OBESITY
Obesity is a chronic (long-term) medical condition where the body carries excessive body fat.
It is estimated that by 2030, 1 in every 2 people will have obesity (defined as a Body Mass Index or BMI >30 kg/m2). Both overweight (BMI >25 kg/m2) and obesity increase the likelihood of developing other health conditions.
These issues include type 2 diabetes, high blood pressure, but are not limited to them.
Other health problems include stroke, fatty liver and more severe forms of liver disease, sleep apnea, osteoarthritis, gallstones, high cholesterol, gout, and some types of cancer. Obesity can make the treatment of many other medical conditions more difficult, lead to increased disability, and even increase the risk of early death.
Obesity is sometimes associated with stigma, which can affect a person's mental health and quality of life, and lead to prejudice in how people with obesity are treated.
Gastric Baloon
The simplest method to help with weight loss is the gastric balloon procedure. In this method, a balloon filled with liquid or air is placed inside the stomach with the help of an endoscope under mild anesthesia. The procedure takes about 15-20 minutes. This reduces the stomach's capacity to hold food and ensures quicker satiety. With this method, patients can lose 7-8 kilograms in a few months. However, the balloon can stay in the body for 6 months, and at most 1 year, after which it is removed through an endoscopic procedure that takes about 5-6 minutes.
The advantage of this method is its simple application and the fact that it does not cause permanent changes in the body. However, if the patient does not change their lifestyle or continue their diet after the balloon is removed, the lost weight may be regained. During the 6-month to 1-year usage period, individuals gain experience on how to eat correctly.
Currently, the gastric balloon method is used for patients who are too high-risk for surgery or for super obese individuals as preparation for basic morbid obesity surgery. It can also be used for individuals who do not have excessive weight.
Gastric Sleeve
It is one of the most commonly used methods for weight loss worldwide. In this method, approximately 80-90% of the stomach is removed, leaving the stomach in the shape of a tube. This reduces the person's calorie intake. The gastric sleeve surgery is performed using a minimally invasive technique and takes about one to two hours. The hospital stay typically lasts two to three days. After the surgery, patients can switch to solid food after two weeks of consuming liquids, followed by two weeks of soft foods. Vitamin supplements may be required.
In this surgical method, the fundus of the stomach is completely removed, which prevents the release of the Ghrelin hormone, thereby helping to reduce the person's appetite.
After this surgery, individuals can lose about 80% of their excess weight within a year. Following the surgery, it is important to chew food thoroughly and consume small portions. In addition, exercise should not be neglected. To avoid regaining the lost weight, it is essential to avoid consuming high-calorie liquid foods with refined sugars in large quantities.
Gastric Bypass
In these methods, the stomach is essentially divided into two parts: one large and one small. The newly created small stomach is then reconnected to a part of the small intestine, bypassing the duodenum. Two goals are targeted. The first is to restrict the person's calorie intake, and the second is to reduce the absorption of the consumed nutrients. These methods are successfully applied today using laparoscopic techniques.
Gastric Bypass surgeries are one of the most commonly performed bariatric surgeries worldwide. It is one of the most metabolically effective methods for solving obesity and obesity-related health problems. Weight loss may continue for up to 1.5 years after the surgery. Post-surgery follow-up is important. Patients may require long-term vitamin supplementation. It is crucial for them to stay in contact with their dietitians and doctors regarding their nutrition.
Duodenal Switch
The Duodenal Switch procedure leads to more significant weight loss because it directly affects metabolism. It is particularly suitable for individuals with a BMI greater than 50 kg/m2. In this surgery, both food intake is restricted, and the absorption of nutrients is reduced. It is an effective method for treating conditions associated with excessive weight, such as diabetes, hypertension, and high cholesterol. Since it reduces fat absorption, it is especially effective for patients who consume fatty foods.
Although it is one of the most effective surgeries for weight loss in bariatric surgery, it is not commonly used due to the higher risk of complications during and after the surgery. After the surgery, chronic foul-smelling diarrhea and vitamin and protein deficiencies due to reduced fat absorption are commonly observed.
Mini Gastric Bypass
It is a modification of the gastric bypass surgery that is easier to perform. After creating a long stomach pouch, a segment of the small intestine located 2 meters from the beginning is connected to the stomach pouch. Although the surgery time is shorter and the cost is lower, it has a very successful effect on resolving type 2 diabetes and weight loss. The main disadvantage is that, like in RNY gastric bypass, the remaining part of the stomach outside of the pouch cannot be endoscopically visualized later, and patients may require long-term vitamin supplementation.
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