Metabolic Surgery and Diabetes Surgery Information
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What is Metabolic Surgery?

Metabolic surgery refers to surgical methods used in the treatment of obesity and related metabolic diseases, especially type 2 diabetes, hypertension, high cholesterol and metabolic syndrome. These surgical interventions aim to control diseases by directly affecting the metabolic processes in the body as well as losing weight. Metabolic surgery is considered a very effective treatment method, especially in patients with type 2 diabetes due to obesity.

The main purpose of this surgery is to make changes in the digestive system, to positively change the body's hormonal balance, especially insulin sensitivity, and to regulate blood sugar. At the same time, it controls calorie intake by reducing the absorption of food and provides weight loss. Metabolic surgery uses similar methods to bariatric surgery (weight loss surgery), but its primary goal is to treat and cure metabolic diseases.

The goal of metabolic surgery is not only to lose weight but also to treat metabolic diseases related to obesity.

Prof. Dr. Mehmet ÖZDOĞAN

What is the Purpose of Metabolic Surgery?

The aim of metabolic surgery is not only to lose weight, but also to treat obesity-related metabolic diseases and improve the complications of these diseases. It is a very effective treatment option especially in controlling conditions such as type 2 diabetes, hypertension, high cholesterol and metabolic syndrome. Metabolic surgery makes structural changes in the digestive system, both reducing body weight and positively affecting metabolic processes by regulating hormonal balances.

The main purpose of metabolic surgery is to reduce insulin resistance and provide better control of blood sugar. After surgery, positive effects are observed especially on insulin production and insulin use. In this way, blood sugar levels are better controlled in type 2 diabetic patients and the need for diabetes medications is reduced. In addition, these surgeries contribute to the recovery of other obesity-related problems such as hypertension, sleep apnea and fatty liver.

Another aim of metabolic surgery is to improve the quality of life of patients by providing long-term weight control and to reduce the risk of death due to obesity. These surgical methods allow patients to live a healthier life by restricting calorie intake and nutrient absorption.

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For Which Diseases Is Metabolic Surgery Used?

Metabolic surgery is used in the treatment of metabolic diseases, especially those that develop due to obesity and excess weight. These surgical interventions help control these diseases by regulating the body's hormonal balance and metabolic processes, as well as providing weight loss.

Type 2 Diabetes

Metabolic surgery is particularly effective in treating type 2 diabetes. After surgery, insulin sensitivity increases and blood sugar levels can be controlled. Patients with type 2 diabetes can reduce their need for insulin or diabetes medications after surgery, and some patients can even stop taking these medications altogether.

Metabolic Syndrome

Metabolic syndrome encompasses a range of health problems that occur together, including obesity, high blood sugar, high blood pressure, and high cholesterol. Metabolic surgery reduces these risk factors, improving patients' overall health and controlling metabolic syndrome.

Hypertension (High Blood Pressure)

Obesity and being overweight are significant risk factors for developing hypertension. Metabolic surgery helps lower blood pressure by causing weight loss. Many patients can reduce or completely stop taking their blood pressure medications after surgery.

High Cholesterol and Triglyceride Levels

Metabolic surgery reduces high cholesterol and triglyceride levels by reducing body fat, which significantly reduces the risk of cardiovascular disease.

Obesity-Related Sleep Apnea

Obesity is a significant risk factor for sleep apnea. With weight loss after metabolic surgery, sleep apnea symptoms may decrease and the patient's sleep quality may improve significantly.v

Fatty Liver (Non-Alcoholic Fatty Liver Disease)

Metabolic surgery can reduce fatty liver disease by providing weight loss and metabolic improvement. This condition, which develops due to obesity, usually improves significantly after surgery.

Polycystic Ovary Syndrome (PCOS)

Obesity worsens hormone imbalances in women with PCOS. Weight loss through metabolic surgery can relieve PCOS symptoms and restore patients' hormone balance.

Gastroesophageal Reflux Disease (GERD)

Obesity is an important factor that triggers reflux disease. When weight loss is achieved through metabolic surgery, reflux symptoms can be relieved and problems with stomach acid can be reduced.

Insulin Resistance

Insulin resistance is a condition that plays a role in the development of type 2 diabetes. Metabolic surgery regulates blood sugar by reducing insulin resistance and reduces the risk of diabetes.

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What are the differences between metabolic surgery and bariatric surgery?

Metabolic surgery and bariatric surgery often involve similar surgical procedures and are both used to achieve weight loss, but there are important differences in the focus and basic purposes of these two terms.

1. Difference in Purpose

  • Bariatric Surgery: Its main purpose is to achieve weight loss. It is used to treat obesity and reduce the health risks of being overweight. These surgical methods have been developed specifically to help morbidly obese patients lose weight.
  • Metabolic Surgery: In addition to weight loss, its main purpose is to treat obesity-related metabolic diseases (type 2 diabetes, hypertension, high cholesterol, etc.). Metabolic surgery aims to control these diseases by correcting the hormone balances in the body. Metabolic disorders such as type 2 diabetes are the focus of these surgeries.

2. Targeted Patients

  • Bariatric Surgery: It is usually applied to patients with a BMI (Body Mass Index) of 40 and above and who have serious obesity problems. Bariatric surgery is a weight loss method for patients whose health is at risk due to excess weight.
  • Metabolic Surgery: It can also be used for people with a BMI between 30-35 who are not extremely obese but have diseases such as type 2 diabetes or metabolic syndrome. The goal is to treat and control metabolic diseases beyond weight loss.

3. Focused Diseases

  • Bariatric Surgery: The main focus is to alleviate problems related to excess weight. When weight loss is achieved, obesity-related complications such as hypertension, sleep apnea and joint problems also improve, but the primary goal of these surgeries is not to treat metabolic diseases.
  • Metabolic Surgery: It focuses on treating obesity as well as metabolic diseases such as type 2 diabetes, high blood pressure, high cholesterol and insulin resistance. The aim is to control and improve these diseases by correcting hormonal balances.

4. Surgical Procedures

  • Bariatric Surgery: The most common bariatric surgery procedures include sleeve gastrectomy, gastric bypass, and gastric banding. These procedures reduce the size of the stomach, allowing you to eat less and/or limit nutrient absorption, resulting in weight loss.
  • Metabolic Surgery: Metabolic surgery procedures may be similar to bariatric surgery, but the methods used and the focus are more on hormonal effects. Gastric bypass, duodenal switch, transit bipartition surgeries are used to reduce insulin resistance and treat diseases such as type 2 diabetes.

5. Goal of Results

  • Bariatric Surgery: The success of surgery is usually measured by weight loss. The goal is to reduce the patient's BMI to a healthy level by losing excess weight. Weight loss contributes to the improvement of other health problems.
  • Metabolic Surgery: Success is measured by improving metabolic diseases such as improving type 2 diabetes, controlling blood sugar, reducing or completely eliminating insulin needs, as well as weight loss. Weight loss is a side benefit of metabolic surgery, but the main focus is hormonal adjustments.

6. Reducing Medication Use

  • Bariatric Surgery: With weight loss, patients can reduce the medications they use for problems such as hypertension and sleep apnea. However, the primary goal of surgery is not to stop these medications.
  • Metabolic Surgery: Medications used for type 2 diabetes, hypertension, and high cholesterol can be significantly reduced or completely stopped after metabolic surgery. In particular, the need for diabetes medications and insulin therapy is greatly reduced.

Frequently Asked Questions

Metabolic surgery can be very effective, especially for type 2 diabetes, and many patients can control their blood sugar without medication after surgery. The length of time you have had diabetes, your insulin reserves, and your overall health will all affect the success rate of the surgery. In most patients, their diabetes will improve greatly or may go away completely, but this depends on your history of diabetes. Regular follow-up and lifestyle changes are also very important to maintain this improvement.
The weight loss process usually begins immediately after surgery. The first 6 months will be the fastest period of weight loss. During this period, you can lose 30-50% of your excess weight. With the hormonal changes provided by the surgery, your metabolism speeds up, your appetite decreases, and your body begins to lose weight more efficiently. However, healthy eating habits and exercise are very important for long-term success.
Metabolic surgery can help improve many obesity-related diseases, as well as type 2 diabetes. Metabolic problems such as hypertension, high cholesterol, sleep apnea, and fatty liver can be improved after surgery. With weight loss, the symptoms of these diseases decrease and your quality of life increases. The results may vary for each patient, but in general, this surgery is very effective in controlling metabolic diseases.
After losing weight after surgery, diabetes and other metabolic diseases are usually under control. However, if you do not pay attention to your lifestyle and return to unhealthy habits, you may gain weight and diseases may reoccur. Metabolic surgery should be supported by a healthy diet and regular exercise for long-term success. Otherwise, there is a risk that diseases will return.
After surgery, you will start eating small portions and will need to switch to a protein-rich, low-carb diet. You will start with liquid foods in the first weeks and gradually move on to soft and solid foods. You may also need to take supplements for life to prevent vitamin and mineral deficiencies. Avoiding high-sugar and high-fat foods is important for healthy weight loss and metabolic control.
Metabolic surgery is generally a safe procedure, but as with any surgical procedure, it carries some risks. Complications such as bleeding, infection, and intestinal leakage can occur in rare cases. In addition, long-term nutritional problems such as vitamin and mineral deficiencies can occur. Serious complications are rare, and most patients have a smooth ride through this surgery. We will provide you with detailed information about the risks before the surgery and take the necessary precautions to minimize them.
After surgery, most patients reduce or completely eliminate their medications, especially those for diabetes and hypertension. Your need for medications for type 2 diabetes, high blood pressure, and cholesterol will decrease with weight loss and metabolic improvement after surgery. However, this depends on your personal health history and metabolic improvement after surgery. Some patients may continue to take certain medications at reduced doses.
The recovery from surgery is usually rapid. Most patients can return to work within 2-4 weeks. If you have a desk job, you may be able to return to work sooner. However, if you have a physically demanding job, you may need more rest. Avoid heavy lifting and intense physical activity in the first few weeks. Your doctor will give you a more specific time frame based on your recovery.
You can lose 60-70% of your excess weight in the first year after surgery. However, the most important benefit of metabolic surgery is that it helps improve metabolic diseases such as type 2 diabetes, high blood pressure, and cholesterol. In other words, you not only lose weight, but this weight loss also improves your metabolic health. Weight loss improves your overall health, increases your energy levels, and significantly improves your quality of life.
Prof. Dr. Mehmet Özdoğan | Adana Gastric Sleeve and Obesity Surgery
Prof. Dr. Mehmet Özdoğan | Adana Gastric Sleeve and Obesity Surgery
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