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Obesity Treatment

Obesity can be treated.

OBESITY TREATMENTS

As we cannot evaluate obesity as being overweight or having a high fat ratio in the body, the point of view that only one method can be successful in its treatment will not be correct.

Treatment should be multidimensional with a multidisciplinary approach. Treatment is a long and difficult process for the patient. One of the most important factors in the treatment of obesity is the patient’s determination, as it will take time to reach the treatment results.

During this process, the patient must adhere to the treatment methods applied resolutely, follow the targets set closely, and display a devoted and disciplined approach in order to achieve the purpose of the treatment together with the doctor, dietitian or psychologist.

şişman kadın parkta yürüyor

In order to determine the treatment process, first of all, many other factors involving obesity such as the root causes of obesity, the patient’s character, lifestyle, body mass index and obesity class, waist circumference, fat rate should be addressed.

By evaluating these factors, the most appropriate treatment method to be applied for the treatment of the patient is determined by your doctor. However, this method is not just the application of one of the methods we will talk about below. It is also important that these methods are applied together with the ones that are suitable for the person.

In other words, only surgical intervention does not mean that obesity is cured. For example, the patient should change his/her lifestyle after surgical treatment, follow a nutritional diet and include exercise or sports activities in his life.

elma yada çörek şeç

It is important that the root cause of obesity is known by the patient and awareness is raised, and obesity is accepted as a treatable disease.

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HEALTY EATING AND PHISICAL ACTIVITY

The goal in the treatment of obesity is to reach the ideal weight and therefore the body mass index of the patient. Thus, complications caused by obesity or excess weight will be eliminated. For this reason, weight gain should be stopped immediately and the loss of excess weight should be started in the first place.

As might be expectedsağlıklı beslenme the first step of the treatment will be the right diet. Exercise or an active lifestyle also supports treatment, but this is sometimes not possible for obese patients.

Significant weight loss after surgery in the first 6 months is important both for maintaining the stability of the patient in the continuity of treatment and more importantly, for eliminating the health problems caused by obesity.

However, as mentioned in the causes of obesity, in case obesity is triggered by another health problem, the patient may also need to use regular medication for the treatment of this health problem.

NON-SURGICAL TREATMENT

We mentioned about the importance of significant weight loss in the first 6 months of obesity treatment. Since calorie intake must be limited in order for the patient to lose weight, the most common application that does not require surgical procedure is the application of gastric balloon.
 

Gastric Balloon:

 

mide balonu aşamaları

Gastric balloon is endoscopically placed in the stomach in a deflated state and then inflated. It creates a feeling of satiety in the stomach and thus restricting food intake.

It is a widely used, easy to apply, effective and reliable method in the treatment of obesity. Gastric Balloon can be applied to overweight people (non-obese) who cannot lose weight with diet and exercise and do not require surgery, 

In morbidly obese patients, in order to reduce the risk of anesthesia and surgery before the bariatric surgery for providing some weight loss, and also it can be applied in obese patients when there is fear of surgery and any medical restrictions that  prevent surgery.

As the advantages of gastric balloon application,

  • It can be placed in a very short time under clinic conditions,
  • Afterwards, the person can return to his/her normal life without the need for hospitalization,
  • Its procedure is very easy and painless,
  • It can be considered that the patient can be removed at any time, so  it is reversible any time.

However, the disadvantages of the gastric balloon are as follows:

  • Nausea, which is frequently seen, can sometimes decrease the quality of life for a short time (3-7 days) due to abdominal tension.
  • It can stay in the stomach for 6 months – 1 year.
  • The amount of weight lost is less than surgical methods.

The patient’s determination facilitates the weight loss process. However, after the stomach balloon is removed from the stomach, as long as it is not supported by diet and exercise programs, the lost weight can be regained.

Allurion Swallowable Gastric Balloon:

Allurion Banner about swallowable gastric balloon(Allurion Elipse Gastric Balloon) Swallowable Gastric Balloon has the same effect as the endoscopic gastric balloon. It restricts food intake by occupying space in the stomach and allows the person to lose weight by eating less with a constant feeling of fullness.

The difference between  gastric balloon and elipse balloon is that no endoscopy and anesthesia required The deflated balloon is in the capsule and swallowed with water without the need for endoscopy or sedation. It is then inflated and placed in the stomach.
The elipse balloon does not need to be removed. After about 4 months, it goes out by itself and is thrown out of the intestines by natural way. Thus, the required endoscopy and sedation for removal process are not applied again.

Yutulabilir ve endoskopik mide balonunun nasıl uygulandığını gösteren çizim. İnsan gölgesi ve mide içinde balon çizilmiş.

Gastric Balloon

Gastric Balloon WHAT IS GASTRIC BALLOON? Gastric balloon is made of silicone or polyurethane material, placed in the stomach as deflated and then inflated with

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SURGERY TREATMENTS (BARIATRIC SURGERIES)

The amount of morbid obesity disease is increasing day by day. According to the researches of the World Health Organization, approximately 2 billion people in the world are overweight and 650 million of them are obese.

Obesity is a disease and can be treated. It is wrong to see obesity as excessive adipose tissue formation and gaining weight. Obesity must be treated because of the vital diseases it causes. Obesity is involved many diseases such as Type-2 diabetes, cardiovascular diseases, joint disorders, asthma, sleep apnea, respiratory failure, cancer, stroke, psychological problems, skin diseases.

Rapid weight loss is vitally important for patients with morbid obesity who has a body mass index of 40 and above. Because day by day, obesity releated diseases becoming chronical. It is important to eliminate vital risks. However, if there are vital health problems in patients with a body mass index of 35, surgical treatment should be considered also.

Surgical treatments are also known as Bariatric Surgery, the general purpose of stomach reduction surgeries or weight loss surgeries is to reduce food intake and absorption. Bariatric surgeries are performed laparoscopically.

Bariatric surgery treatment methods are the most successful and most effective treatment method for obesity treatment today. After the surgery, the metabolism of the patient changes. Since the stomach becomes very small, appetite and food intake cravings decrease. Some bariatric surgeries limits the amount of nutrients the body absorbs by bypassing a portion of the small intestine begin to lose weight rapidly.

However, bariatric surgeries cannot be reversed. Considering that the treatment is a serious operation and the patient’s psychology, the first approach in the treatment of obesity is to evaluate the treatments that do not require surgery, of course depend on the health status of the patient.

As mentioned before, surgery does not mean that obesity is cured. The patient’s determination and lifestyle changes (nutrition and physical activity) after surgical treatment are important.

Classifying surgical treatments according to their purpose is important in terms of information. We can classify surgical techniques as restrictive surgeries, absorption-reducing-malabsorptive surgeries, or both restrictive and malabsorptive surgeries.

Restrictive Surgeries

Gastric Sleeve (Sleeve Gastrectomy)

Gastric sleeve surgery is the most commonly used surgery in the treatment of obesity in the world. Sleeve gastrectomy has become the most widely used method in laparoscopic bariatric surgery applications in the treatment of obesity, as it provides significant weight loss in a short time.
 
tüp mide resmiIt is done by cutting a large part (80%) of the stomach by laparoscopic methods and leaving the stomach in the form of a tube. Depend on the size of the removed part the secretion of the appetite hormone ghrelin decreases. As the appetite decreases, creates a feeling of fullness.
Since gastrointestinal anastomosis or intestinal bypass is not applied in this technique, it is technically much easier than other bariatric surgeries. Post-operative complications are much less. Since it does not impair absorption, vitamin deficiency is not observed.
Loss of excess weight depends on the patient’s adherence to diet, determination and lifestyle. In this technique, it has been observed that patients lose up to 60% of their excess weight on average. This rate may increase depending on the person.
 

Gastric Band

As can be understood from the name of the gastric band, the silicon-coated band made of titanium alloy is placed on the stomach.mide kelepçesi The band creates a small stomach pouch at the top by placing it approximately 5 cm below the esophagus and compressing it.
Before the food goes into the stomach, it enters this stomach pouch and provides the patient with a feeling of fullness without overeating.

Restrictive and Malabsorptive Surgeries

Gastric Bypass

gastrik bypass

Gastric Bypass surgery is one of the most common surgical methods used in the treatment of obesity.

This surgery, called Roux-en-y Gastric Bypass, is performed by cutting the stomach leaving a small part just after the esophagus and creating a small stomach, and then bypassing and connecting a part of the small intestine to the formed stomach. Thus, both the volume of the stomach is restricted and the absorption is restricted by shortening the intestine.

This surgery is widely used in general. However, the surgery is more complicated than sleeve gastrectomy surgery. Complications that may occur after surgery are 2 times more. It has been observed that there is no significant difference in excessive weight loss rates when compared to Sleeve Gastroctemy (Gastric Sleeve) surgery. However, RYGB surgery is effective in the treatment of diseases associated with obesity.

COMPLICATIONS OF BARIATRIC SURGERIES

The most serious complication of surgical methods used in bariatric surgery is leakage and bleeding. The development of the tools used with the developing technology reduces this possibility. Especially in gastric sleeve surgery, the original and top quality staplers used to close the remaining part of the stomach after cutting will minimize the possibility of leakage in this surgery.

covidien tri-stapleWe use Covidien brand TRI-STAPLE™ staplers, the quality is accepted worldwide, without sacrificing quality in our surgeries. 

Since the surgeries are performed with minimally invasive methods (laparoscopic or robotic), the rate of wound or pain in patients is very low.

Since Roux-en-y Gastric Bypass surgery is complicated and the intestine and stomach are cut and bypassed from several places, the possibility of leakage and bleeding is high. In addition, vitamin deficiency can be seen in this surgery because absorption is restricted. The patient may need continuously vitamin and mineral supplements. In addition, because the length of the small intestine is shortened, dumping syndrome associated with high sugar consumption can be seen in these patients.

It is very difficult to perform revision surgery in patients who have undergone gastric bypass surgery if the treatment is unsuccessful. In this regard, revision of gastric sleeve surgery can be done much easier and more successfully.

WHICH TREATMENT?

Factors causing obesity and the patient’s determination to change their lifestyle have a great impact on determining the most appropriate obesity treatment for the individual. In addition, of course, factors such as body mass index, comorbidity with obesity, other health problems, whether the patient wants a surgical operation or not are evaluated.

Revision surgery may be required for patients who have previously had bariatric surgery but have not been able to achieve results in the treatment.

In general, among individuals who have not been successful in losing weight through pre-surgical or non-surgical dietary habits and exercise, morbidly obese patients with a body mass index of 40 and above or 35 or above and also obesity-related type 2 diabetes, hypertension, sleep apnea, respiratory, bariatric surgical treatment is considered. It is also appropriate for individuals with comorbidities such as respiratory disease, non-alcoholic fatty liver disease, joint diseases, and heart diseases.

Although the expected result in surgical methods varies according to the individual, up to 80% of the excess weight is lost within 2 years in surgical treatment.

In the gastric balloon application, 10-15% weight loss is expected in 6 months.

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