We call obesity to have more fatty tissue in our body than it should. In obesity, if there is a general fat accumulation in the body, especially if the fat accumulates around the abdomen, we call it central obesity or visceral obesity. Central obesity is the most dangerous form of obesity, and in the case of prolonged central obesity, it is almost always associated with diseases such as diabetes, hypertension, sleep apnea, dyslipidemia, ie high blood fats, and fatty liver.
Obesity is a preventable or curable disease and obesity is one of the most important causes of preventable death.
Although there are different calculation methods, the most widely accepted obesity calculation method in the world is the Body Mass Index calculation. In this calculation, your weight in kg is divided by the square of your height in meters (kg / m2) and a value is obtained. If your body mass index (BMI) value is 30 and above, you are in the obesity group and you have to do something to solve this problem!
Today, obesity is accepted as a disease alone and it is one of the elements of a very dangerous syndrome called Metabolic Syndrome. The most common components of metabolic syndrome are; central obesity, type 2 diabetes or insulin resistance, dyslipidemia and hypertension. In addition to being a part of the metabolic syndrome, obesity is the main factor that constitutes the metabolic syndrome. Most of the patients who are obese for a long time will develop very serious and life-threatening problems such as diabetes, blood pressure and blood fat disorder.
The easiest treatment of obesity is prevention of obesity, that is, never encountering this problem, but unfortunately the wrong eating habits, not doing sports, not having access to exercise opportunities, not having access to healthy and natural food, sedentary life, excessive TV watching, rupture from nature, depression, parental unconsciousness, parental obesity and it is no longer unlikely that obesity is a problem due to certain genetic conditions.
If we are experiencing obesity problems, the first thing to do is always to get used to the right diet, to reduce calorie intake and to increase calorie consumption as soon as possible and to take steps in this direction.
In cases where exercise and diet precautions do not work, our patients with obesity problems should never be despaired and should turn to other treatments. There are non-surgical and surgical treatments of obesity.
As non-surgical treatment, drug therapies (GLP Analogs), non-surgical therapies such as gastric balloon, gastric botox, constitute surgical treatments of obesity; tube stomach surgery (gastric reduction), gastric bypass, sadi, sadi S, duodenal switch creates many operations such as. In the surgical treatment of obesity in the world and in Turkey, the most commonly used method is Gastric Sleeve Surgery ( Sleeve gastrectomy )
Surgical treatment options for obesity are Gastric Sleeve Surgery, Gastric Bypass,Mmini Gatsric Bypass, Sadi, Duodenal switch. In all of these surgeries, the stomach needs to be reduced to a certain extent. This reduces stomach volume and low calorie intake due to early saturation, and another effect of obesity surgery is a significant reduction in appetite. Nowadays, the most common surgical obesity treatment in the world and in our country is Gastric Sleeve Surgery.
Vertical Sleeve Gastrectomy is based on the principle of vertically reducing the stomach by 75-80% and turning it into a tube. By reducing the stomach after Gastric Sleeve Surgery, the volume is reduced and much less caloric intake is provided, so that the patient enters a rapid weight loss process after the operation. In addition, a portion of the stomach, called the Fundus, is removed during the reduction of the stomach. It is known as the appetite center because of the appetite hormone Ghrelin secreted by the Fundus. Since the Fundus is removed, the appetite decreases after gastric surgery and the appetite control is very easy, in this way the weight loss is very easy.
Gatsric Sleeve Surgery is not an aesthetic surgery but a surgical obesity treatment, so for the purpose of performing Gastric Sleeve Surgery, the patient must be included in the obesity group and could not lose weight with exercise and diet before. Patients with a body mass index of 35 and an additional chronic disease, or patients with morbid obesity with a body mass index of 40 or more, are eligible for Gastric Sleeve Suregry or other kinds of bariatric surgeries.
Gastric Sleeve Surgery is performed by laparoscopic method under general anesthesia via 4 millimetric incisions.In this operation a HD camera called laparoscope and laparoscopic hand tools are used, the stomach reduction process is applied with a special tool called stapler. In Gastric Sleeve Surgery, the stomach is reduced by 75-80% and the appetite center of the stomach called Fundus is removed. Laparoscopic Gastric Sleeve Surgery is an operation that lasts approximately 60 minutes, patients stay in hospital 2 nights and 3 days after surgery. After the surgery, firstly water and then liquid diet is started, depending on the bowel movements and the patient's readiness, foods such as soup, yogurt and sugar-free protein pudding are started gradually.
Gatsric Sleeve Surgery is a restrictive bariatric operation. In this type of bariatric surgery the size of the stomach is reduced by reducing the volume of the stomach by 80%. The reduced stomach becomes more easily saturated with food, so caloric intake will be severely reduced, and the appetite-reducing effect of the gastric sleeve surgery is evident, as the stomach called the fundus is removed. Decreased appetite will be a very effective element in weight control.
In the group with indication, that is, obesity patients who need bariatric surgery because of having very high body mass index, Gastric Sleeve Surgery has an effect that prolongs life, improves quality of life. Gastric Sleeve Surgery treats or alleviates metabolic syndrome, treats or alleviates 2 diabetes, improves psychology, improves, facilitates and improves social life. Although having many aesthehtic results, It should not be forgotten that Gastric Sleeve Surgery is never an aesthetic surgery.
Gastric Sleeve Surgery is not a miracle but is a very effective surgical obesity treatment, so as in every surgery, there are some risks. Some of these risks may be caused by surgery and some of them may be caused by anesthesia and some of them may be caused by the patient's obesity and metabolic syndrome. General risks of the gastric sleeve surgery are; infection, deep vein thrombosis, embolism, bleeding, gastric leak and anesthesia based risks. Although it is not possible to reduce these risks to zero, it is possible to reduce them significantly. A good and detailed preoperative preperation, the initiation of the necessary behavioral or drug treatment beforehand, the cessation of smoking and alcohol, the patient education and awareness, the use of high quality materials during the operation, the use of high-quality hospital with an adequate level of intensive care unit, the use of bio- adhesive materials or manual re-suturing method to the incision line, embolic prophylaxis, lung exercise, and, if any, pre-treatment of diseases such as Asthma and COPD are some of the risk reduction measures.
A careful and thorough preparation process prior to Gastric Sleeve Surgery is essential for; the safety of the operation, short and long term benefit of the patient, reducing the risk of weight gain back in the long term and shortening the hospitalization process.The first step of this preparation process is to explain the operation to the patient in detail and to answer all the questions in the patient's mind. At this stage, the benefits of surgery as well as the risks should be explained in detail and the patient must be understood. Patients who choose to undergo surgery should be told exactly about the preparation of the surgery and their post-operative life so that the patient can visualize his / her experience. The next step is to tell the patient how important it is to terminate habits such as cigarettes and alcohol, if any, and to allow the patient to take a step in this direction, thus significantly reducing the risks of surgery. The next step is to complete very detailed blood tests, respiratory tests, gastroscopy for gastric examination and the consultation with internal medicine, anesthesia, chest diseases, cardiology and psychiatry. If a problem or disease is detected during these examinations, it must be eliminated or controlled before surgery.The patient who has undergone all educational and informational processes, examinations, tests and gastroscopic examination will now be ready for a safe gastric sleeve surgery.
Patients should quit smoking and alcohol before surgery, if they regularly use drugs should give the list to the physician beforehand, some blood thinners should be discontinued and the appropriate ones for surgery should be started (this stage will be done with the recommendation of the physician). It will be beneficial as it will prepare the process psychologically and facilitate the operation. Again to know and experience about the lung exercise device called Triflu, it would be beneficial to start Triflu exercise 2-3 days before the operation. It may also be useful to talk to people who have already undergone surgery, but the experience of the surgery is very personal, so please note that you can only get the most accurate information from your doctor!
It is very useful and necessary to stand up and start walks a few hours after the operation. Again for several hours after surgery It is very important to start lung exercises. After the operation, no smoking and alcohol should be exposed. Post-operative diet is a very special stage of surgery, which should only be performed with the advice of your physician and the process should be followed very carefully. Postoperative blood thinning needles and varicose veins stockings are some other precautions to reduce the risk and should be applied according to the physician's advice.
Control of existing lung diseases (asthma / COPD), smoking and alcohol prior to use, using the highest quality instruments and devices in the surgery, gastric incision line, tissue adhesive application or stapler line re-suturing, a good bleeding control during the procedure, the necessary precautions for embolism before and after the procedure are the most important risk reduction measures.
After tube gastric sleeve surgery, patients lose weight for about 12-18 months and get rid of obesity. In this process, they will experience a diet process which starts with liquid diet, continues with puree diet and then continues with semi-solid and solid diet. While this diet process is important for weight loss, its main effect will be to give the patient a healthy eating habit and to maintain the weight they lose after many years, so this diet process also has the duty of educating the patient and getting used to the new diet. In order to prevent weight gain in the long term, it is very important to acquire a new eating habit as well as to acquire a regular exercise habit and an active lifestyle.
Yes, there are some patients who gain weight back after a long period of gastric sleeve surgery, which may be caused by the patient or surgery itself teherefore some patients may have to undergo revision bariatric surgery. Gastric Sleeve may be chosen a revision surgery after a previous failed gastric sleeve, or a failed gastric sleeve may be revised to another bariatric procedure like gastric by-pass . To decide for a revision procedure it is essential to get into direct contact with the surgeon him/herself.
This short article briefly describes why and how obesity effects heart and cardiac health. Here we have good and bad news. Bad news is if you are in obese group you are in a great risk for developing heart disease. The good news is if you succeed to lose weight substantially, you will probably be able to reverse many of the bad effects of obesity on you heart and general health. Please keep reading to see why and how!
Obesity is a risk factor for heart failure. Particularly severe obesity, causes changes in heart structure and function that leads to heart failure, moreover heart failure may occur in severely-obese individuals in the absence of other causes of heart disease. There is even a special term which is used to describe heart failure due to chronic obesity and this is “Obesity Cardiomyopathy”!
High blood pressure or “hypertension” and sleep apnea diseases which occur in obese persons cause changes in heart structure and function that make the development of heart failure to be more likely in obese persons. The most effective treatment for "obesity cardiomyopathy" - a term which is used to describe obesity related heart disease - is weight loss. This may be accomplished by diet and exercise or bariatric surgery.
Substantial weight loss helps to reverse many of the heart problems as well as many of the clinical signs and symptoms of “obesity cardiomyopathy”.
We believe that every person suffering obesity has the power to overcome it, sometimes by her/himself or sometimes with some help like bariatric surgery! Make the first step. Decide!