Bariatric Surgery

Obesity is one of the biggest health problems seen worldwide, especially in western societies. In many scientific studies, obesity has been shown as the most important cause of many diseases that increase mortality and morbidity. The most commonly used measurement method for obesity is BMI (Body Mass Index). It is the value obtained by dividing the weight by the square of the height.

18.5-24.9 kg/m2 Normal individuals

25-29.9 kg/m2       Overweight

30-40 kg/m2<            obese

40 kg/m2<            Morbidocloth

However, an increase in BMI does not always mean obesity. A person with more muscle tissue may have a high body mass index. Expert evaluation is important to understand the source of the increases in body weight. If the waist circumference is 102 cm in men and 88 cm or more in women, obesity should be considered.

The main purpose of obesity surgery is to prevent the development of diseases caused by obesity (DM, cardiovascular diseases, sleep apnea syndrome, etc.) or to treat diseases if they occur, in addition to losing weight.

Alone or many factors together can cause obesity. These are genetic predisposition, endocrine and metabolic diseases, social and cultural differences. If the amount of energy entering the body is more than the amount burned, it causes obesity.

It is estimated that around 1.7 billion people worldwide are overweight. In the USA, the situation is more serious. About 2/3 of the population is overweight and about half of them are classified as obese.

Obesity surgery has been widely performed in the world in recent years. The first effective bariatric surgery was performed in the United States in 1954 by Kremen and Linner (jejunoileal bypass).

The operations are divided into 3 according to the mechanism of action:

1. Restrictive surgery (Adjustable Gastric Banding, Sleeve Gastrectomy)
2. Surgery that disrupts absorption (Roux-en-Y Gastric Bypass, Mini-Gastric Bypass)
3. Restrictive and absorption-impairing combined surgeries (Duodenal switch, SADI-S)

WHO SHOULD HAVE SURGERY TREATMENT?

1. When choosing patients suitable for surgery, we decide according to the following criteria.
2. Having a body mass index above 40 or having a concomitant disease (hypertension, diabetes mellitus, sleep apnea, arthritis) with a body mass index of 35-40.
3. Presence of obesity for at least 3 years.
4. Absence of hormonal diseases. (Hypothyroidism, adrenal gland diseases)
5. Failure to lose weight for at least 1 year despite medication and diet therapy.
6. Not addicted to alcohol or drugs.
7. The patient's understanding of the method to be applied and being able to adapt after the operation.