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Underlying Mechanisms of Obesity
Episode 325th March 2024 • Reset Diabesity • CineMed
00:00:00 00:56:34

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We discuss the state of underlying mechanisms of obesity, the US and global obesity epidemic, and a variety of treatments available for managing metabolic disease.


Rob Johnston, PhD

Chief Scientist, Johnston Analytics

Houston, TX


Mitchell Roslin, MD, FACS

Chief of Bariatric Surgery

Lenox Hill Hospital

New York, NY

Useful resources


The Obesity Society

American College of Surgeons

Obesity Medicine Association

American Board of Obesity Medicine

Learn more about Reset Diabesity:

About Rob Johnston

Dr. Rob Johnston is a computational social scientist and applied ethnographer specializing in technology and political-national security. Rob is the Chief Scientist at Johnston Analytics, Inc., a data science, machine learning, and national security consultancy. He is a Distinguished Visiting Scholar in the School for Public and International Affairs at North Carolina State University. Rob is also a Research Scholar at the Laboratory for Analytic Sciences (a National Security Agency partner Laboratory) at North Carolina State University focused on the intersection of Artificial Intelligence, Machine Learning, and Social Science.

Prior to this Rob was the Deputy Chief of Globalization and Workforce Modernization at the Central Intelligence Agency supervising over hundreds of staff and contractors, he served as Program Manager for Business and Workforce Modernization, he was the founder and first Chief of the Lessons Learned Program at CIA, was the Director of the Lessons Learned Program at the Office of the Director of National Intelligence, and was a research scientist in the Center for the Study of Intelligence and the Office of the Chief Scientist at CIA.

Rob is a former Associate of the National Intelligence Council for both Warning and Transnational Threats. He served as a team lead and member of several global crisis task forces that monitored, prepared, and responded to emerging threats, forced migration, ethnic violence, and political crises. Rob is a former Visiting Scholar at the Sherman Kent Center, a CIA Postdoctoral Research Fellow, the author of “Analytic Culture in the US Intelligence Community: An Ethnographic Study” published by CIA and producer of the award-winning Intelligence Community 2011 Best Documentary “Extraordinary Fidelity.”

Rob was a research analyst at the Institute for Defense Analyses where he conducted research for the White House Office of Science and Technology Policy, the Department of Defense, and the Intelligence Community. He has worked on science and technology policy with the JASONS, the Intelligence Science Board, and the Defense Science Board. Rob served at NASA during graduate school where he conducted research for the Virtual Environment Research Institute at the Johnson Space Center to support the Space Flight Training Division for manned missions: STS-82 Hubble Space Telescope Servicing, STS-88 International Space Station Assembly, STS-96 International Space Station Supply, and STS-103 Hubble Space Telescope Servicing.

Rob is a former Fellow of the Royal Anthropological Institute, the Society for Applied Anthropology, and the Inter-University Seminar on Armed Forces and Society. He has been a Lecturer at Yale University, an adjunct instructor at the University of California San Francisco, and the Baylor College of Medicine. Rob has conducted fieldwork in North and Central America, China, Europe, Eurasia, the Caucasus, East and South Asia, Africa, and the Middle East. He has published over 50 articles, book chapters, and books, and has been a guest speaker at over 200 national and international conferences and events.                

About Dr. Roslin

Dr. Roslin is frequently asked by private bariatric practices all over the country to teach established surgeons new techniques and procedures. Recently, Dr. Roslin has served as invited faculty and given talks in Israel, Mexico, and Europe. Additionally, Dr. Roslin has been an innovator in the search for new and better treatments. He holds several patents in the emerging field of Pacing Technology for the treatment of obesity. Most recently he has designed a method for the endoscopic treatment of relapse following gastric bypass surgery.

Dr. Mitchell Roslin was born in Brooklyn, New York. He graduated from Stuyvesant High School and completed his undergraduate studies at the University of Pennsylvania. He attended medical school at New York University and received his surgical training at Maimonides Medical Center in New York City.

In 1996, Dr. Roslin became the Director of Bariatric Surgery at the Maimonides Medical Center. In 2000, he was appointed the Chief of Obesity Surgery at Lenox Hill Hospital in New York City and has supervised its growth into one of the most prestigious programs in the United States.

Dr. Roslin is also the President of Manhattan Minimally Invasive and Bariatric Surgery PC.

Dr. Roslin is a faculty member at the Minimally Invasive Surgical Symposium, The Consensus conference on Sleeve Gastrectomy. He is the editor of the VideoTextBook of Bariatric Surgery, serves as the major teaching proctor for sleeve gastrectomy and duodenal switch, and is the course director for symposiums on revisional bariatric surgery.

Dr. Mitchell Roslin has received numerous awards during his career. He has been voted one of the outstanding doctors in New York, by both Castle and Connolly and New York Magazine. Dr. Roslin recently has been selected as one of the best minimally invasive surgeons in New York. He is the founding president of the NYS-ASMBS and co chair of the access committee of ASMBS.

Dr. Roslin has been an active advocate for breaking through insurance barriers to bariatric surgery.

Hardware / Software Requirements

An internet connection speed of at least 4Mbps and a modern browser

•Modern browsers have a built in PDF reader which would be necessary for you to view your completion certificates.

Release Date: 4/12/24 

Expiration Date: 4/12/27

Target Audience

This activity is designed for internal medicine physicians and supporting staff who treat patients with obesity and associated co-morbid conditions.

Learning Objectives

At the completion of this activity, learners should be able to:

  • Recognize patient risk factors for negative outcomes associated with obesity
  • Identify treatment options for obesity, including but not limited to medications, dietary changes, exercise and surgery
  • Describe the team approach to managing patients with obesity
  • Discuss dietary and exercise changes that can be beneficial to patients with obesity
  • Identify indications and contraindications for bariatric surgery for the treatment of
  • obesity

Activity Goal

This activity is designed to address the following core and team competencies: 

Patient Care, Medical Knowledge, Professionalism, Employ evidence-based practice, Value & Ethics, Team & Teamwork, Interprofessional Collaboration, and Interprofessional Communication.


The accredited provider verifies that sound education principles have been demonstrated in the development of this educational offering as evidenced by the review of its objectives, teaching plan, faculty, and activity evaluation process.  The accredited provider does not endorse or support the actual opinions or material content as presented by the speaker(s) and/or sponsoring organization.


The accredited provider adheres to accreditation requirements regarding industry support of continuing medical education. Disclosure of the planning committee and faculty's commercial relationships will be made known at the activity. Speakers are required to openly disclose any limitations of data and/or any discussion of any off-label, experimental, or investigational uses of drugs or devices in their presentations. - All employees in control of content have no relevant financial relationships to disclose. All relevant financial relationships have been mitigated.

Relevant Financial Relationships

Mitchell Roslin, MD - Johnson and Johnson - Consultant

Mitchell Roslin, MD - Medtronic - Consultant


In support of improving patient care, Cine-Med is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


Cine-Med designates this live activity for a maximum of 1.0 AMA PRA Category 1

Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses / Physician Assistants

All other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for activities designated for AMA PRA Category 1 Credits™, consult your professional licensing board(s).

Other Healthcare Professionals

All other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for activities designated for AMA PRA Category 1 Credits™, consult your professional licensing board.

Certificates: To claim your CME/CE credits, complete the online Credit and Evaluation form using the following URL:

This is a one-time credit submission.  Credits should be tracked at the completion of the activity. Participants will be able to download or print a certificate once the form has been submitted.

American Board of Surgery (ABS) Reporting:  Successful completion of this CME activity enables the learner to earn credit toward the CME requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.  Claimed credits will be reported to the ABS one-time, in December of the calendar year. 


This activity is being supported by an unrestricted educational grant from Medtronic.

Background References

1.     Addison, P., Carsky, K., Patti, M.E. and Roslin, M., 2022. Hypoglycemia and dysautonomia after bariatric surgery: a systematic review and perspective. Obesity Surgery32(5), pp.1681-1688.

2.     Becker, A., Gaballa, D., Roslin, M., Gianos, E. and Kane, J., 2021. Novel nutritional and dietary approaches to weight loss for the prevention of cardiovascular disease: ketogenic diet, intermittent fasting, and bariatric surgery. Current Cardiology Reports23(7), p.85.

3.     Boyce, S.G., Goriparthi, R., Clark, J., Cameron, K. and Roslin, M.S., 2016. Can composite nutritional supplement based on the current guidelines prevent vitamin and mineral deficiency after weight loss surgery?. Obesity surgery26, pp.966-971.

4.     Casajoana, A., Borden, B., Zarabi, S. and Roslin, M., 2019. Conversion of laparoscopic roux en Y gastric bypass (RYGB) to single anastomosis duodenal switch (SADS). Obesity Surgery29, pp.3412-3413.

5.     Cooper, D.J., Zarabi, S., Farrand, B., Becker, A. and Roslin, M., 2022. Continuous glucose monitoring reveals similar glycemic variability in individuals with obesity despite increased HOMA-IR. Frontiers in Nutrition9, p.1070187. 

6.     Cottam, A., Cottam, D., Roslin, M., Cottam, S., Medlin, W., Richards, C., Surve, A. and Zaveri, H., 2016. A matched cohort analysis of sleeve gastrectomy with and without 300 cm loop duodenal switch with 18-month follow-up. Obesity surgery26, pp.2363-2369.

7.     Cripps, C. and Roslin, M., 2016. Endoluminal treatments for obesity and related hypertension: Updates, review, and clinical perspective.  Current hypertension reports18, pp.1-7.

8.     Matarasso, A., Roslin, M.S., Kurian, M. and Plastic Surgery Educational Foundation Technology Assessment Committee, 2007. Bariatric surgery: an overview of obesity surgery. Plastic and reconstructive surgery119(4), pp.1357-1362.

9.     Pearlstein, S., Sabrudin, S.A., Shayesteh, A., Tecce, E.R. and Roslin, M., 2019. Outcomes after laparoscopic conversion of failed adjustable gastric banding (LAGB) to laparoscopic sleeve gastrectomy (LSG) or single anastomosis duodenal switch (SADS). Obesity Surgery29, pp.1726-1733.

10.   Rincon, L., Becker, A., Zarabi, S. and Roslin, M., 2023. Duodenal Switch (DS) for the Surgical Treatment of Diabetes and Metabolic Disease. Duodenal Switch and Its Derivatives in Bariatric and Metabolic Surgery: A Comprehensive Clinical Guide, pp.627-638.

11.   Roslin, M., 2016. Paired Editorial for “Insurance Mandated Medical Weight Management Prior to Bariatric Surgery”. Surgery for Obesity and Related Diseases12(3), pp.500-501.

12.   Roslin, M.S., 2015. Why it matters. A paired editorial for “Hypoglycemia after Roux-en-Y gastric bypass: detection rates of continuous glucose monitoring (CGM) versus mixed meal test”. Surgery for Obesity and Related Diseases11(3), pp.569-572.





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