Weight: 129 lbs.

“They provide a fabulous network of support for all patients - outstanding nutritionists, a psychologist and support group meetings - which is essential and vital for a gastric bypass patient...”

As I compose these words, many will read it and say, "this is me!" I have battled weight gain my entire life. I have tried this diet and that diet. I have lost and gained the same weight over and over again through the years. Then the weight loss stopped and I was only gaining. A red light went off in my head.

I did extensive research and talked to a lot of people before considering gastric bypass surgery. The decision to undergo gastric bypass wasn't made hastily. I visited several doctors for consultations and advice before choosing a doctor. Finally, I chose Dr. Raul Rosenthal at the Cleveland Clinic Florida in Weston. Not only is he a fantastic surgeon who made me feel comfortable and secure, but his entire staff is outstanding. They provide a fabulous network of support for all patients, such as outstanding nutritionists, psychologist, and support group meetings. This support is vital for a gastric bypass patient before and after the surgery.

I am very happy to say that I have lost 116 lbs. so far, and I must thank the entire staff at the Bariatric and Metabolic Institute. If you are struggling with weight and it has reached a point where you can no longer control it, do not hesitate to contact Cleveland Clinic Florida. You will not regret it.

Ralph Moccia

Ralph Moccia Before and After | Cleveland Clinic Florida

Procedure: Gastric Bypass
Before Weight: 340 lbs.
After Weight: 210 lbs.

“Cleveland Clinic Florida has a world class bariatric team, from the docs to the nurses and nutritionists. They have the tools to make it work…”

My weight loss success is credited to going to support and nutrition meetings. The dedication of the Cleveland Clinic staff is what has kept my weight off for over 10 years. I would do the surgery again in a heartbeat and I am a one million percent supporter of Cleveland Clinic Florida and Dr. Rosenthal.

I was always a big boy. However, I really put on some weight within two years of being diagnosed with Fibromyalgia. Due to high blood pressure, diabetes, sleep apnea and the lack of mobility, I gained 125 pounds. At that point, I needed to find a solution and sought help at the Bariatric and Metabolic Institute at Cleveland Clinic Florida. After consulting with Dr. Rosenthal, I decided to undergo the Roux-en-Y Gastric Bypass. In February, I celebrated my four year anniversary of the surgery. I have lost 130 lbs. and maintained a weight within five pounds of my lowest weight.

Cleveland Clinic Florida has a world class bariatric team, from the docs to the nurses and nutritionists. They have the tools to make it work, such as physiological and nutrition counseling, as well as a mentor group of former bariatric patients. This support is the key success factor - the rest is up to the patient to make changes in their behavior.