Yeditepe University Kozyatağı Hospital General Surgery Specialist Op. Dr. Cihan Şahan gave information about reducing the degree of obesity in the eligibility criteria for surgery and the surgical treatment of obesity.
Kiss. Dr. Cihan Şahan gave the following information on the subject:
“Surgery was previously recommended for individuals with 3rd degree obesity, regardless of whether there was additional disease or not. In this guideline, if individuals with obesity have a 2nd degree obesity disease, that is, if their body mass index is between 35-40 kg/m2, surgery is recommended without seeking additional disease. Surgery is also recommended for individuals with additional diseases, especially in chronic disease conditions such as diabetes and hypertension, and in individuals with 1st degree obesity.” said.
Pointing out that obesity has increased approximately 2021 times in the last 50 years, according to the data of the World Health Organization in 3, General Surgery Specialist Op. Dr. Cihan Şahan said, “In this report, it is stated that more than 18 billion adults aged 1,9 and over are overweight, and more than 650 million of these are individuals with obesity disease. In addition, it is shown that 5 million children and adolescents between the ages of 18-340 are overweight or obese, in addition, 5 million children under the age of 39 are overweight or obese.
Underlining that the main cause of obesity is poor eating habits and insufficient physical activity, Op. Dr. Cihan Şahan said, “However, the point that should be known is that obesity is a treatable and preventable disease. Many reasons can be added to bad eating habits, where people eat unhealthy at a young age, environmental factors and some psychological reasons also come into play. Our main goal with obesity treatment is to make our patients lose weight and keep the weight at a certain level. In this way, we prevent other complications that may develop due to obesity.” used the phrases.
Mentioning that obesity is a public health problem and that it is necessary to take precautions beforehand, Op. Dr. Shahan said:
“The treatment needed by people with obesity should be comprehensively addressed and determined by an experienced team. Which patient needs surgical or endoscopic treatment and which patient needs medical treatment should be determined with a multidisciplinary approach. In this context, it is extremely important that the surgical decision is taken in well-equipped centers with experienced teams in the field of obesity and metabolic surgery.”
“People who have weight problems actually know that this is a problem and they try different methods (diet and exercise, etc.) of their own choice to overcome this problem. These trials create a short-term and temporary effect,” said Op. Dr. Cihan Şahan continued his words as follows:
“When the desired effect is not achieved, it can fail as a result of situations such as hopelessness and ignorance. Short and temporary methods are not important in the fight against obesity. It is necessary to make long-term plans with lifestyle changes, proper nutrition and exercise. We can define clinical obesity as the situations in which individuals cannot succeed despite many attempts, that is, the situations in which individuals cannot overcome obesity on their own. In cases where individuals who have struggled with obesity for many years cannot achieve any success and cannot overcome this situation on their own, we need to support patients.”
Pointing out that obesity centers are more accessible and individuals with obesity apply to these centers, a road map should be drawn after a professional evaluation and continuous follow-up of this should be done. Dr. This situation, which we define as "clinical obesity disease", should be evaluated very well, surgical and medical approaches should be determined, and as a result, the necessity and effectiveness of surgery should be explained to the people who are decided to have surgery. In clinical obesity disease, I can say that surgery is the most effective method in people with 2nd degree or higher obesity. he said.
Pointing out that the International Federation of Obesity and Metabolic Surgery (IFSO) and the American Society of Metabolic and Bariatric Surgery (ASMBS) have entered a new era in the field of obesity with the joint new guide published in December 2022, Op. Dr. Şahan stated the following about the process:
“We first evaluate the degree of obesity in our patients who come for obesity treatment. Until last year, we were able to indicate surgery in patients with 3rd degree obesity, that is, with a body mass index above 40. However, in the new guide published as of December 2022, surgery is recommended for people with 2nd degree obesity, that is, with a body mass index above 35, regardless of the additional disease status. However, surgeries are also recommended for first degree obesity patients with additional disease, that is, with a body mass index between 30-35. With the announcement of this guideline, a new era has been entered in bariatric surgery.”
Stating that several points were effective in taking such a decision and entering the guide, Op. Dr. Cihan Şahan said, “Successful results obtained from gastric bypass surgery, which has been applied for approximately 60-70 years in obesity surgery, and tube stomach surgeries, which have been applied for the last 20 years, are important. Since surgery has become the most effective and safe method in the prevention of obesity, which has become an epidemic in the world, I think that guidelines have been formed by reducing the degree of obesity. In addition, its effect on the regression of chronic diseases is also important. As an example, there are studies showing that diabetes regresses by over 90 percent after bariatric surgery in people with obesity, especially those with non-familial diabetes, and even drug use is completely discontinued.
Emphasizing that the multidisciplinary approach is very important in the success of obesity surgery, Yeditepe University Kozyatağı Hospital General Surgery specialist Op. Dr. Cihan Şahan concluded his speech as follows:
“The patient should be evaluated well before the operation and followed up well after the operation. It is extremely important for patients to be psychologically ready for these processes, to adopt a new lifestyle after surgery, and to comply with follow-up programs and nutritional recommendations. As an experienced team should be, patient follow-up in the postoperative period also plays an important role. We share all these processes with the patient before the operation. The more the patient adapts in the post-operative period, the higher the success rate, and it stays for many years. In order to ensure this permanence, our patients are followed closely for 1 year after the operation, and then annual follow-ups are made and this follow-up period continues for up to 5 years. We carry out all the processes covering the pre-operative, surgical and post-operative period by working as a team with an experienced and coordinated team.”
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