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Bariatric and Metabolic Institute and Minimally Invasive Surgery

The Bariatric and Metabolic Institute and Section of Minimally Invasive Surgery at Cleveland Clinic Florida treats patients who want to achieve weight loss through bariatric surgery, as well as patients with gastrointestinal conditions.

Cleveland Clinic Florida'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 gastrointestinal tract.

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The Bariatric Surgeons at Cleveland Clinic Florida have a proven record of favorable outcomes which has resulted in the Institute being designated a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery.

In addition, Cleveland Clinic Florida’s multidisciplinary team approach provides convenient access to 240 Cleveland Clinic physicians with expertise in 35 specialties, resulting in better patient care.

South Florida Appointments

To request an appointment, please call toll-free 877.463.2010.

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 97 million Americans, more than one-third of the adult population, are overweight or obese. An estimated five to 10 million of those are considered morbidly obese.

Morbid obesity is typically defined as being 100 pounds. or more over ideal body weight or having a Body Mass Index of 40 or higher. According to the National Institutes of Health Consensus Report, morbid obesity is a serious disease and must be treated as such. It is a chronic disease, meaning that its symptoms build slowly over an extended period of time.

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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 and regular exercise. Unfortunately, even the most effective interventions have proven to be effective for only a small percentage of patients. 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. Occasionally a procedure will be considered for someone 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.

For more information on heartburn, its causes and possible cures, visit www.heartburnhelp.com.

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.

What We Treat In South Florida

  • Obesity, metabolic syndrome (Gastric Bypass, Gastric Sleeve, Gastric Banding) 
  • Intragastric Balloon and Revisional surgery
  • Gallstones 
  • Laparoscopic Cholecystectomy
  • Paraesophageal and Diaphragmatic Hernias
  • Esophageal tumors, benign and malignant
  • 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 liver, spleen and pancreas.
  • Gastroparesis
  • Flexible endoscopy

Florida Weight Loss 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 an 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.   

Intragastric Balloon

This is a non-surgical option recently approved in the US, but used for several years in other countries. This procedure consists of placing a removable balloon inside the stomach through an endoscope under anesthesia. There are no incisions involved with this procedure. The balloon is kept in place for 6 months and then removed again endoscopically under anesthesia. During the six months of the balloon insertion and the following six months the patients are closely followed by a multidisciplinary team of doctors, dietitians and nurses.

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.

Bariatric Surgery Center Network

This designation means that the Bariatric and Metabolic Institute’s program has met the essential criteria that ensure it is fully capable of supporting a bariatric surgery care program and that its institutional performance meets the requirements outlined by the American Council of Surgeons (ACS) Bariatric  Surgery Center Network (BSCN) Accreditation Program.

Established by the American College of Surgeons in 2005 in an effort to extend established quality improvement practices to all disciplines of surgical care, the ACS BSCN Accreditation Program provides confirmation that a bariatric surgery center has demonstrated its commitment to providing the highest quality care for its bariatric surgery patients. Accredited bariatric surgery centers provide not only the hospital resources necessary for optimal care of morbidly obese patients, but also the support and resources that are necessary to address the entire spectrum of care and needs of bariatric patients, from the pre-hospital phase through the post-operative care and treatment process.

The American College of Surgeons is a scientific and educational association of surgeons that was founded in 1913 to raise the standards of surgical education and practice and to improve the care of the surgical patient. Its achievements have placed it at the forefront of American surgery and have made the College an important advocate for all surgical patients. The College has more than 69,000 members and is the largest organization of surgeons in the world.

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.
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 16 to 24 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.

Cleveland Clinic Florida is with you every step of the way.

The Bariatric and Metabolic Institute at Cleveland Clinic Florida offers monthly information sessions to provide information about surgical weight loss options available at Cleveland Clinic Florida. Participants can meet with our registered dietitians, program coordinators, and insurance authorization specialists to have their questions addressed by our experts.

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 support groups and information sessions are provided at no cost. Join us at our upcoming information session to learn more about the options available to you.

All information sessions and support groups are held at:

Cleveland Clinic Florida - Weston
David G Jagelman Conference Center
2950 Cleveland Clinic Blvd.
Weston, Florida 33331

For more information click below or to speak with one of our coordinators call 866.910.6396.

Sessions Schedule

Morning Sessions
Morning sessions are held every week on Tuesdays and Thursdays

  • Time: 8 a.m. to 10 a.m.
  • Location: David G. Jagelman Conference Center

Evening Sessions
Evening sessions are held the second Wednesday and fourth Tuesday of the month.
(March 2016: sessions will be held second Wednesday and Fifth Tuesday)

  • Time: 5 p.m. to 7 p.m.
  • Location: David G. Jagelman Conference Center

Spanish Information Sessions
Spanish sessions are held the first Tuesday of the month.

  • Time: 5 p.m. to 7 p.m.
  • Location: David G. Jagelman Conference Center
Support Groups

The Bariatric and Metabolic Institute at Cleveland Clinic Florida offers a variety of support groups for our weight loss surgery patients. The support groups provide general information, nutrition and emotional support. They are open forums and give patients the opportunity to discuss common experiences, and valuable information pertinent to bariatric surgery, nutrition and lifestyle. All pre and post-operative weight loss surgery patients and their family members are welcome to join us.

All support group meetings are led by our licensed support group facilitators and held at our Weston campus.

General & Nutrition Support Groups

Support groups provide the opportunity for post-operative patients to meet, share experiences and support each other.

Our support group facilitators and registered dietitian nutritionists will discuss the latest research on nutrition topics and trends.

General & Nutrition Support Group Sessions Schedule

Morning Sessions

The morning general information and nutritional support group sessions are held the second Monday of the month.

  • Time: 9 a.m. to 11 a.m.
  • Location: David G. Jagelman Conference Center

Evening Sessions

The evening general information and nutritional support group sessions are held the last Monday of the month.

  • Time: 5 p.m. to 7 p.m.
  • Location: David G. Jagelman Conference Center

Emotional Support Group

The emotional support group is offered for post-operative patients. Our support group facilitators will discuss the importance of your emotional health as you transition into your new lifestyle.

Emotional Support Group sessions are held the last Monday of the month.

  • Time: 4 p.m. to 5 p.m.
  • Location: David G. Jagelman Conference Center

Dates are subject to change.

For more information or questions about our support groups, please contact our support group facilitators at 866.910.6396.

Jose Rodriguez

Jose Rodriquez

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.

Michelle Knowles

Michele C. Knowles

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

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.

News

Weight Loss Surgery Can Lead to Good Sugar Levels

Miami Herald – November 22, 2015

“We have known for decades that weight loss surgery will result in a reduction of Type 2 Diabetes,” said Dr. Raul Rosenthal. A bariatric surgeon, he is the new president of the American Society of Bariatric and Metabolic Surgeons and chief of staff at Cleveland Clinic Florida.

Call us for an Appointment

To find a Bariatric & Metabolic Institute specialist for your needs, contact us toll-free at 877.463.2010.

Scheduling

To learn more about our monthly information sessions regarding surgical weight loss options call 866.910.6396 or click here.