As obesity became one of the most important problems of mankind, alternative solutions to this problem began to be developed. The most popular of these ways today is surgical intervention. In other words, reducing a person's eating capacity by physically shrinking the stomach or shortening the digestive tract, and thus ensuring that the person reaches satisfaction more quickly. In this article, we will briefly talk about what this surgical procedure is actually, and then we will examine how successful this surgical procedure is in the long term.
What is Bariatric Surgery and how is it performed?
In general, surgical interventions against weight loss and all kinds of health problems that it will cause are combined under the name bariatric surgery. The word" bariatric "is derived from a combination of the Greek word" bar- (baros) "meaning" weight, burden "and the words"- iatri (iatrikos) "meaning" medical/medical treatment". The word" Bariatric " was first used in English around 1965. Since the 2000s, it has also been used in our language as an English origin.
Although many ways of bariatric surgery are applied today, there are 3 basic forms of application. These;
- Biliopankreatik diversiyon (BPD)
- Gastrik bypass (roux-en-Y)
- Sleeve gastrectomy
All of them, reducing the weight, the weight associated with heart disease, hypertension, obstructive sleep apnea, type-2 diabetes, non-alcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), gastroesophageal reflux disease (GERD) and osteoarthritis (joint pain), such as diseases aims to unravel. In addition, it is hoped that thanks to this procedure, patients will be able to demonstrate their daily activities more comfortably and thus increase their standard of living.
First, let's start with the most common gastric bypass: in the gastric bypass process, a new stomach sac is created, about 5% of the existing stomach. It's called a gastric bag. Then the descending part of the small intestine is cut and attached to this new posh. In this way, both the volume of the stomach is reduced and the digestive tract is shortened. Because a person reaches satisfaction more quickly and cannot absorb all the nutrients, he quickly loses weight.
Another method is tube stomach surgery. A small tube or banana-shaped stomach is left behind. Because the stomach shrinks and cannot expand immediately, it becomes easier for a person to lose weight.
Biliopancreatic diversion (bpd), on the other hand, is actually a combination of the two methods mentioned above: both the volume of the stomach and the length of the intestine are reduced. In this method, a much larger stomach is left than gastric bypass. In other words, weight loss is basically achieved by restricting absorption.
To Whom Is Bariatric Surgery Recommended?
Not every overweight person is recommended to seek bariatric surgery. Generally:
- Extremely obese people with a body mass index (BMI) of 40 or above
- Those whose body mass is between 35-39.9, but who also have a dangerous weight-related disease such as Type-2 diabetes, hypertension and sleep apnea
- In very rare cases, people with a body mass index of 30-34 have multiple health problems
If these criteria are not met, surgeons may refuse this surgical intervention. Even if you meet these conditions, you may need to undergo a fairly strict audit and agree to make certain changes to your lifestyle.
In addition, after surgery, you will need to continue to see your doctor, participate in follow-up research, especially to keep your diet within certain limits. We'll come to these in more detail soon.
What Are The Risks Of Bariatric Surgery?
As with any surgical intervention, there are certain risks in bariatric surgery. These are the most common ones:
- Excessive bleeding
- Infection
- Adverse reaction to anesthesia
- Blood clots
- Lung and respiratory problems
- Leakage in the digestive tract
- Rarely death
But the risks of this operation continue not only during the operation, but also after it:
- Intestinal obstruction
- Dumping syndrome, which we will talk about again soon
- Gallstones
- Hernia
- Low blood sugar (hypoglycemia)
- Lack of food
- Ulcer
- Reflux
- Needing repeat surgeries
- Rarely death
Is Bariatric Surgery The definitive treatment for obesity?
Although the effectiveness of these surgical interventions is seen in the short term, in the long term, the person has great responsibilities in the persistence of weight loss. Although the capacity of the stomach decreases according to the operation performed by the person, if it continues to feed as before the operation, the stomach can expand again and become old.
According to a study published in 2020, the failure rates of people undergoing bariatric surgery to achieve their personal goals range from 15-30%. This means that about one in every 4 people who have surgery fails. So it shows that bariatric surgery should not be considered a definitive solution to obesity, but it is clear that it is still a very effective method.
It would be best to see surgery as just an aid against obesity and other ailments caused by weight. In order to achieve success after bariatric surgery, there are many factors that a person should pay attention to. At the beginning of these factors, of course, is changing diet and eating habits.
Because there will be serious changes in the digestive tract after surgery, your digestion will be quite inadequate. So in the first stage, you need to follow a diet consisting only of liquids that you can digest easily. Over time, foods that are made of pureed consistency or very soft foods can be added to this diet with the approval of your doctor or dietitian. In addition, in order not to strain your stomach capacity too much, you should limit our daily calorie intake to 400 to 900 for at least 1 year. If you eat too much or too fast, there will be a rapid and excessive intake of nutrients into your small intestine. This, in turn, causes Dumping syndrome, which leads to sweating, nausea, vomiting, dizziness and diarrhea.
On the other hand, you should start using nutritional supplements because you cannot get the necessary nutrients with nutrients. The nutrients you need to take are calcium, iron, copper, zinc, vitamin D, Vitamin B12 and protein. But of course, these elements can be increased and reduced by your doctor or dietitian. Therefore, it is important to receive medical nutritional support after the operation.