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Obesity is a state of excessive fat accumulation that occurs because the calories we spend are more than the calories we take. Obesity is accepted as a “disease” by the World Health Organization (WHO).

Obesity causes many organic problems as well as social and psychological problems.

Obesity is a problem that affects not only the patient but also his/her environment.

Obesity should be considered as a health problem, but we cannot deny that it also causes cosmetic problems. Cosmetic effects may result in the psychosocial problems.

Like as any disease, preventive measures are the best approach in obesity. Paying attention to diet and doing daily exercises will eliminate this problem before it occurs.

The fact that the body mass index is above normal should be a stimulus for us and we should take action at this stage. We need to shed our excess weight by paying attention to our diet and doing exercises. Let’s not forget that, as our weight accumulates, we will progress towards the class described as obese. And another thing we should not forget is that, as our weight increases, it will become increasingly difficult for us to lose it naturally, such as diet and exercise. Very few (less than 3%) of the patients with a body mass index over 40 can lose their weight with diet and exercise.

The main causes of obesity are consuming more calories than we need and a sedentary lifestyle. However, it should be noted that each person’s metabolism is different. For this reason, two people who eat the same amount and do the same exercises may have different weight gain or loss.

Genetic factors, pregnancy, aging, drugs such as steroids and antidepressants, and some hormonal diseases are among the factors that cause obesity.

Today, the obesity is graded mostly by body mass index. We can find the body mass index by dividing the body weight (in kilograms) by the square of our height (in meters). In other words, if we divide our body weight (in kilograms) twice by our height (in meters), we can find the body mass index.

BMI= Weight/Height ²

If the value we find is below 25, it means we are not overweight.

Between 25 and 30 is considered as overweight

and over 30 is considered as obese.

30-35 is classified as 1st degree,

35-40 is classified as 2nd degree,

and above 40 is classified as 3rd degree obesity.

Obesity is a condition that causes premature aging and shortened lifespan and accompanies many diseases;

metabolic diseases; Type 2 DM, hypertension, lipid elevation in blood, Cardiovascular diseases,

Stroke,

Sleep apnea,

Gallstone,

Gout,

joint ailments

Some cancers such as breast, ovarian, endometrium, prostate, colon cancer

They are high-risk patients for the development of polycystic ovary syndrome, hypogonadism, and infertility.

Obesity is also a condition that causes many psychological problems such as depression and many social problems such as social exclusion.

The most important criterion in decision making is body mass index (BMI).

Bariatric surgery may be an option for you if your BMI meets the following criteria:

BMI is 40 or more (morbid obesity),

BMI is between 35-40 and you have a obesity related health problems,

BMI is between 30-34 and you have an obesity-related health problem that cannot be controlled by other methods and surgery is thought to be beneficial.

BMI is not the only indicator in decision making;

If you cannot lose weight with diet, exercise and medical support,

If you do not have a health problem that prevents you from having surgery,

In addition, if you are ready to make permanent changes for a new lifestyle, bariatric surgery may be an option for you.

First of all, bariatric surgery is not suitable for patients whose body mass index does not meet the criteria for bariatric surgery.

And also, among the patients who meet this criteria, those with diseases such as bleeding disorders and heart failure that prevent surgery are not suitable for bariatric surgery.

We should not forget that patients should adopt a life change after bariatric surgery.

After bariatric surgery, your meal amount will decrease for two reasons. First, because your stomach is getting smaller and you can not eat too much. Secondly, because we remove the fundus area of your stomach where the appetite hormone is secreted, your appetite decreases and you eat less.

However, it should be kept in mind that bariatric surgery will do more harm than good to patients who can not follow the diet, have eating disorders, psychiatric patients who do not have a certain cognitive level, and patients with alcohol dependence.

Today, when obesity surgeries are mentioned, two types of surgery come to mind the most. Gastric sleeve, which has become increasingly popular in recent years, is now the most frequently performed obesity surgery in the world. In gastric sleeve, 70-80% of the stomach is removed, but no other changes are made on the digestive tract. Although it can be performed more easily, gastric sleeve surgery has almost the same effectiveness and less metabolic problems such as post-operative vitamin and mineral deficiencies compared with the other types of bariatric surgeries. The main mechanism of action is the reduction of food consumption, mainly due to the shrinkage of the stomach. In addition, since the area we call “fundus” at the beginning of the stomach is removed, the appetite hormone (ghreline) produced here is eliminated and the appetite decreases. The rapid passage of the taken food from the shrunken stomach to the intestines also contributes to rapid satiety and weight loss.

In other types of surgery, in addition to reducing the stomach, it is planned to reduce the absorption of the foods we eat by changing the position of the intestines. These operations differ from each other according to the way the intestines are connected to the stomach. Roux en Y gastric bypass and minigastric bypass are the two most common types. Although they are a little more effective than sleeve gastrectomy, their disadvantages are the difficulty of the operation and more metabolic problems including mineral and vitamin deficiencies. For this reason, although they were the most used method in the past, they become less preferred over time. Another issue is that in cases where sleeve gastrectomy is not successful, it can be converted to roux en y and minigastric bypass surgeries more easily. However, revision of bypass surgeries is more complicated.

You can start right away. Start with simple, short walks while in the hospital. The important thing is to start slowly without forcing your body. For the first month, it is necessary to avoid compelling movements such as lifting weights.

The most important pillar of long-term success after surgery is regular exercise.

Exercise is important for most patients, not only for burning calories, but also for stress and appetite control.

As you get older, lack of activity becomes more important. Regular exercise is necessary to have healthy bones and avoid muscle loss.

We should not think of exercise as something that should be intense and painful. Even a little regular activity is much more beneficial in the long run. You can find a variety of activities that might work for you. There is no one-size-fits-all plan.

Sleeve gastrectomy and other weight loss surgeries, known as bariatric surgery, involve changes in your digestive system to help you lose weight. Bariatric surgery is done when diet and exercise don’t work or you have serious health problems with your weight. Some bariatric procedures limit how much you can eat, while others work by reducing the absorption of nutrients. Some procedures can do both.

Bariatric surgery can provide many benefits, but all forms of these procedures are major surgeries. After bariatric surgery, you need to keep your diet healthy and exercise regularly to ensure long-term success.

You can start right away. Start with simple, short walks while in the hospital. The important thing is to start slowly without forcing your body. For the first month, it is necessary to avoid compelling movements such as lifting weights.

• Eat balanced meals in small portions. In the early period after surgery, you can only tolerate one to two tablespoons of food at a time.
• Eat slowly in small bites and chew thoroughly.
• Adequate fluid intake is important: Drink 1.5 to 2 liters of fluid per day, unless restricted for medical reasons. But do not take with meals.
• Minced meat is more easily tolerated than red meat.
• Avoid hard-to-chew foods such as rice, bread, raw vegetables, fresh fruit.
• Avoid using straws, carbonated drinks, chewing gum and ice. Swallowing air may cause discomfort for the small volume stomach left after surgery.
• Avoid sugar, sugary foods and drinks, and fruit juices.
• Over time, increase the variety of foods in your diet. Foods that were initially intolerable, such as red meat, chicken, bread, and high-fiber fruits and vegetables, will become more easily tolerated over time.
• Alcoholic beverages will have a faster and stronger effect than before the surgery and will pose serious risks. Avoidance is a strong recommendation.

You can start right away. Start with simple, short walks while in the hospital. The important thing is to start slowly without forcing your body. For the first month, it is necessary to avoid compelling movements such as lifting weights.

You can start right away. Start with simple, short walks while in the hospital. The important thing is to start slowly without forcing your body. For the first month, it is necessary to avoid compelling movements such as lifting weights.