Obesity is one of the biggest health problems in the world, especially in developed and developing countries. Many scientific studies have shown that obesity is the leading cause for many diseases (diabetes, cardiovascular diseases, sleep apnea syndrome, etc.) that increase mortality and other health problems.
Obesity can be defined as an abnormal and excessive fat accumulation in the body that can lead to health problems. Obesity occurs when the body fat percentage exceeds 25% (in women 30%). An obesity or bariatric procedure is defined as a surgical procedure in the digestive tract to help obese patients after the body fat ratio has been measured. The main purpose of a surgical treatment method for obesity is to reduce food intake, limit nutrient intake or both.
Restrictive surgery reduces the amount of food entering the stomach and the amount of food given to the patient. Surgical procedures to reduce ingestion bypass part of the intestines to reduce nutrient uptake.
Depending on the type of procedure the patient undergoes, the daily intake of food and the percentage of food ingested in the intestine will be reduced. In this way, the patient can lose weight quickly and get closer to an ideal weight in a short period of time. However, for obesity surgery to be effective and long lasting, it is necessary to know that after the operation has taken place, that the patient should continue to eat properly and exercise after the operation. This procedure must be continued under the supervision of a doctor or dietician.
Who qualifies for obesity surgery?
Terms and conditions
Obesity surgery is recommended for people who cannot lose weight through diet and exercise programme, regardless of whether hormonal disorders or other treatments have been applied and have not worked. However, surgical procedures are not suitable for all obese patients. It is very important to find the right slimming method that is suitable for the individual, both from a physical and a psychological point of view.
What surgical procedures are used in obesity surgery?
- If you are between 18-65 years old
- If your body mass index (BMI) is higher than 35
- If the patient has been born with an obesity disorder; in cardiovascular diseases, diabetes, sleep apnea or high cholesterol levels
- Obesity that has not been treated for at least 5 years
- If there has been no change in the course of the disease after one year of medication and diet.
- The patient has no hormone problems
- There are no disorders related to endocrinology
- There is no question of excessive alcohol consumption or drug addiction
- If the patient is fully knowledgeable and understanding and can be coordinated with the postoperative obesity team
What is the procedure like after the obesity surgery?
Thanks to technological advancement, it is now easier to carry out obesity operations and the healing process has been shortened. In general, there are three methods that are used in obesity surgery
- Restrictive procedures
- Malabsorptive procedures
- A combination of restrictive and malabsorptive procedures
Some restrictive procedures (gastric bypass) are used less frequently than before. Although malabsorptive procedures that disrupt nutrient uptake are very effective, they have significant side effects. In obesity surgery, the most used method at present is the laparoscopic (closed method) sleeve-gastrectomy (tubular stomach) which falls within the scope of restrictive procedures. Patients must consider the fact that they have to live differently and adopt a new lifestyle. A low-carb and high-protein diet monitored by a dietician, more meals in smaller portions, better chewing habits, daily multivitamin, calcium, and D vitamin supplement. Also exercise and the amount of fluid consumed per day are of great importance.
Gastric sleeve operation
Gastric sleeve surgery is an obesity operation that consists of the laparoscopic removal of about 80% of the stomach. First, the newly formed stomach reduces food intake by the visibly reduced and smaller volume compared to the old stomach. However, the most important effect after surgery is the change in the regulation of fasting and postprandial blood sugar levels due to changes in the gastrointestinal hormones, rather than the restriction of food intake. Even though the patient does not start losing weight shortly after surgery, it has been shown that the increased blood sugar level due to diabetes has reached a normal level and that the medicines and insulin used for diabetes have been completely or partially discontinued.
What is the procedure after the operation?
Technological developments and relevant medical research have made the methods used in obesity surgery simpler, painless and fast. A few hours after the operation, patients can get up and take care of their own needs. After leaving the hospital, they can resume their normal lives and return to work.
In general, the process is as follows
- Hospital stay (1-3 days)
- Duration of liquid diet (first 15 days)
- Duration of finely ground diet (next 15 days)
- Solid food (from 1st month)
Patients may only drink water in the first two days after surgery. After two days, it is possible to switch to a liquid diet under the supervision of the doctor and the dietician.
Duration of liquid diet
During this period, patients should only eat clear and liquid food. These liquids include broth, chicken broth, bone broth, buttermilk made from lactose-free yoghurt, handmade fruit juice, purée, lactose-free milk and additional protein powders.
Shared properties of all liquids that can be consumed during this period; clear, granular, sugar-free and warm.
Under the guidance of a dietician and a doctor, the patient can switch to the finely ground dietary period during this process, depending on the patient’s condition.
Duration finely ground diet
During this period, patients can eat a little more solid food. Finely ground food from cooked egg white, curd cheese, yoghurt, fruit purée, cooked vegetables and pieces of minced meat and/or chicken meat can be eaten during this period under the control of the dietician.
During the finely ground diet, no tomato paste, herbs, oil, lemon, onion-garlic or spices may be added.
In this process, it is important that a regular diet is followed by those who have acquired healthy eating habits. Fried, grilled or cooked lean red meat, white meat and fish may be eaten. It is important to chew as much as possible and eat slowly. Otherwise, it can lead to weakness and dizziness. The daily requirement for fluids should be met at regular intervals with small sips. Otherwise, it can lead to weakness and dizziness. The daily requirement for fluids should be met at regular intervals with small sips.
(Alternatieven) Gastric Balloon and Botox
The balloon system consists of a soft, expandable balloon, a placement tube and a filling system. Intragastric balloon is too big to pass into the gut and leads to a relatively long-term feeling of fullness with smaller food portions. In general, intra- gastric balloon placement significantly reduces portion sizes and helps you to achieve your long-term weight loss goals.
Gastric botulinum toxin injections have been widely used in recent years and botulinum toxin is injected into the gastric fundus using an endoscopy needle. Botulinum toxin affects striated muscles of the stomach, inhibits their con- tractions; in this way it slows the digestion of food in the stomach. It takes longer the stomach to digest the food and accordingly, the sensation of fullness persists for a longer period of time.