Obesity Overview
Obesity, one of the most common problems in the modern world, appears when the body mass index is above 30. 15-18% of the bodyweight of an adult male and 20-25% of females are composed of fat. When this rate rises above 25% in men and 30% in women, obesity is diagnosed. When the body intake more energy than it consumes, it is stored as fat and creates obesity.
What is Bariatric Surgery?
The common name of all surgical weight loss operations is “bariatric surgery.” These operations aim to lose weight and regulate metabolism by changing the digestive system; these are carried out with special criteria. Having a body mass index of 40 and above indicates serious obesity and creates a ground for these operations. Individuals who cannot lose weight with efforts and nutritional restrictions can achieve metabolic regulation through this treatment.
People who can lose weight temporarily but who gain weight again achieve permanent results with these interventions. Experiencing urinary incontinence, chronic joint pain, above-normal cholesterol values, high blood pressure, type 2 diabetes, sleep apnea show that you are a suitable candidate. These operations performed to normalize the problems that arise due to excessive weight are enriched based on the dynamics of science developing day by day.
What are Bariatric Surgery methods?
Bariatric surgery methods are performed in different ways, but they serve the same purpose. One of these methods is making the stomach smaller, and the other is making the digestive tract change. Let’s look closer at the details of these methods:
Gastric Balloon (Intra-gastric balloon)
By reducing the stomach volume, it enables the patient to reach the feeling of fullness with smaller portions thanks to the mass effect it creates in the stomach, and thereby achieve the ideal balance. This method, which offers effective results, is performed without general anesthesia. The balloon, which withstands stomach acid for 6 months, is placed by the endoscopy. During the operation, the patient goes to sleep for 15 minutes with conscious sedation. It’s not possible to feel or remember anything. If there are no reflux, ulcer, and severe gastritis in the stomach, a gastric balloon is placed. The operation takes 15 minutes and it’s possible for the patient to leave the hospital on the same day after a few hours of observation. At this phase, no discomfort is felt.
It may be experienced cramping, nausea or vomiting within a few hours. Generally, this is considered as the natural reaction of the stomach. However, these are easily eliminated with medicines or these disappear by themselves after a week. After 6 months, the gastric balloon is removed endoscopically. The biggest advantage of the gastric balloon is that it enables the patient to acquire a new eating habit within 6 months. In this process, the patient, who has reached the feeling of fullness with smaller portions, continues the diet that s/he has become accustomed to when the gastric balloon is removed. After the operation, the diet program should be followed; so, the patient experiences a 20-25% weight loss. With the help of a healthy diet, 30-40 kilograms can be lost. These results completely depend on the patient’s effort. It is of utmost importance that the patients who reveal determination in this regard reflect the same motivation in all areas of their lives.
Adjustable gastric band (Stomach band)
The silicone stomach band process applied to the intersection of the stomach with the esophagus is called an adjustable gastric band. Since the procedure is completely laparoscopic, it is a very fast and painless method. Just like in the gastric balloon process, it provides patients reaching the feeling of fullness with smaller portions and thereby ensuring weight loss. Within 18 – 24 months, the patient can provide 80% of the target weight loss. This gastric band made of silicone divides the stomach into two compartments, just like an hourglass. The small part of the stomach on the top makes the patient feel full with much smaller portions than s/he normally needs. However, as with all operations on obesity, it is not the definitive solution alone unless the patient maintains the diet. The patient needs to eat according to new and healthy habits.
In case not paid attention to food intake as before, gaining weight again is inevitable. The most attractive feature of this method is that no incisions are opened in the stomach or intestines during the procedure. Since it is completely laparoscopic, complications like bleeding, etc. are the least likely. We can say that it is the simplest way among the operations performed for losing weight. Also, the gastric band is suitable for readjustment over time.
Gastric Sleeve (Sleeve gastrectomy)
In this method, 85% of the stomach that includes the part in which the Ghrelin hormone (the hunger hormone) is produced, is taken to decrease the volume, so the patient’s food intake decreases, too. Since the stomach’s new form resembles a tube after the reduction, this is also called tube stomach. As with the gastric banding, no external objects are placed into the body. This method directly eliminates appetite and excessive food intake. Gastric sleeve surgery is effective to balance the hormones that cause obesity. The operation that is carried out laparoscopically, takes 35-40 minutes, and 4-5 small incisions are made. It requires 2-3 days of hospitalization.
Gastric By-pass
Gastric By-pass aims to reduce the volume of the stomach by connecting the stomach to the small intestine by the by-pass method. With this method, conscious absorption disorder is created and digesting food normally is prevented. It provides effective results in morbid obesity since it allows serious weight loss and changes nutritional habits in the long run. Many patients lose 66% of their excess weight in the first year. To get maximum efficiency, the patient should stop snacking. Also, this method is the first choice for patients with Type 2 diabetes, fatty liver, high blood pressure or super morbidly obesity. In addition to weight loss, this is effective to treat the side diseases caused by excess weight.