Obesity Surgery in Turkey
What do you want to know about Obesity Surgery? Answers to all your questions are in our article below.
What is Obesity and How to Treat It
Today, obesity has become an important health problem not only in developed countries but also in developing countries such as our country. Obesity; Increasing income levels, the establishment of a western lifestyle, the spread of fast-food type and standing snacks, and a high-calorie and fatty diet have a great role in the increase of obesity. Eating excessive calories with nutrition and not consuming excess calories triggers obesity.
Today’s human being avoided physical activity, remained motionless for hours in front of the computer, television, phone, and at the same time was constantly eating snacks with high calories. With the increase in means of transportation, people walk less and work less with the introduction of technological tools into our lives. As a society, the fact that the habit of doing sports is too little plays a big role in this increase.
What is Obesity and Morbid Obesity?
We can define obesity as excessive fat accumulation in the body. WHO (World Health Organization) defines obesity as “abnormal, excessive fat accumulation in the form and rate that will cause diseases in the body”.
Morbid Obesity is defined as severe obesity that threatens life seriously due to the fatal problems it causes. Those with a Body Mass Index (BMI) above 40 are considered morbidly obese.
The average body fat ratio is 25-30% in women and -20 in men.
What are the dangers of obesity, what diseases does it cause?
Obesity causes disorders in all systems of the body. Experts say obese people live 12-15 years less than their peers. Obesity causes many diseases such as type 2 diabetes mellitus (diabetes), hypertension, cardiovascular diseases, fat metabolism disorders, sleep apnea, reflux, sexual disorders, bone and joint problems, respiratory system disorders. Since the external appearance of obese patients deteriorates, social life and mental health of these patients also deteriorate, and many problems such as depression occur. Some types of cancer such as breast and colon cancers are more common in obese patients.
How should obesity treatment be?
In obesity treatment 1. Diet 2. Exercise 3. Drug therapy 4. Surgical treatment options are available (obesity surgery).
Diet and exercise play a big role in treatment. First of all, patients should change their lifestyle. Patients should receive a good nutrition education and learn the mistakes in this regard. Exercise must be included in life. When all these are insufficient, drugs can be tried in certain groups of patients. However, most of them have serious side effects, and today there is still no very effective drug with little side effects.
Studies have shown that the rate of permanent weight loss with non-surgical methods in the treatment of morbid obesity is around 2%. Today, permanent and effective treatment of morbid obesity is surgery.
Obesity treatment is completely a team work. A team consisting of endocrinology, general surgery, psychiatry, nutrition and diet experts should evaluate the patient and determine the treatment method.
Which obese patients do you recommend surgical treatment?
In morbidly obese patients with BMI = 40 kg / m2 and above, even if there is no additional concomitant disease,
In obese patients with BMI = 35-40 kg / m2, hypertension, cardiovascular diseases, type 2 DM, hyperlipidemia, sleep apnea syndrome, etc. Surgical treatment is indicated in the presence of at least one of the diseases.
Which methods are used in surgical treatment?
What are the Obesity Surgery Options?
A) Restrictive surgeries:
1) Adjustable stomach band: It is also known as stomach clamp among the people. It is not used much anymore because of its complications and the loss of its effectiveness when excessively liquid calorie food is taken. The problems caused by this surgery in the past played a major role in keeping our people at a distance from obesity surgery.
2) Sleeve gastrectomy (Tube stomach): The stomach is cut longitudinally with special staples and narrowed by turning it into a tube. It is a physiological surgery and can be converted to another method in the future. For this reason, the most popular surgery in recent years has been sleeve gastrectomy. Gastric sleeve restricts eating and decreases appetite.
3) Stomach folding: It is an operation that has been on the agenda in recent years. The stomach is narrowed by stitches from top to bottom. Complications are few, but the effect is limited because the feeling of hunger continues.
4) Stomach Balloon: Actually it is not surgery. With endoscopy, a balloon is placed in the stomach and inflated. It creates a constant feeling of satiety in the stomach. It is not a weight loss method alone. However, it is used in super morbid obese, that is, very overweight, to lose some weight and to facilitate surgery or to support other treatments. It should be removed in an average of 6 months. It has side effects such as perforation, damage to the stomach, and causing intestinal obstruction.
B) Absorption-disrupting surgeries:
1) Gastric Bypass: It is the most performed surgery in the world. Both the stomach is reduced and the stomach is connected to the small intestines far below, so the small intestine distance absorbed is reduced. Thus, even if the patient eats a little too much, these foods are thrown away without being digested. Lifelong vitamin and mineral support is essential.
2) Mini gastric bypass: It is easier than normal bypass. Approximately 2 m small intestine is disabled in absorption.
3) Duodenal Switch surgery: It is a highly effective but difficult operation. The stomach is first made into a tube and then connected to a very low small intestine. Mineral and vitamin support is required throughout life.
4) Duodenal bypass / sleeve gastrectomy: Similar to the previous surgery, lifelong mineral and vitamin support is required.
Does everything end with obesity surgery?
No, it doesn’t end. Surgery offers the patient a great chance. The patient should definitely have their controls, follow the recommendations, adopt a new lifestyle. Do not forget about vitamin and mineral supplements. Diet and sport should be part of life.
Weight Loss After Obesity Surgery
It is recommended that patients who have had obesity surgery with the tube stomach or gastric bypass method follow a diet and exercise program regularly after surgery. The success of the surgery is considered to be related to the patient’s compliance with this order.
Those who have obesity surgery can lose weight by following a regular diet and exercise program after surgery. In this process under the supervision of experts, it is aimed to reach a healthy weight in approximately 1-1.5 years.
The following improvements can be achieved in the health status of patients with weight loss:
High blood pressure is improving. 70 percent of the patients can stop their blood pressure medications completely.
Blood cholesterol improves. Cholesterol levels have been reported to decrease in 80 percent of patients. Values can return to normal 2-3 months after surgery.
The risk of heart disease is reduced.
Few patients diagnosed with Type II diabetes may need to take medication.
Patients at the border of diabetes usually recover completely.
Asthma attacks decrease to a great extent, and in some patients they recover completely.
Breathing problems improve within a few months after surgery. Many patients can return to activities and normal routines that they had to quit due to respiratory problems.
Obesity-related sleep disorders such as sleep apnea syndrome are eliminated.
Acid reflux disease is disappearing.
Weight loss provided by these methods is permanent provided that the rules are followed.
How is Follow-Up Performed After Obesity Surgery?
After obesity surgery, some patients have regained weight after 2 years at a rate of 10-20%. The main reasons for this are that the patients cannot change the environment after surgery, which we call postoperative rehabilitation, cannot change their kitchen habits, cannot learn healthy nutrition and cannot have a bariatric kitchen.
In addition, active life is at least as important as diet, and insufficient physical activity after surgery is one of the most important factors that cause weight gain. In summary, living away from sports, high carbohydrate diet are important factors that cause weight gain.
For this reason, IFSO points out patient follow-up of bariatric surgery centers as one of the most important items. Only surgery and non-follow-up of patients results in weight gain, which occurs with a decrease in eating restriction after 1.5 years in the long term.
Generally, patients consider the surgery as a touch and think that a mechanism is placed in their stomach and thus they will weaken. Partly true, hormonal mechanisms are involved in the surgery, but since the stomach is an organ that can stretch over time, the patient who is full when eats 2 meatballs can become eating 3-4 meatballs.
Therefore, an increase in the eating portions of the patients may occur due to the fact that some wrong practices, which make the stomach bigger, are not known or applied by the patients.
Made works; Patient follow-up with a multidisciplinary team consisting of doctors, dieticians, psychologists, nurses and active life counselors shows that weight gain is highly prevented. In our clinic, the weight gain rate is less than 3%.