THE TREATMENT OF OBESITY.

THE TREATMENT OF OBESITY;

The first stage of the obesity treatment is to make changes in your diet, exercise and behaviors. There are surgical treatment options for the patients who cannot achieve results from these treatments.

SURGICAL TREATMENT;

The purpose in the surgical treatment of obesity is to ensure the patient can lose 80% or more of the excess weight within 1-1.5 year period.

Before the obesity surgery, the patient’s dietary habits, psychological and hormonal conditions and the existence of other illnesses must be examined in detail.

To be able to apply the surgical process, the patient must fulfill these conditions:

have a Body/Mass Index (BMI) above 40
the existence of an illness based on obesity for the patients with BMI 35 and above
receive no benefit from continuous diet, exercise and behavioral change treatments.
no alcohol and drug addiction
no mental or physical disease that may prevent the surgery.

SLEEVE GASTRECTOMY SURGERY;

The sleeve gastrectomy is a surgery within the category of surgeries that reduce the stomach size and it is based on removing 75-80% part of the stomach with a long-axis cut. Although the main effect is about reducing the stomach volume, the center that secretes the “ Ghrelin “ hormone that is known as the appetite hormone is also removed, which strengthens the effect.

The surgery is carried out under general anaesthesia with laparoscopic (closed) method, with the help of 4 or 5 holes. The stomach is cut at the long-axis with the help of special cutting – stapling instruments known as the “stapler” and the stomach is taken outside of the abdomen.

Similar to all obesity surgeries the purpose after the surgery is to ensure 80% of the excess weight is lost within 9-12 months.

The method does not change the digestion mechanism therefore the vitamin/mineral lost after the surgery is minimum and no long-term vitamin/mineral supplement is necessary.

The patients are discharged from hospital generally on the 3. or 4. day after the surgery and they can usually return to their daily lives after 10-15 days of rest.

GASTRIC BY-PASS SURGERIES;

It is a surgery which restricts the stomach volume and disrupts the absorption and this surgery method has been much more frequently applied throughout the world as it is an older technique when compared to sleeve gastrectomy. In other words the patient eats less and benefits less from what is eaten.

A stomach with 30-35 cc is prepared at the stomach location next to the esophagus and the small intestine’s selected point is connected to the prepared stomach. The prepared stomach and connected small intestine is called as “Mini Gastric By-Pass” or “ Roux En Y Gastric By-Pass” depending on the connection’s location. Both are carried out under general anaesthesia and with laparoscopic method.

The hospital stay and resting periods after the surgery are same as the “Sleeve Gastrectomy” surgery, but the patients must receive long-term vitamin and mineral support after Gastric By-Pass surgery.

FOLLOW-UP;

The patients’ surgical examinations are carried out within 1. , 3. , 6. and 12. months after the surgery. During this process the patients are closely observed by the dieticians at our hospital.

It should not be forgotten that such attempts provide our patients with a new body within 9-12 months. Preserving this body and improving it is at the hands of our patients, with the help of a healthy diet and suitable exercise programs.

THE NON-SURGICAL ALTERNATIVE “STOMACH BALLOON“;

The stomach balloon application, which is one of the methods used in the treatment of obesity, is a method in which a balloon with 600-700 cc volume is placed inside the stomach to reduce the stomach volume and to make patients’ diet adaptation easier. This method is especially preferred by the patients who do not want a surgery, whose body/mass index is not suitable for surgery and the patients who want to lose weight or patients with super morbid obesity, during the stage of preparation for a surgery. Stomach balloon application is absolutely a non-operative method, and the balloon is just placed and removed endoscopically. The process is carried out during the state of sleep that is called sedation, and the patients do not feel anything during the process.

Because of its nature, the stomach wants to transfer the content to the small intestine or remove it by vomiting. Therefore there might be some complaints during the first week (especially the first three days) after the process such as nausea, vomiting or stomach pain that extends to the back. During these periods the patients should be supported by medications taken from the mouth or intravenous serum therapy. The patients should continue the process after this problematic period with the help of dieticians.

The balloon stays in the stomach for approximately 8-9 months and it is removed at the end of this process endoscopically (without surgery).

The stomach balloon application is a method with higher failure rates when compared to surgical methods. There is a risk that the lost weight can be taken back especially after the balloon is removed. It is because the balloon application is a patient-dependent method when compared to the surgical method. The balloon application’s purpose is to decrease the stomach volume temporarily, so that the patents can have a new dietary habit. The failure is observed only on the patients who cannot get a new dietary habit or who return to their old dietary habit.

THE TREATMENT OF OBESITY.