Rebirth with Obesity Surgery

Upon deciding for the obesity surgery; the heart and circulatory system, lungs, hormones are tested and other general assays are performed. In addition, the patient undergoes psychological evaluation.

When a person loses most of their excess weight after obesity surgery, they don’t just recover physically, but socially as well. They regain their confidence, living the joy of a rebirth. Liv Hospital Obesity Surgery Specialist Prof. Dr. Hasan Altun explained the obesity surgery.


 

Who are overweight, obese and morbid obese people?

Body mass index is used to decide whether a person is overweight or obese. Body mass index is calculated by dividing the weight by the square of the height. Let’s consider a 100kg and 170cm person; their body mass index would be approximately 35. People with body mass index between 20-35 are defined as overweight, if BMI is over 30 than it is called obese. And a BMI value over 40 is defined as morbid (fatal) obesity.
 

Is it impossible for morbid obese people to lose weight with sports and diet?

The main goal of the obesity treatment is to enable the person to lose weight by making lifestyle changes. Non-surgical methods (diet, acupuncture, medication, sports etc.) must be the priority.

However, the success rate of these methods in morbid obesity is 10%, at most. There are people who managed to lose weight with these methods, however, generally the problem is weight maintenance.
 

What is the admission reason of obesity patients; aesthetics or health?

Generally, patients refer to surgery as a last resort. Majority of the patient admitting to the clinic are the ones who tried and failed with many methods. There are patients who come for aesthetic reasons, but they are very few. Most of the time, their concern is health. Unsuccessful drug treatment of the diseases caused by obesity, such as diabetes, hypertension, sleep apnea, high cholesterol is another reason for patients to opt for surgery.
 

What is the current status of obesity in Turkey?

Based on body mass index numbers published by Turkish Statistical Institute; 25% of women are obese, 29% are overweight, while 15% of men are obese and 38% are overweight. These numbers are close to that of those developed countries.
 

What other diseases does obesity cause?

There are many common and obesity-related accompanying diseases that significantly reduce quality of life. Diabetes, obesity, sleep apnea, high cholesterol, hypertension, reflux, asthma, joint problems, vascular problems in the legs are some of them.
 

Can everybody undergo surgery? Who are eligible for obesity surgery?

Not every patient who apply for obesity surgery can be operated. Patients are required to meet certain criteria. They must have tried non-surgical methods for a period of time. Patients must be 18-65 years of age and be able to go under anesthesia. Body mass index must be over 40; or there must be an additional obesity-related disease if BMI is between 35-40, and diabetes or metabolic syndrome if BMI is between 30-35. In addition, there must be no untreated psychiatric disorder and no substance or alcohol addiction.
 

Do you decide for surgery on your own?

Surgery decision is made by a committee. This committee is consisted of obesity surgeon, endocrinologist, cardiologist, pulmonologist, psychologist or psychiatrist and a dietitian. The surgery decision is made by the evaluation of these experts.
 

How is surgery performed?

Today, these surgeries are performed with high technology means. Laparoscopic or robotic methods are used to perform the operation through one or multiple holes, instead of opening the abdomen area. Surgeries gradually take less time with the advanced technology. The sleeve gastrectomy, one of the most common obesity surgery, can be completed in 45 minutes.
 

When do patient return their normal life?

Thanks to technology, these surgeries are performed without opening the abdomen; therefore, patients can return their daily lives within 1 week.
 

When does weight loss start?

Patients start losing weight right after the surgery; they can lose up to 3-4 kilograms during their 2-3 days hospital stay. The weight loss happens rapidly in the first months and lasts for 1-1.5 years. Patients lose 75-80% of the excess weight.

Is 100% success possible after the surgery?

Compared to diet and other methods, success rate of these surgeries is very high. Success rate varies between 80-95% depending on the method.
 

Do patients have difficulty after the surgery? Can they adapt quickly?

The patient adaptation after the surgery is high. Especially the rapid weight loss in the first months increases the adaptation rate. In order to enhance the adaptation, patients are followed up after the surgery. The patient is closely monitored by the surgery team,dietitian and psychologist and necessary actions are taken for patients that have difficulty with adaptation. And periodic group therapies are performed to increase compliance and success.
 

Is there a risk of failure to lose weight or regain?

If the patients are monitored well, the risk of weight loss failure or weight regain is very low. Depending on the method, this rate is 5-10%, at most.
 

What is required from the patients after the surgery?

After the surgery, liquid diet is required for 1 month and then the process of transitioning to solid food. Compliance is very important in this period. The patients are required to comply with certain limitations after the surgery and support the weight loss by increasing their physical activity.
 

What is improved after the surgery? What sort of comfort can patients have?

With weight loss, the patients can get rid of many accompanying diseases caused by obesity. Additionally, they can perform their physical activities more comfortably and become free from many restrictions caused by obesity in their life. Efficiency and success in the business life also increases with weight loss.

People regain their confidence and their psychological problems decrease.
 

What are the surgical methods performed for obese patients?

Sleeve gastrectomy is the most common obesity surgery. Previously, the most frequent method was vertical banded gastroplasty, also known as stomach stapling. However, it became less common due to low success rates and associated complications. Other methods include gastric bypass that restricts absorption and duodenal switch surgeries.
 

Why sleeve gastrectomy is the most common method?

Sleeve gastrectomy surgeries are shorter and simpler. They do not restrict or disrupt absorption; there is no intestinal intervention. Therefore, there is no risk of future intestinal problem and no need for lifelong vitamin and mineral supplement. It is the most preferred method for its highly successful outcomes and simple method.
 

How about gastric bypass?

Gastric bypass is an older method. It has been used for a long time. In addition to restricted food intake, it also disrupts absorption as intestines are shortened. In comparison to sleeve gastrectomy, bypass method provides better weight loss, and higher recovery from obesity-related accompanying diseases. However, surgery duration is longer, more complicated and required lifelong vitamin and mineral supplement. Therefore, gastric bypass is used for a limited patient group.