We cannot evaluate obesity tratments only as being overweight or having high body fat ratio, and the perspective that a single method can be successful in its treatment will not be correct.
Treatment should be done in a multidisciplinary approach and in many ways. Treatment is a long and difficult process for the patient. Since it will take time to achieve treatment results, one of the most important factors in obesity treatment is the determination of the patient.
During this process, the patient must comply with the applied treatment methods with determination, closely follow the set goals and exhibit a devoted and disciplined approach in order to achieve the purpose of the treatment together with the doctor, dietician or psychologist.
In order to determine the treatment process, first of all, the root causes of obesity disease, the patient’s character, lifestyle, body mass index and obesity class, waist circumference fat rate and many other factors should be considered.
By evaluating these factors, the most appropriate treatment method to be applied for the patient’s treatment is determined by your doctor. However, this method is not the application of only one of the methods we will mention below. It is also important to apply the ones that are suitable for the person together.
In other words, only performing surgical intervention does not mean that obesity disease is treated. For example, the patient needs to change his/her lifestyle after surgical treatment, follow a nutritional diet and include exercise or sports activities in his/her life.
It is important for the patient to know the root cause of obesity and to create awareness, and for obesity to be accepted as a treatable disease.
The goal in the treatment of obesity is for the patient to reach the ideal weight and therefore the body mass index. Thus, the complications caused by obesity or excess weight will be eliminated. For this reason, weight gain should be stopped immediately and the loss of excess weight should be started.
As can be expected, the first step of the treatment will be the right diet. Exercise or an active lifestyle also supports the treatment, but this is sometimes not possible for obese patients.
Significant weight loss in the first 6 months is important both to maintain the patient’s determination in the continuity of the treatment and, more importantly, to eliminate the health problems caused by obesity.
However, as mentioned in the causes of obesity, if obesity is triggered by another health problem, the patient may also need to use regular medication for the treatment of the health problem in question.
We have mentioned the importance of losing significant weight in the first 6 months of obesity treatment. Since the patient’s calorie intake must be restricted in order to lose weight, the most common method that does not require surgery is the gastric balloon application.
A gastric balloon is a procedure in which the balloon is placed endoscopically into the stomach in a deflated state and then inflated, creating a feeling of fullness in the stomach and thus restricting food intake.
It is a widely used, easy to apply, effective and reliable method in obesity treatment. Gastric Balloon;
The decision to have a gastric balloon inserted depends on the person himself, unlike obese patients. It can be preferred in cases of urgent and rapid weight loss. The advantages of gastric balloon application are;
However, the disadvantages of gastric balloon are as follows:
The patient’s determination and compliance makes the weight loss process much easier. However, once the balloon is removed from the stomach, the lost weight can be regained unless it is supported by nutrition and exercise programs.
The incidence of morbid obesity is increasing in our age. According to research by the World Health Organization, approximately 2 billion people in the world are overweight and 650 million of them are obese.
Obesity is a disease and can be treated. It is wrong to see obesity as excessive fat tissue formation and weight. The reason obesity must be treated is because of the vital diseases it causes. Obesity is the cause of many diseases such as Type-2 diabetes, cardiovascular diseases, joint disorders, asthma, sleep apnea, respiratory failure, cancer, stroke, psychological problems, skin diseases.
In patients with morbid obesity whose body mass index is 40 and above, it is vital that the treatment loses weight as quickly as possible. Because the diseases it causes become chronic day by day. It is important to eliminate vital risks. However, if there are vital health problems in patients with a body mass index of 35, surgical treatment should be considered.
Surgical treatment methods are the most successful and best-resulted treatment methods applied for obesity treatment today. After the surgical operation, the patient’s metabolism changes. Since the stomach becomes very small, appetite and food intake decrease. Weight loss begins rapidly.
However, reversal of surgical treatment is not possible. Considering that the treatment is a serious operation and the patient’s psychology, the first approach in obesity treatment is to evaluate treatments that do not require surgery, taking into account the patient’s health condition.
As mentioned before, surgical application alone does not mean that obesity is cured. After surgical treatment, the patient’s determination and the lifestyle changes (nutrition and physical activity) that he/she must follow are important.
Surgical treatments are also defined as Bariatric Surgery, the general purpose of stomach reduction surgeries or weight loss surgeries is to reduce food intake and absorption. Bariatric surgery surgeries are performed laparoscopically.
It is also important to separate surgical treatments according to their purpose for informational purposes. We can classify surgical techniques as restrictive surgeries, malabsorptive surgeries, or both restrictive and malabsorptive surgeries.
It is performed by cutting a large part of the stomach (80%) and removing it in the form of a tube using laparoscopic methods. The secretion of the appetite hormone ghrelin decreases in direct proportion to the size of the removed part. The patient feels the need to eat less as the appetite decreases.
placed approximately 5 cm below the esophagus of the stomach and compressed to create a pocket at the top.
Gastric Bypass surgery is one of the most common surgical methods used in the treatment of obesity.
This surgery, called Roux-en-y Gastric Bypass, is performed by cutting the stomach, leaving a small section just after the esophagus, creating a small stomach, and then bypassing and connecting a section of the small intestine to the created stomach. In this way, both the stomach volume is restricted and absorption is restricted by shortening the small intestine.
This surgery is generally widely used. However, the surgery is more complicated than sleeve gastrectomy. Post-operative complications are twice as high. When compared to Sleeve Gastroctemy surgery, it has been observed that there is no significant difference in excessive weight loss rates. However, RYGB surgery is effective in the treatment of diseases associated with obesity.
The most serious complications of surgical methods used in obesity surgery are leakage and bleeding. The development of technology and the development of the instruments used reduce this possibility. Especially in sleeve gastrectomy surgery, the staplers used to close the remaining part of the stomach after it is cut should be original and of the highest quality, which will minimize the possibility of leakage in this surgery.
We use Covidien brand TRI-STAPLE™ staplers, whose quality 
is accepted worldwide, without compromising on quality in our surgeries .
Since the surgeries are performed with minimally invasive methods (laparoscopic or robotic), the rate of patients experiencing scarring or pain is very low.
Roux-en-y Gastric Bypass surgery is complicated and since the intestines and stomach are cut and bypassed in several places, there is a high possibility of leakage and bleeding. In addition, since absorption is restricted in this surgery, vitamin deficiency can be seen. The patient may need continuous vitamin and mineral supplements. In addition, since the length of the small intestine is shortened, dumping syndrome related to excessive sugar consumption can be seen in these patients.
In patients who have had gastric bypass surgery, it is very difficult to perform revision surgery if the treatment is unsuccessful. In this regard, gastric sleeve revision surgery can be done much more easily and successfully.
In determining the most appropriate treatment for an individual, the factors that cause obesity and whether the patient is determined to change their lifestyle have a great impact. In addition, factors such as body mass index, existing comorbidity with obesity, i.e. other health problems, and whether the patient wants a surgical operation are also evaluated.
Revision surgery may be necessary for patients who have previously undergone bariatric surgery but have not achieved results with treatment.
In general, bariatric surgery treatment is considered appropriate for individuals who have not been successful in losing weight through dietary habits and exercise prior to surgical or non-surgical treatment, morbidly obese patients with a body mass index of 40 and above, or individuals with a body mass index of 35 and above and comorbid conditions such as obesity-related type 2 diabetes, hypertension, sleep apnea, respiratory difficulties, non-alcoholic fatty liver disease, joint diseases, and heart diseases.
Although the expected result of surgical methods varies from person to person, the expected result is the loss of 80% of excess weight within 2 years of surgical treatment.
With gastric balloon application, a 10-15% weight loss is expected in 6 months.