Bariatric Surgery in Turkey

Bariatric Surgery in Istanbul

Bariatric surgery is a surgical procedure performed to achieve weight loss in patients with extreme obesity. Bariatric surgery is a procedure with a long historical background and a field that has been changing and developing with modern technological advancements.

Historically, bariatric surgery was first used in the 1950s. Early procedures included gastric bypass, a method that limited food intake by creating a small outlet from the stomach. However, early surgeries had limited success due to complications and side effects.

In the 1980s, bariatric surgery was revitalized with the development of innovative techniques. Various procedures, including gastric banding, gastric bypass, gastric sleeve, and duodenal switch, are among these techniques. These methods are designed to be in line with technological advancements to improve the safety and efficacy of the surgery.

Today, bariatric surgery has become more effective with improvements in pre- and post-operative care, the use of less invasive techniques, and lifelong patient follow-up. Surgeons can choose different techniques according to the needs of patients, and patients typically recover in a shorter time period.

Technological advancements in bariatric surgery have also led to the use of more advanced techniques, such as robotic surgical techniques. These technologies can help make the surgery more precise and controllable and can make the recovery process faster and less painful for patients.

What Is Obesity?

Obesity is a health problem characterized by excessive fat accumulation in the body. Obesity is typically defined using a measure known as the body mass index (BMI). BMI is calculated by dividing a person’s weight in kilograms by their height in meters squared. Individuals with a BMI value above 30 kg/m2 are considered obese.

Obesity is a growing health problem worldwide. In 1975, approximately 4% of adults worldwide were obese. However, by 2016, this had increased to 13.8%. During the same period, childhood obesity also significantly increased. In 1975, 1% of children were obese, but by 2016, this had risen to 5%.

Several factors play a role in the development of obesity. These include a sedentary lifestyle, unhealthy eating habits, stress, genetic predisposition, environmental factors, and the use of certain medications. Additionally, there are various health problems that can lead to obesity, such as hormonal disorders like hypothyroidism.

Obesity carries serious health risks. Obese individuals are more likely to develop a range of health problems, including heart disease, diabetes, high blood pressure, liver disease, respiratory problems, joint pain, cancer, and depression. Therefore, combating obesity by adopting a healthy lifestyle and implementing an appropriate diet is important.

What Is Bariatric Surgery?

Bariatric surgery is a series of surgical procedures performed on individuals who are overweight or obese with the aim of weight loss. These surgical procedures are used to treat obese people who have not been able to lose weight through other methods such as weight loss diets and exercise programs.

Bariatric surgery is typically recommended for individuals who have a body mass index (BMI) of 40 or higher or a BMI of 35–39.9 with obesity-related health problems such as diabetes, hypertension, sleep apnea, and heart disease. However, it may not be suitable for everyone, and individuals considering bariatric surgery should consult with a bariatric surgery specialist first.

Bariatric surgery procedures are typically performed using one of the following methods: stomach size reduction (such as a gastric balloon, gastric banding, gastric bypass, or sleeve gastrectomy) or intestinal bypass (such as a duodenal switch). The choice of surgical procedure is determined by factors such as the patient’s level of obesity, obesity-related health problems, and overall health status.

Bariatric surgery can play a significant role in improving weight loss and obesity-related health problems. However, like any surgical procedure, bariatric surgery carries risks and requires significant lifestyle changes after surgery. Therefore, when considering bariatric surgery as an option, the potential benefits and risks to the patient should be carefully evaluated.

What Is Bariatric Surgery?

Bariatric surgery is a surgical procedure performed to achieve weight loss in severely overweight individuals. The surgery aims to accelerate weight loss by reducing the size of the stomach, making changes to the digestive system, or both.

Types of bariatric surgery include:

• Gastric Balloon: In this method, a balloon is placed inside the stomach. The balloon fills the stomach, making the person feel less hungry.This method is usually a temporary solution and is removed within a period ranging from 6 months to 1 year.
• Laparoscopic Sleeve Gastrectomy: In this method, a large portion of the stomach is cut and left as a small tube that is connected to the colon. This allows the small portion of the stomach to fill up faster, and the person needs to eat less.
• Laparoscopic Gastric Bypass Surgery: In this method, the upper part of the stomach is cut to create a small section. A small section of the intestine is passed under the cut section of the stomach and connected directly to the small intestine. This method is used to reduce the size of the stomach and speed up the passage of nutrients to the small intestine.
• Biliopancreatic Diversion (BPD): In this method, a large portion of the stomach is cut and left as a small tube that is connected to the colon. In addition, a section of the small intestine passes through a section that prevents the digestion of nutrients and is connected to the remaining intestine.
• Duodenal Switch (DS): In this method, a large portion of the stomach is cut and left as a small tube that is connected to the colon. In addition, a section of the small intestine is cut and connected to the colon, and then passed through a section that reduces nutrient absorption before being connected to the remaining small intestine.

Each of these methods has different advantages and disadvantages, and the method to be applied is determined according to the patient’s condition and preferences.

What Causes Obesity?

Obesity is when a person’s body weight is above a healthy level. Internal and external factors that can cause obesity include:

Internal factors:

• Genetic factors: Some genetic factors can create a predisposition to obesity and contribute to weight control.
• Hormonal factors: Hormone irregularities, especially thyroid hormones, insulin, and leptin hormones, can trigger obesity.
• Metabolic factors: factors such as metabolism rate, calorie burning rate, and digestion rate can affect obesity.
• Psychological factors: stress, anxiety, depression, and other psychological factors can be associated with overeating behavior and obesity.

External factors:

• Dietary habits: Consuming high-calorie, high-fat, sugary, and processed foods can cause obesity.
• Physical activity level: insufficient physical activity reduces calorie burning and can lead to weight gain.
• Environmental factors: Environmental factors, especially the quality and accessibility of food in schools, workplaces, or home environments, can increase the risk of obesity.
• Medications: Some medications, especially antidepressants, corticosteroids, and diabetes medications, can cause weight gain.

These factors that cause obesity are often interrelated, and the combination of multiple factors can increase the risk of obesity.

What Are The Harmful Effects Of Obesity?

Obesity is defined as having a body weight that is greater than a healthy level. The harmful effects of obesity are numerous, including physical, psychological, and social consequences.

Among the physical harms are heart disease, diabetes, high blood pressure, respiratory problems, joint problems, and digestive problems. Obesity also has negative effects on a person’s psychological health, such as low self-esteem, depression, anxiety, and eating disorders.

Social harms include exclusion, work-related problems, and difficulties with social interaction. Obesity can lead to social exclusion, make it harder for a person to find and keep a job, and impact their ability to socialize with others.

Factors that contribute to obesity can be divided into two groups: internal and external factors. Internal factors include genetic, hormonal, metabolic, and psychological factors, while external factors include eating habits, physical activity levels, environmental factors, and certain medications.

Obesity is a serious health problem that reduces quality of life and can shorten a person’s lifespan. Therefore, it is important to combat obesity and maintain a healthy weight to lead a healthy life. Adopting healthy eating habits, engaging in regular exercise, and practicing stress management techniques are effective ways to combat obesity. Additionally, working with healthcare professionals can help find more effective and safe ways to manage obesity.

How Can We Prevent Obesity?

Obesity has become an increasingly prevalent health problem worldwide. Unhealthy eating habits, irregular physical activity levels, and other factors can contribute to obesity. However, it is possible to prevent obesity by adopting a healthy lifestyle. Here are some tips for preventing obesity:

• Adopt Healthy Eating Habits: Review your eating habits and strive to make healthy choices. Create a meal plan that includes fresh fruits, vegetables, whole grains, lean protein sources, and healthy fats.
• Avoid fast food and processed foods: fast food and processed foods contain unhealthy fats, sugars, and salt and increase the risk of obesity. Choose to cook at home and consume natural foods instead.
• Engage in Regular Physical Activity: Engage in at least 150 minutes of moderate-intensity physical activity per week or 75 minutes of high-intensity physical activity per week. This will help speed up your metabolism and aid in weight loss.
• Add Variety to Your Exercise Program: Make your exercise program more enjoyable by adding different types of exercises and activities. Challenge your body with various exercises such as walking, running, yoga, cycling, dancing, and swimming.
• Develop Regular Sleep Habits: Developing regular sleep habits reduces stress and regulates your metabolism. Getting enough sleep is essential for maintaining your weight.
• Increase Water Consumption: Drinking at least 2-3 liters of water per day helps maintain your body’s water balance and regulates your digestive system. Increasing your water consumption can also help with weight loss.
• Alcohol consumption should be limited because it can increase weight gain and the risk of obesity. Therefore, limiting alcohol consumption or quitting altogether is essential for preventing obesity.
• Practice Stress Management Techniques: Stress can increase weight gain and the risk of obesity. Stress management techniques such as yoga, meditation, deep breathing exercises, walking, and engaging in hobbies can help reduce stress levels, aid in weight loss, and prevent obesity.
• Set Goals for Yourself: Increase your motivation by setting achievable goals for yourself. Adopt healthy eating habits and engage in regular physical activity based on your goals.
• Join support groups: Getting support is essential for preventing obesity. Join support groups with your family, friends, or other people struggling with obesity. These groups can motivate you to adopt a healthy lifestyle.
• Schedule Regular Check-Ups: Make time for regular health checks.This will help you detect other health problems that obesity can cause while adopting a healthy lifestyle. Continue to adopt a healthy lifestyle by following your doctor’s recommendations.

In conclusion, preventing obesity requires adopting a healthy lifestyle, including eating a healthy diet, engaging in regular physical activity, managing stress, and getting adequate sleep.

What Are The Diseases Related To Obesity?

Obesity is a serious health problem that can have negative effects on many systems in the human body. Disorders occurring in systems such as the endocrine system, cardiovascular system, respiratory system, gastrointestinal system, skin, genitourinary system, and musculoskeletal system indicate health problems caused by obesity.

For example, obesity can lead to heart and vascular diseases. Serious problems such as high blood pressure, coronary artery disease, heart failure, and stroke risk can occur with obesity. In addition, many health problems such as type 2 diabetes, sleep apnea, asthma, COPD, gallbladder disease, liver steatosis, osteoarthritis, back pain, neck pain, and knee pain are also among the problems caused by obesity.

Furthermore, obesity can also lead to mental health problems. Loss of self-confidence, social isolation, depression, and anxiety are among the psychosocial effects caused by obesity. Obesity, which also affects reproductive health, can increase the risk of polycystic ovary syndrome (PCOS) in women and infertility in men.

To combat obesity and maintain a healthy life, it is important to engage in regular physical activity, adopt healthy eating habits, and receive necessary medical treatments. Considering the seriousness of health problems caused by obesity, taking preventive measures against obesity is necessary to maintain a healthy life.

Is Bariatric Surgery Time Consuming?

The duration of bariatric surgeries can vary depending on the type of surgery and the patient’s physical condition. The surgery time usually ranges from 1 to 4 hours. However, factors such as preparations before and after the surgery, anesthesia time, and the complexity of the surgery can also affect the duration.

Surgeries performed using laparoscopic methods generally take less time. This method is performed by making small incisions in the area being operated on and using a camera and thin instruments. Therefore, it is a less invasive procedure compared to traditional surgeries and can provide a shorter recovery time.

However, the duration of the surgery is not only dependent on one factor. Each patient is different, and preoperative evaluations and special preparations based on the type of surgery can alter the duration. Therefore, it is important for patients planning bariatric surgery to have a detailed discussion with their doctors about the details of the surgery before the operation.

Why Can’t I Lose Weight?

Not following the diet and exercise recommendations after surgery can slow down weight loss or even cause a complete stop in weight loss. Additionally, digestive system problems that occur after surgery in some individuals can cause a decrease in nutrient absorption, which can also affect weight loss. It is important for individuals who encounter the problem of not being able to lose weight after obesity surgery to communicate with their dietitians and doctors, identify the cause of the problem, and support the weight loss process by implementing recommendations. Additionally, it is important to regularly attend follow-up appointments after surgery to monitor your health status and weight loss.

How Is The Body Mass Index Calculated For Obesity?

You can follow these steps to calculate your BMI:

• Measure your height in meters. For example, let’s assume it is 1.70 meters.
• Measure your weight in kilograms. For example, let’s assume it is 80 kilograms.
• BMI is calculated by dividing your weight by the square of your height.The formula will be: BMI = weight / (height x height)In our example, the BMI value is calculated as follows: 80/(1.70 x 1.70) = 27.68
• Examine your BMI in relation to the obesity classification.Values below 18.5 are classified as underweight, values between 18.5-24.9 are normal weight, values between 25-29.9 are overweight, values between 30-34.9 are obese (1st degree obesity), values between 35-39.9 are severely obese (2nd degree obesity), and values of 40 and above are morbidly obese (3rd degree obesity).

If your BMI value is outside the normal range, you can create an appropriate treatment plan by consulting with your dietitian or physician.

Why Is Body Mass Index Important In Obesity Surgery?

BMI is a measure calculated by taking a person’s weight and height into account. BMI is used to predict the risk of diseases associated with obesity. If a person’s BMI is 30 or higher, they are considered obese. A person is considered morbidly obese if their BMI is 40 or higher.

Morbid obesity carries a higher health risk than other types of obesity. Therefore, patients with morbid obesity should consider bariatric surgery to reduce the risk of obesity-related diseases. However, since there are risks associated with any surgical procedure, it is necessary to confirm that patients are suitable candidates for bariatric surgery.

BMI is an important criterion used to determine suitable candidates for bariatric surgery. Patients with a BMI of 40 or higher are considered suitable candidates for surgical interventions. However, it is also determined based on the presence of obesity-related diseases whether patients with a BMI of 35 kg/m² or higher are suitable candidates for bariatric surgery.

In conclusion, body mass index (BMI) is an important tool for obesity surgery. BMI is used to predict the risk of diseases associated with obesity and is an important criterion for determining suitable candidates for bariatric surgery. Healthcare professionals involved in obesity surgery should understand the importance of BMI and the need to monitor their patients’ BMI values.

Why Is Diet Important After Bariatric Surgery?

Bariatric surgery is a surgical method with different types, and a different diet program needs to be applied after each one.  Choosing the right nutrients and eating a balanced diet will not only facilitate weight loss but also help you maintain a healthy weight for a lifetime after bariatric surgery.

In the first few weeks after bariatric surgery, serious dietary restrictions are imposed to prevent postoperative complications and reduce side effects. However, the diet is not just for this short-term period but a lifelong one.

Many people gain weight again after rapid weight loss following bariatric surgery. This may be due to irregular eating habits and a lack of physical activity. Therefore, the diet after bariatric surgery is important not only in the postoperative recovery period but also in the long term.

Who Are The Best Candidate For Bariatric Surgery?

Bariatric surgery may be an option for people who are severely overweight or obese. However, surgical intervention is not always the first-choice method. Bariatric surgery is generally considered when other weight loss strategies such as diet and exercise have proven ineffective.

The most suitable candidates are individuals who possess the following characteristics:

• those with a body mass index (BMI) of 40 or higher. Individuals with a BMI between 35 and 40 may also be suitable for surgical intervention, but additional factors such as obesity-related health issues (e.g., diabetes, hypertension, sleep apnea) should be taken into consideration.
• Individuals with obesity-related health issues, such as type 2 diabetes, high blood pressure, sleep apnea, heart disease, or joint problems
• those for whom other weight loss strategies, such as diet and exercise, have failed or are not applicable.
• those who have understood and accepted the risks associated with bariatric surgery. Individuals who can make lifestyle changes after surgical intervention and commit to following the diet and exercise requirements post-surgery

However, suitable candidates for bariatric surgery are influenced by a combination of several factors. Therefore, it is recommended that an obesity surgery specialist evaluate an individual to determine whether or not they are suitable for bariatric surgery.

How Much Weight Is Lost After Obesity Surgery?

Different surgical procedures and individual factors can have varying effects on weight loss. However, the average weight loss after obesity surgery can vary depending on the surgical intervention method.

Some research shows that the average weight loss after the most common obesity surgery procedures, such as gastric bypass, sleeve gastrectomy, gastric balloon and laparoscopic adjustable gastric banding, is as follows:

• Gastric bypass: an average of 30–35% in the first 6 months, 50–60% within the first year, and up to 60–70% within the first two years.
• Sleeve gastrectomy: an average of 30–35% in the first 6 months, 50–60% within the first year, and up to 60–70% within the first two years.
• Laparoscopic adjustable gastric banding: an average of 15–25% in the first 6 months, 30–40% within the first year, and up to 40–50% within the first two years.

However, the weight loss process also depends on how well the patient adheres to dietary and lifestyle changes in addition to the surgical procedure. Therefore, the rate and amount of weight loss after surgery may vary depending on personal factors.

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