Bariatric Surgery

Obesity is among the most common health problems worldwide in recent years. Over time, due to irregular nutrition, weight gain begins and this amount of weight increases over time. Many health problems are also experienced due to increasing weight. Excess weight deteriorates the physical appearance and causes psychological problems in addition to health problems.

Thanks to developing technology and modern medicine, many methods have been developed to solve overweight and health problems. Surgical intervention is the most successful treatment method. Bariatric surgery; It allows patients to lose weight quickly by changing the structure of the stomach and small intestine.

What Is Bariatric Surgery And How Is It Performed?

Surgical procedures applied for the treatment of overweight and weight-related diseases are called bariatric surgery. Bariatric is derived from the Latin word baros meaning weight and iatrikos meaning medical treatment. It means treatment of excess weight in Englısh. It has been used as bariatric surgery since the 2000s.

The main purpose of all operations performed in obesity surgery is to reduce weight, accelerate healthy weight loss and treat weight-related diseases. Diseases such as heart, fatty liver, reflux, cancer, sleep apnea, respiratory failure, diabetes and high blood pressure occur due to being overweight. After bariatric surgery, many of these diseases go away completely or are significantly reduced. The drugs used for these diseases are also discontinued over time or the dose is reduced.

Many methods of bariatric surgery are applied today. Generally, the most frequently applied bariatric surgery methods are;

• Biliopancreatic diversion
• Gastric bypass
• Gastric sleeve operation

Gastric Bypass: In gastric bypass operations, which are the most commonly performed bariatric surgery, the volume of the stomach is reduced to around 5% and a new gastric pouch is created. This newly formed stomach is called gastric pouch. The upper part of the small intestine is connected to this newly formed stomach. Thus, both the stomach volume is reduced and the digestive tract is shortened. In this way, the person becomes fuller more quickly and the nutrients are removed from the body before they are fully absorbed, and the patient loses weight quickly thanks to the calorie deficit.

Gastric Sleeve Surgery: In all stomach surgeries, which are among the most applied obesity surgeries, the stomach volume is reduced by removing the most enlarged part of the stomach. Due to the reduction of the stomach volume, the patient also consumes less food and loses weight quickly.

Biliopancreatic Diversion (Bpd): in this method, both stomach volume and intestinal length are reduced. In this method, a larger stomach volume is left compared to other methods and weight loss is achieved by restricting absorption.

Who Is Bariatric Surgery Recommended For?

It is not recommended for every overweight person to resort to bariatric surgery. Bariatric surgery is a personalized process and not every method is suitable for every patient. In general, patients who are suitable for bariatric surgery;

• Overly obese people with a body mass index of 40 or above,
• Those who have a body mass index between 35-39.9 and also have a dangerous disease caused by overweight such as type-2 diabetes, hypertension and sleep apnea,
• In very rare cases, bariatric surgery is recommended for people with a body mass index of 30-34 who have certain health problems.

In the absence of these criteria, many surgeons do not accept to perform bariatric surgery. For the application of obesity surgery, you need to go through a very comprehensive examination and analysis process. Apart from the surgeon, it may be necessary to be interviewed by a dietitian or even a psychologist if necessary. Since you need to completely change your lifestyle and nutrition process after obesity surgery, you need to be ready for this process both physically and psychologically. In addition, you should continue to talk to your doctor after the surgery, have the necessary tests done when your doctor recommends, eat healthy and do sports.

What Are The Risks Of Bariatric Surgery?

As with any surgical intervention, there are certain risks in bariatric surgery. The most common side effects in bariatric surgery are;

• Excessive bleeding
• Infection
• Reaction to anesthesia
• Throwing a blood clot
• Lung and respiratory problems
• Leakage in the digestive tract
• There is a rare possibility of death
• Some of the problems experienced after bariatric surgery are
• Intestinal obstruction
• Dumping Syndrome
• Gallbladder stones
• Hernia problem
• Low blood sugar (hypoglycemia)
• Nutritional deficiency, vitamin and mineral deficiency
• Ulcer
• Reflux
• The need for a second surgery
• In rare cases, death within 30 days after the operation

What Is Obesity Frequency?

Made a Studies show that 1.7 billion people worldwide are overweight or obese. In England, it is known that 1 million people struggle with obesity. Whether a person is obese is determined by reaching the body mass index by making a certain calculation. Persons with a body mass index of 25 and above are defined as overweight, those of 30 and above are obese, 40 and above are morbidly obese, and those over 50 are malignantly obese.

Is Bariatric Surgery The Definitive Treatment Of Obesity?

Obesity surgery is a long process and the patient has responsibilities as much as the surgeon. After the operation, patients lose a large proportion of their excess weight quickly. Afterwards, the patient continues to lose weight by continuing his special diet. The weight loss process after obesity surgery takes 1.5-2 years.

After bariatric surgery, the patient must completely change his old diet. After the operation, the patient is fed with liquid in the first stage, at this stage, the patient is fed with liquid foods such as soup. Afterwards, the puree begins to be fed and the food is consumed by pureeing. On the other hand, the transition to solid foods is made gradually and at this stage, soft foods that are easy to eat are consumed. Since the structure of the stomach and digestive system will completely change after the operation, the foods consumed are very important and since digestion will be difficult in the first process, they are consumed with liquid and soft foods. If the patient does not leave his old diet after the operation, the reduced stomach volume starts to grow again and the patient starts to gain weight. In order to avoid such a problem, you should pay attention to your lifelong nutrition after the operation. The applied diet is approved by the doctor and dietitian and is changed over time. In order not to strain the stomach and digestion, the patient is fed 400 to 900 calories per day for an average of 1 year. If you do not pay attention to this amount of calories and eat too much and fast, it causes Dumping syndrome, which causes sweating, nausea, vomiting and dizziness. According to studies, 1 out of every 4 patients undergoing bariatric surgery fails. Considering this research, it is not correct to say that bariatric surgery is the definitive solution for the treatment of obesity, but it is a very effective method.

There are many diseases related to obesity and overweight. Thanks to obesity surgery, these diseases are completely healed or decrease to levels that do not affect the patient’s quality of life.

What Are The Results Of Obesity Surgery?

Many diseases occur due to obesity. Many health problems such as hormonal disorders, heart failure, kidney failure, fatty liver, respiratory failure, cancer, diabetes, high blood pressure, sleep apnea and snoring are seen due to excess weight. Especially in women, ovarian, breast and cervical cancers are frequently seen. In line with the researches, it is proven that these diseases are completely eliminated or significantly reduced in people who have obesity surgery due to excess weight and lose a healthy weight.

What To Know About The Results Of Bariatric Surgery?

A group of physicians reviewed 136 individual studies that had characteristics of patients who had a total of 22,094 bariatric surgeries between 1990 and 2003. In the study, the effects of surgery on diabetes, hyperlipidemia, hypertension and sleep apnea were investigated. The mean age of the patients is between 39-40, and 70% of them are women. The body mass index of the patients before the operation is between 46-50.

Among the bariatric surgery methods performed, there are many surgical methods such as gastric band, gastric bypass, sleeve gastrectomy, biliopancreatic diversion or duodenal switch and mini bypass.

What Is The Average Weight Loss After Surgery?

The most striking effect of obesity surgeries is the rapid weight loss of patients. According to studies, weight loss after obesity surgery is;

Gastric band 47.5%

61% in gastric bypass

68% in gastroplasty

70% in BPD or duodenal switch

What Is The Mortality Rate In Obesity Surgery?

As with any surgical operation, obesity surgeries have risks. Generally, the risk of death in obesity operations is very low. Health problems due to obesity-related diseases cause more death. Mortality rates seen within 30 days after the operation are;

• 1% only in restrictive surgeries such as gastric band and gastroplasty,
• 5% in gastric bypass
• 1% in biliopancreatic diversion or duodenal switch.

What Are The Effects Of Obesity Surgery On Obesity-Related Health Problems?

In diabetes mellitus caused by obesity, 77% of the patients completely recover after the operation. More than 70% of the hyperlipidemia patients recovered, while 62% of the hyperlipidemia patients recovered completely, while the disease was reduced in 78%. 83% of patients with obesity-related sleep apnea have completely recovered.

What Are The Health Effects Of Obesity?

With the onset of obesity, some diseases such as diabetes, blood pressure, heart attack, asthma and sleep apnea begin to appear due to excessive weight gain. If such diseases are not treated by losing weight, they impair the health of the person and reduce the quality of life. According to studies, the life expectancy of morbidly obese people is shortened to a certain extent compared to normal-weight people. In line with the research, it is determined that the life expectancy of someone who is obese at the age of 25 is shortened by 22%, that is, by an average of 12-13 years. According to the research, it has been proven that if such obese people are not treated in time, their diets applied in the future are ineffective.