‘Obesity is the second leading preventable disease causing death’

Increasing smoking and obesity in Turkey and in the world are among the top 2 preventable diseases that cause death. Drawing attention to obesity and treatment methods, General Surgery Specialist Op. Dr. Gokhan Atesgave information about obesity, which has become a global health problem.


Mentioning that the degrees of obesity are defined by the body mass index, Op. Dr. Gokhan Ates, “Morbid obesity has become an epidemic problem in the last 100 years and is the second leading cause of death after smoking among preventable diseases. Degrees of obesity are defined by body mass index. Patients are classified as underweight, normal weight, overweight, obese, morbidly obese, and superobese. While the metabolic effects of obesity, some disorders defined as ‘Metabolic Syndrome’ are more common with the increase in body mass index, the risk of cardiovascular disease increases threefold in this case. Many concomitant diseases occur due to the metabolic effects of obesity. he said.


Providing information about obesity treatment, Ateş said, “Surgical treatment of obesity is called bariatric surgery. With bariatric surgery, long-term permanent weight loss is achieved, many co-morbidities are prevented by reducing the metabolic effects of obesity, and survival is increased. Sustainable weight loss is achieved only with bariatric surgery. Bariatric surgery provides more than 50 percent reduction in excess weight. Surgery is one of the pillars of the multidisciplinary approach in the treatment of morbid obesity. Surgical treatment results are better in well-motivated, well-educated patients who participate in multidisciplinary evaluations and fail medical treatment. Substance abuse is strictly prohibited for surgery. Patients who will undergo surgery; The expected benefit is to be clearly informed about the risks and long-term consequences of surgery, lifelong nutritional counseling and biochemical follow-up.

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Underlining that metabolic diseases can also be treated with bariatric surgery, Op. Dr. Ateş said, “The necessary conditions for bariatric surgery were determined in the consensus decisions of the US National Institute of Health (NIH) in 1991. With bariatric surgery, obesity and metabolic diseases are also treated. The mechanisms of action of bariatric surgical procedures occur due to the complex interactions of absorption and gastric resection, as well as hormonal and neural signals that affect hunger and satiety. Complete diabetes recovery was observed in 78 percent of patients. The lipid profile improves in 70% of patients after bariatric surgery. Mortality rates in bariatric surgery procedures are equal to those of small intra-abdominal surgeries such as laparoscopic cholecystectomy.

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Talking about the post-operative period, Op. Dr. Fire, “Post-operative fluid support and adequate urine output are very important. Follow-ups at the 3rd week, 3rd month, 6th month, and 1st year postoperatively should focus on results and nutritional deficiencies. These patients lose 60-80 percent of their excess weight within 1 year after surgery. As a result, significant improvement is seen in fatal overweight diseases. Gastric Bypass is more effective than sleeve gastrectomy, especially in curing symptoms of type 2 diabetes and gastro-esophageal reflux disease. Sleeve Gastrectomy (Vertical Gastrectomy) In patients who are super obese and in whom gastric surgery is risky, sufficient weight is lost in the early period with only Sleeve Gastrectomy. This method has been put into practice as a risk-reducing method in patients who cannot tolerate high-risk and long-term procedures.” he said.

Stating that gastric bypass is shown as the gold standard in the surgical treatment of morbid obesity, because it provides long-term permanent weight loss and its morbidity and mortality are acceptable, Op. Dr. Ateş said, “The obvious improvement is 15 percent in patients with fatally overweight diseases due to their excess weight within 1 year after the surgery. It is especially effective in correcting type 2 diabetes and gastro-oesophageal recline. While 92 percent of diabetics and 90 percent of sleep apnea patients recover after surgery, 80 percent of asthmatics reduce their medication dose.

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Underlining that there is improvement in metabolic disorders such as type 2 diabetes and dyslipidemia and hypertension after bariatric surgery, Op. Dr. Ateş concluded his statement as follows:

“It is accepted that bariatric surgery is the most effective method for long-term weight loss in morbidly obese patients. bariatric surgery; It provides improvement in metabolic disorders such as type 2 diabetes and dyslipidemia and hypertension. These positive effects occur as a result of endocrine changes as well as weight loss. As a result, the mortality rate in patients decreases.”

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