Bariatric Surgery Treatment Guide | Cleveland Clinic Florida

Overview

If you're significantly overweight and want to make a lifestyle change, you may be a candidate for bariatric surgery at Cleveland Clinic in Florida.

Our expert team of surgeons, physicians, anesthesiologists, psychologists, dietitians, counselors, dietitians and specialized nurses focuses on your long-term weight loss success. Together with specialists in sleep disorders, gastroenterology, nutrition, cardiology, internal medicine and other obesity-related fields, as needed, we provide you with the support you need to permanently regain your health.

Each patient in our surgery program is also assigned a dedicated caregiver, who serve as a primary point of contact throughout your weight loss surgery journey, offering encouragement and support every step of the way.

At Cleveland Clinic in Florida's Bariatric and Metabolic Institute, our team will perform a thorough physical exam, which may require blood work and other diagnostic tests, to help create a weight loss plan that’s right for you.

Surgical Weight Loss

Surgical weight management is typically designed for those 100 pounds or more overweight. You may also qualify with a Body Mass Index (BMI) of 35 to 40 if you have other serious illnesses, such as diabetes, cardiovascular disease, hypertension or sleep apnea. Weight loss surgery can help patients achieve a healthier BMI.

Obesity is harmful to a person’s health. Someone who is 40 percent overweight is twice more likely to die prematurely than an average-weight person. (This effect is seen after 10 to 30 years of being obese.) In this country alone, about 300,000 deaths per year can be blamed on obesity. Obesity is a risk factor for many conditions and life-threatening diseases, including:

Cancer
Chronic kidney disease
Depression
Diabetes
Fatty liver disease
GERD (Gastro Esophageal Reflux Disease)
Heart disease
High blood pressure (hypertension)
High cholesterol
Infertility
Menstrual irregularities
Obstructive sleep apnea
Osteoarthritis of weight-bearing joints
Osteoporosis
Stroke
Urinary stress incontinence

We also manage patients postoperatively to ensure adequate weight loss, adjusting medications when associated illnesses begin to improve and to prevent nutritional deficiencies.

Surgical Procedures Offered

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

Restrictive procedures that decrease food intake
Hypoabsorptive procedures that alter digestion, thus causing food to be poorly digested, incompletely absorbed and 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 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 Sleeve’ – Laparoscopic Sleeve Gastrectomy

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 in a reduction of the stomach and removal of 80% of the appetite hormone (Ghrelin) producing cell mass, thus limiting the amount of ingested food and decreasing the appetite. Similar to the gastric bypass, it also results in a positive alteration of the gastrointestinal hormones.

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. Roux-en-Y procedure reroutes a variable length of the small intestine to connect to a newly created smaller stomach pouch, bypassing a portion of the digestive system. The procedure promotes weight loss not only by limiting food intake, but also by decreasing the absorption ability of the digestive system.

Intragastric Balloon

The Intragastric Balloon System is implanted in the stomach via a 30-minute minimally invasive endoscopic outpatient procedure while the patient is under mild sedation. Once in place, the balloon device is inflated with a sterile solution. The balloon partially fills the stomach to provide a feeling of satiety. The balloon is removed after six months, at which time patients remain in a structured dietary program to maintain weight loss.

Duodenal Switch

Duodenal Switch is a combination of the gastric sleeve and gastric bypass procedure. The procedure creates a smaller stomach that is connected to the farthest part of the small intestine. The duodenum, jejunum and part of the proximal ileum are bypassed and then connected to a point near the ileocecal valve. The surgery is effective, but also riskier than other procedures. It is generally only for people who have a BMI higher than 50.

Reoperative Bariatric Surgery

Bariatric surgery is considered successful if 50 percent of excess weight is lost and maintained for at least five years, resulting in improvement of obesity-related conditions and quality of life. Revisions often involve converting a failed procedure of some other type to Roux-en-Y (RNY) gastric bypass, but patients who have received the RNY sometimes require revision of the procedure to clear up complications or to achieve further weight loss.

We perform highly complex re-interventions in patients that have complications from previous bariatric procedures. For patients who have experienced complications following either VBG or LAP-BAND, our surgeons perform a surgical revision, converting to Roux-en-Y (RNY) gastric bypass. While RNY is a technically challenging procedure that requires surgical expertise, it has been proven to be safely integrated into a bariatric treatment program with good results.

Surgical outcomes

Six months after surgery, patients often find they no longer need medication or treatment for diabetes, high blood pressure, obstructive sleep apnea and a host of other conditions. Cleveland Clinic’s STAMPEDE (Surgical Treatment And Medications may Potentially Eradicate Diabetes Efficiently) study shows bariatric surgery is a highly effective and durable treatment for type 2 diabetes in obese patients, enabling nearly all surgical patients to be free of insulin and many to be free of all diabetic medications three years after surgery.

Medical Weight Loss

For patients who choose not to undergo surgery, or for those who are not eligible, we offer medical management options.

Dietitians review each patient’s food and exercise history and psychologists address issues such as depression, eating disorders and smoking and other addictions. Exercise physiologists also can create individualized exercise programs, including stress testing. Medication, such as appetite suppressants, can be prescribed to help with weight loss.

Patients who are 100 pounds or more overweight are generally referred for surgical weight management. Our team continue to be involved in the surgical part of the process by assisting patients with weight loss prior to surgery. They also manage patients post-operatively to ensure adequate weight loss, perform medication adjustments when associated illnesses begin to improve, and prevent nutritional deficiencies or other complications which could occur without frequent follow-up appointments.

Support Programs

Many behaviors, habits, thoughts and emotions can affect your weight loss. We offer ongoing support groups and classes that address preparing for surgery, binge eating, reducing the risk of substance abuse, life after surgery and other issues.

Take the First Step

Cleveland Clinic in Florida makes scheduling easy. Whether a doctor’s appointment or diagnostic test, we have locations throughout southeast Florida for your convenience.

To schedule a consultation or to discuss common questions, call the Cleveland Clinic in Florida location nearest you:

Weston FL – 877.463.2010
Stuart FL – 772.223.2890
Vero Beach FL – 772.770.0323

Why Choose Us?

Why Choose Cleveland Clinic in Florida’s Bariatric & Metabolic Institute?

We are committed to providing patients with a path to a healthier future. There are many reasons to choose Cleveland Clinic as a partner on your weight loss journey, including:

Comprehensive team approach to your care, which includes a bariatric nurse and bariatric dietitian
Number of bariatric surgery options available (including Gastric Sleeve, Gastric Bypass, Complex reoperations, and possible care of LapBand)
Experienced bariatric surgeons with advanced training
Support groups
Financing self-pay options available
Skilled, experienced surgeons who have performed thousands of bariatric surgical procedures and handle complex cases (people with certain liver problems or previous abdominal surgery, adolescents and reoperations)
More than 95 percent of surgeries are performed using minimally invasive (laparoscopic) techniques
High success rates, low complication and mortality rates

National Bariatric Surgery Accreditation

Accreditation of our bariatric surgery programs at Cleveland Clinic Weston Hospital and Cleveland Clinic Martin North Hospital by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) acknowledges our commitment to quality improvement and safety efforts for patients undergoing metabolic and bariatric surgery. Our leadership and care teams continually work to improve outcomes and achieve additional accreditations across the region.

Industry Leadership in Research & Innovation

The bariatric surgeons at Cleveland Clinic in Florida have performed over 6,000 weight loss surgeries making it one of the largest bariatric programs in Florida. They are internationally renowned for advancing surgical weight loss approaches through research -- from gastric sleeve surgery and lap band procedures to all forms of gastric bypass surgery. They are also innovators in the use of obesity surgery to treat type 2 diabetes and as a bridge to organ transplantation candidacy.

Our team includes current and past presidents of the American Society of Bariatric and Metabolic Surgeons (ASMBS) and the Florida Chapter of the ASMBS as well as editors of leading industry publications, such as Surgery for Obesity and Related Diseases (SOARD), the official journal of the ASMBS, Bariatric Times, and the peer-reviewed journal Obesity Surgery.

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Bariatric & Metabolic Surgery Locations

Cleveland Clinic Weston Hospital – Weston, FL
Cleveland Clinic Coral Springs – Coral Springs, FL
Tomsich Health & Medical Center of Palm Beach County – West Palm Beach, FL
Cleveland Clinic Martin North Hospital– Stuart, FL
Cleveland Clinic Indian River Hospital – Vero Beach, FL

Bariatric Surgery