Bariatric surgery describes surgical interventions performed to achieve weight loss in overweight individuals (morbid obesity). These surgical procedures encourage weight loss by changing the person's eating habits and digestive system. Bariatric surgery does not only aim to achieve weight loss, but also aims to reduce health problems related to obesity.
Bariatric surgery types generally work with two basic mechanisms:
- Restrictive Surgeries: The volume of the stomach is reduced, allowing the person to eat less. An example is sleeve gastrectomy.
- Malabsorptive Surgeries: A portion of the intestines is bypassed, reducing the absorption of food and nutrients. For example, gastric bypass surgery (Roux-en-Y gastric bypass) can be given. Some surgical methods include both restrictive and malabsorptive features.
Types of Obesity Surgery
- Sleeve Gastrectomy: A large portion of the stomach is removed, leaving a thin banana-shaped tube. This method both reduces the stomach volume and suppresses appetite by reducing the production of hunger hormones.
- Gastric Bypass: The stomach is reduced and a portion of the intestines are bypassed, ensuring that less food goes into the stomach and is absorbed less.
- Gastric Band: An adjustable band is placed on the upper part of the stomach and the stomach volume is restricted. The person feels full with less food.
- Duodenal Switch: The stomach is reduced and a large portion of the small intestine is bypassed, significantly reducing the absorption of nutrients.
Who is it suitable for?
Bariatric surgery is generally suitable for people who cannot lose weight with other methods such as diet, exercise and medication, or who have difficulty losing weight. Suitability for surgery is assessed by considering body mass index (BMI) and obesity-related health problems.
Suitability Criteria:
- Body Mass Index (BMI):
- People with a BMI of 40 or higher (morbid obesity) are generally candidates for surgery.
- People with a BMI between 35-40 may be considered for surgery if they have serious obesity-related health problems such as diabetes, hypertension, and sleep apnea.
- Diet and Exercise Failure:
- A surgical solution may be recommended if the person has tried traditional weight loss methods such as diet, exercise, and behavioral therapies but have not been successful.
- Health Problems Related to Obesity:
- Surgery is considered in cases where surgery can help treat obesity-related diseases. These diseases include type 2 diabetes, high blood pressure, sleep apnea, fatty liver disease, joint problems and cardiovascular diseases.
- General Health Status:
- When evaluating suitability for surgery, the person's general health status is also taken into consideration. A surgical solution may not be appropriate for people with serious health problems that may increase the risks of surgery.
- Psychological Status:
- Bariatric surgery is a process that requires major lifestyle changes. It is important for the person to be psychologically ready for surgery and to show determination to adapt to the new life order after surgery.
- Age Factor:
- People between the ages of 18-65 are generally considered suitable for obesity surgery. However, in some cases, surgery may be considered for younger or older patients. The risks of surgery in older individuals should be evaluated more carefully.
Who is it not suitable for?
Bariatric surgery is not suitable for every patient. In some cases, surgery may be risky or the person may not be suitable for surgery:
- Alcohol or substance abuse: Healthy lifestyle changes are necessary after obesity surgery. Therefore, people with alcohol or substance addiction should first resolve these issues.
- Serious psychiatric disorders: Surgery may be risky for people with serious psychiatric disorders such as active and untreated depression, eating disorders or schizophrenia.
- Serious health problems that increase the risks of surgery: Surgery orderDuring and after high-risk cardiovascular diseases or serious respiratory problems may not make surgery appropriate.
Benefits of Bariatric Surgery
- Permanent Weight Loss: Bariatric surgery can provide significant weight loss, and this weight loss can be permanent.
- Healing of Obesity-Related Diseases: It can help improve or control health problems such as diabetes, high blood pressure, sleep apnea and joint problems.
- Increasing Quality of Life: With weight loss, mobility increases, general health improves and quality of life increases.
Bariatric Surgery Risks
Like any surgical intervention, bariatric surgery carries some risks. These risks may include infection, bleeding, nutritional deficiencies, embolism, dumping syndrome and anesthesia-related complications. Vitamin and mineral supplements may be required for life after surgery.
