Obesity is one of the most important health problems of developed and developing countries. In addition, if left untreated, it causes diseases such as Type 2 diabetes, hypertension, and some types of cancer.
As the Atlas University Hospital family, we pay special attention to obesity patients. We are serving our patients with our surgeons who are experienced in obesity surgery. On the other hand, as part of our vision to provide quality service, we prefer to use the latest technology, first-class materials in operation. In this context, we continue to perform all types of obesity surgery such as Sleeve Gastrectomy, Gastric Bypass, Mini-gastric Bypass, and Revisional Surgery quite successfully.
Obesity Treatment
1- Medical Treatment
- Diet Therapy
• Exercise Therapy
• Medication
• Behavior Change Treatment
2- Interventional Treatment
- Gastric Balloon Application
• Obesity Surgery
-Restrictive Surgeries
-Malabsorptive (Absorption Disruptive) Surgery
-Mixed
Diet Therapy
Patients who apply to the obesity center, under the supervision of nutrition and diet experts experienced in obesity, preoperative and postoperative diet programs are prepared for each patient according to their nutritional habits and special health conditions. Patients are under the supervision of a nutritionist throughout the diet program.
Exercise Therapy
Obese patients often have health problems while playing sports due to their excess weight. These problems can cause the patient to completely stop exercising. After obesity surgery, our exercise programs are gradually organized by the Obesity Surgery Coordinator.
Medication Therapy
If the patient has any metabolic problems that cause weight gain, drug treatment is applied by doctors who are experts in their field to eliminate these problems. There are no proven medical treatments for the treatment of morbid obesity.
Behavior Change Therapy
One of the main causes of obesity is the wrong eating habits. Problems such as depression are common among patients who get rid of this behavior pattern and live with obesity. In addition, group therapy is applied by specialist doctors in the field so that patients who have undergone bariatric surgery can continue the next process in a healthier way.
Patients who have been living as morbidly obese (BMI >40) for more than 5 years have a 1-3% probability of experiencing permanent weight loss with any of the medical treatment methods.
Gastric Balloon Application
In this method, it is applied by inserting a balloon into the stomach from the mouth with an endoscopy instrument and inflating it. Thus, by filling the functional stomach capacity of the patient, it is tried to gain the habit of eating less and less frequently. An important difference from other methods is that the balloon should be removed after 1 year. This method is applied to patients who do not meet the necessary criteria for bariatric surgery, who meet the criteria for surgery but do not want to have surgery, or patients who want to lose weight before surgery to reduce the risk of surgery.
Bariatric Surgery
Obesity surgery basically rests on two pillars. The first is to reduce the amount of food that the patient eats at a time (Restrictive), the second is to prevent the digestion of edible foods (Malabsorptive). The most appropriate of these surgeries is life-saving when performed on the right patient at the right time. Therefore, your Obesity Surgeon Specialist should have experience in applying each method.
Who is Bariatric Surgery Suitable For?
It is recommended for bariatric surgery for patients with a body mass index of 40 and above and who cannot lose weight with methods such as medical nutrition, exercise and medical treatment under the supervision of a specialist. In addition, it is recommended for those with a body mass index above 35 and those with comorbidities related to obesity such as high blood pressure, diabetes, sleep apnea.
The probability of permanent weight loss with the appropriate surgical method is over 95%.
Surgical Methods
In the surgical treatment of obesity, 2 basic mechanisms are used, namely volume restriction and malabsorption. As a volume-limiting surgery, the most common surgery we perform is Sleeve Gastrectomy-Tube Stomach surgery, as it is done all over the world.
Sleeve Gastrectomy
In Sleeve Gastrectomy operations, it is aimed to reduce the volume of the stomach (about 100-150 cc) so that the patient feels full with very little food. At the same time, in this technique, the part of the stomach that secretes appetite hormones is also removed, so the patient’s feeling of hunger disappears. As a result, our patient, who is not hungry, loses weight comfortably by eating a small amount during mealtimes and getting full. Since absorption is not impaired in this technique, there is no need for vitamin etc support treatment after the 1st year.
Gastric Bypass
In the treatment of obesity, by-pass surgeries that provide weight loss by impairing absorption as well as volume restriction are preferred in obese patients with metabolic disorders such as type 2 diabetes. The reason for this is that the small intestine hormones that improve insulin resistance increase thanks to the bypass. Since the appetite hormone part is also removed with the volume restriction component, it also acts by reducing absorption and secreting diabetes-correcting hormone without feeling hungry.
Type 2 Diabetes Surgery
In patients with type 2 diabetes, both precellular and intracellular components are formed against insulin. These resistance hormones originating from the digestive system surround the cells like an armor and prevent the entry of insulin into the cell. Thanks to metabolic surgery, resistance hormones originating from the digestive system are extinguished. The most important small intestine hormone effective here is glucagon like peptide-1 (GLP-1). After this armor around the cell is opened, insulin can easily enter the cell and act as a blood sugar lowering agent. Similarly, fat, protein metabolism, fatty liver and liver damage also improve 2-3 months after surgery, and intracellular signaling and transmission mechanisms are reversed. The most commonly performed surgery for this purpose is transit bipartition surgery.
