General Surgery Specialist Assoc. Dr. Eyüp Gemici answered the most frequently asked questions about bariatric surgery; made important recommendations and warnings.
Obesity, declared by the World Health Organization as one of the most serious health problems of the 21st century, is seen in one of every 4 people in the world. It is stated that 67 percent of the adult population in Turkey is overweight and 32 percent is obese. In other words, almost one out of every 3 people in our country is struggling with obesity! Parallel to the increase in obesity, which is defined as 'excessive fat accumulation to impair health in the body', there is a serious increase in the frequency of diseases that affect our whole body, such as cardiovascular diseases, diabetes, respiratory problems, muscle-joint diseases and stroke. In line with the increase in obesity rates in our country, applications for obesity surgeries are increasing day by day.
Acıbadem Bakırköy Hospital General Surgery Specialist Assoc. Dr. Eyüp Gemici pointed out that great successes can be achieved from obesity surgeries today, and said, “Many studies have shown that obesity surgery is an effective treatment option for weight loss, and that it provides very serious improvements in obesity-related health problems such as type 2 diabetes, hypertension and sleep apnea. . Moreover, contrary to the common belief in society, thanks to the experiences and technological developments regarding obesity, the risk in bariatric surgery is not higher than surgeries such as gallbladder and knee replacement when performed in full-fledged hospitals and in expert hands.” said
In which cases is obesity surgery applied?
Mentioning in which situations bariatric surgery is applied, Assoc. Dr. Eyüp Gemici said, “Body mass index (BMI), which is a practical measurement, is used in determining obesity. Obesity with this method; It is determined by dividing the weight in kilograms by the square of the person's height in meters (kg / m2). Accordingly, those with a body mass index between 25 and 30 are defined as overweight, and those with a body mass index of 30 or higher are defined as obese. However, this method is not applied to everyone who suffers from being overweight. Obesity surgery is recommended for overweight people who cannot lose weight successfully despite diet and exercise, who do not have medical barriers to surgery, who do not have eating disorders, and who are psychologically stable. Whether the person is suitable for bariatric surgery is determined by international guidelines. According to this; “Body Mass Index ≥ 40 kg/m² or Body Mass Index 35-39.9 kg/m² and those with one or more obesity-related diseases (such as Hypertension, Type 2 diabetes, sleep apnea, fatty liver, bone and joint diseases) or Body Mass Index Those with a Mass Index of 30-34.9 kg/m² and those with type 2 diabetes who do not improve despite optimal treatment are considered suitable candidates for bariatric surgery. " said.
How does bariatric surgery affect health?
“The main purpose of obesity surgery is to improve metabolic diseases caused by overweight and to ensure that the patient has a much healthier body.” said Assoc. Dr. Eyüp Gemici said, “As a result of the restriction of food intake and/or nutrient absorption with obesity surgery, a series of hormonal and nervous changes develop in the body. Thus, very serious improvements are seen in the health problems caused by obesity. In addition, weight loss occurs steadily after surgery. Many scientific studies have found very rapid improvements in blood sugar and blood pressure levels immediately after surgery. So much so that improvements of up to 2 percent in type 85 diabetes, 80 percent in hypertension and 90 percent in obstructive sleep apnea have been reported. In addition, it has been noted that there is a decrease in the risk of obesity-related cancer, cardiovascular diseases, muscle-joint diseases, nervous system diseases, hormonal diseases and psychological disorders are also regressed. used the phrases.
Which methods are used in bariatric surgery?
The techniques applied in obesity surgery are classified under 3 headings. General Surgery Specialist Assoc. Dr. Eyüp Gemici summarized these methods as follows:
“Techniques that restrict food intake: Sleeve gastrectomy, which is the most commonly used technique in the world and known by everyone, is in this class. In this method, the aim is to reduce the amount of food taken by turning the stomach into a small tube in order to reduce the stomach volume.
Techniques that reduce food absorption: The purpose of this method is to reduce the surface area where the food is absorbed from the small intestines, to ensure that fewer calories are taken into the body. Biliopancreatic diversion surgery is among these methods.
Combined techniques that restrict food intake and reduce food absorption: Mini Gastric Bypass and Roux-en-Y Gastric Bypass surgeries can be given as examples. In these surgeries, calorie intake is limited by reducing the stomach volume and keeping a certain amount of small intestine out of the absorption area.”
How is it determined which method to use?
Referring to how the method to be applied in bariatric surgery is determined, Gemici said, “Determining the technique that will achieve the highest success with the least risk is of great importance in bariatric surgery. First of all, the patient's expectations should be clearly stated. It is of great importance to determine the accompanying diseases such as diabetes, hypertension, crohn's and ulcerative colitis, the drugs used, alcohol consumption, eating habits, physical activities and psychological status. If there is a history of previous interventions and/or surgery, it is learned in detail. Afterwards, body reserves are revealed by blood tests. All this information is evaluated and the most appropriate surgical technique to be applied to the person is done with standard application steps. said.
Is bariatric surgery a risky method?
General Surgery Specialist Assoc. Dr. Eyüp Gemici: “As with all surgical interventions on the human body, there may be some risks in bariatric surgery. However, bariatric surgery is a treatment method that has been performed for many years, has proven its efficacy and safety, and its results have been clearly determined. In addition, according to scientific studies; Bariatric surgery today does not involve more risks than gallbladder or knee replacement surgeries. Appropriate patient selection, adequate evaluation of the patient, the presence of an experienced physician and a team with a multidisciplinary approach, the use of quality and technological materials, strict patient follow-up, the patient who is aware of his responsibilities and fulfills his homework are the most important parameters that ensure success and reduce the risk in bariatric surgery. he said.
How long does it take to lose weight after bariatric surgery?
General Surgery Specialist Assoc. Dr. Eyüp Gemici, “Loss weight; It varies according to the surgical technique applied, the accompanying disease, the person's compliance with a healthy diet, physical activity and individual characteristics. After bariatric surgery, half of the excess weight is lost in the first 6 months, and 70-80% of the excess weight is lost at the end of the first year. So if a rough example is given; A person with a height of 170 cm and a body weight of 120 kg loses an average of 6-30 kg in the first 35 months and 40-45 kg at the end of the first year after bariatric surgery.” he continued.
Is there a risk of regaining weight after bariatric surgery?
General Surgery Specialist Assoc. Dr. Eyüp Gemici pointed out that after bariatric surgery, there is a steady weight loss of 1.5-2 years on average, and said, “Weight regain mainly occurs after 2 years. In scientific studies, 20 percent post-operative weight gain is reported. Inadequate surgical technique, inability of the person to adapt to the post-operative process and the presence of emotional eating disorder are the most important factors in regaining weight. gave the information.
What is the importance of follow-up after bariatric surgery?
General Surgery Specialist Assoc. Dr. Eyüp Gemici pointed out that patient follow-up after bariatric surgery is as important as performing a successful surgery, “Because in patients who are not followed up after bariatric surgery; Problems such as eating disorders, sagging in the body, hair loss, metabolic and psychological problems and weight gain are more common. used the phrases. General Surgery Specialist Assoc. Dr. Eyüp Gemici said, “After surgery, one week, first month, third month, sixth month, first year and annual follow-up is recommended. In addition, according to the needs of the person, it is necessary to stay in constant contact with interim follow-ups. In this follow-up process; It is of great importance to evaluate the patient's body structure, to monitor blood values intermittently and to supplement them quickly if needed, and to keep the motivation and harmony of the patient at the highest level. The professional support provided to the patient in the process of adopting healthy eating habits and increasing physical activity brings success.” he ended his speech.