Obesity is considered as one of the most important health problems of developed and developing countries. Obesity is the state in which excessive fat tissue rate in the body exceeds the desired level. Above 25% of the body weight in men and above 30% of the body weight in women refers to the presence of obesity.
Bariatric surgery is the most effective way to lose excess weight and keep it off in the long term. It is also called weight loss surgery or obesity surgery.
What is bariatric surgery?
Bariatric surgery is surgery that affects your stomach and how you digest food. It's designed to make your stomach much smaller, which causes you to feel full after eating only a small amount of food. You eat less food and absorb fewer calories after bariatric surgery.
Many factors play a role in the occurrence of obesity problem. To mention these briefly;
• Superalimentation and wrong nutrition habits
• Insufficient physical activities
• Education level
• Life quality
• Financial situation
• Hormonal and metabolic factors
• Genetic factors
• Psychological problems
• Frequently used low-energy diets
• Smoking and alcohol consumption
• Usage of several drugs like antidepressants
• Parity and intervals between deliveries
Such factors induce obesity problems. While these situations cause to obesity, there are also health problems induced by obesity. Many diseases are found in obese people secondary to obesity.
• Insulin resistance
• Type 2 Diabetes
• Metabolic syndrome
• Gall bladder diseases
• Several types of cancer
• Sleep apnea
• Increased risks in surgical interventions
• Mental problems
• Coronary artery disease
• Increase in blood cholesterol
• Difficulty in breathing
• Pregnancy complications
• Menstrual disorders,
• Skin and fungal infections
• Musculo-skeletal system problems
What is the surgical treatment “Obesity Surgery”, our primary concern?
Obesity is not a health problem which can only be taken under control with diet programs, exercises or medication therapy. With these treatment methods, it is possible to regain the lost weight, or in other words, not to maintain the lost weight. The most effective method in obesity treatment is obesity surgery. Shortly, to avoid one’s obesity problem via surgical intervention.
Obesity surgery basically stands up on two principles. The aim in obesity surgery is; to reduce the volume of the stomach and/or “malabsorption”, which means to provide the prevention of the absorption of food. Obesity surgery can be appealed if obesity duration is more than 5 years and if the patient is 20 to 60 years old.
Surgical intervention for patients with excessive weight in order to lose weight is called obesity surgery or bariatric surgery, which originates from the word “baros”, which means weight in Ancient Greek.
Results of obesity surgery, which is nowadays one of the gradually disseminating methods, are more successful when compared with other methods. Weight loss provided by surgical intervention reduces death rate substantially. The biggest advantage of it is that it reduces obesity-related diseases.
There are also situations which are unsuitable for obesity surgery. These are:
• Severe eating disorder
• Persistent obesity with excessive use of alcohol
• Serious systemic diseases
• Diseases that affect upper alimentary tract
• Requirement of regular use of anti-inflammatory drugs
Methods used in obesity surgery;
This surgery is known as tube stomach surgery. In this method, a particular part of the stomach is surgically remove and a tube-shaped stomach is left. It provides weight loss just by reducing the amount of food.
Gastric By-pass Surgeries
Surgeries which reduce food intake and the absorption of food are called gastric by-pass surgeries. In this surgical intervention, the stomach is reduced and a part of small intestines are by-passed in terms of digestion and absorption. Classical by-pass surgery, which we call RYGB, is the surgery which reduces the stomach mostly. Absorption control level is nearly zero.
The rationale behind this surgical procedure is that the obesity and diabetes booms associated with modern diets can be avoided by reversing the process, in which no undigested foods remain until foods reach advanced points of the small intestine as a result of industrialization.
What can I expect after bariatric surgery?
You will need to make significant lifestyle changes after bariatric surgery to lose weight and keep it off. For example, you will need to follow dietary guidelines, and you'll probably take vitamins or other supplements for life. Your weight loss program will also involve increased physical activity.
After the surgery, you'll start with liquid foods. Over the next few weeks you'll change to pureed food, then solid food. Your meals will be much smaller and you may have to stop drinking with meals due to your small stomach.
Onur KESLER M.D.
General Surgery, Obesity, Diabetes Surgery