Weight Loss Surgery:
Weight loss surgeries, generally known as Bariatric Surgery, are types of surgeries that aim to make changes in your digestive system to help you lose weight. Bariatric Surgery is performed when diet and exercise do not work or when you have serious health problems (type 2 diabetes, high blood pressure, etc.) Some procedures limit how much you can eat. Other procedures work by reducing the body’s ability to absorb nutrients. Some procedures work with both methods.
Bariatric Surgery provides many benefits, but there are risks and some side effects of weight loss surgical techniques. At the same time, to preserve the effectiveness of these surgical interventions in the long term, the patient’s lifestyle and nutritional habits should be adjusted as recommended by the surgeon. The patient needs to exercise regularly along with permanent healthy changes in his diet after these surgical interventions.
When weight is lost with bariatric surgery methods, it helps to reduce your health problems, which are the cause of weight-related life risks. (Type 2 diabetes, high blood pressure, stroke, sleep apnea, liver diseases, etc.)
How to Calculate Obesity Value:
Obesity is an excessive increase in the ratio of body fat mass to lean mass. In short, obesity is when people are overweight for their height. Obesity rates are increasing day by day. Obesity is a disease that reduces the quality of life as the average life expectancy increases, decreases the production capacity of people, and must be treated. In calculating obesity, the Body Mass Index (BMI), which is calculated by dividing your weight by the square of your height (kg/m²), is used and is based on the reference range of the World Health Organization. According to the results of body mass index, over 30 are obese, over 40 are morbidly obese, and over 50 are super obese.
When you divide your weight by the square of your height (kg/m²), the result indicates whether you are overweight or obese.
- Less than 18.5 kg/m.: Weak
- 18.5 – 24.9 kg/m. between: Normal weight
- 25 – 29, 9 kg/m. among: overweight
- 30 – 39, 9 kg/m. among those: Obese
- Those over 40 kg/m: is seen as severely obese (morbidly obese).
In men, if the waist circumference exceeds 94 cm, it is seen as an increased risk, if it exceeds 102 cm, it is considered high risk. If this ratio exceeds 80 cm in women, it is considered an increased risk, if it exceeds 88 cm, it is considered high risk.
Bariatric Surgery Methods:
Every surgical procedure has its pros and cons. Your surgeon will inform you about these. The most common types of stomach surgery are:
GASTRIC BALLOON:
With the endoscopic method, a fist-sized balloon filled with sterile water is placed inside the patient’s stomach. In this way, food intake is restricted. With this method, a limited amount of weight is lost. It must be removed from the stomach within 6 months – 1 year. If the patient experiences abdominal tension, pain and/or vomiting, the gastric balloon may be removed earlier.
There are four different types of balloons.
- Regular Balloon: This is inserted with endoscopy and removed after 6 months with endoscopy.
- Orbera Balloon: This is inserted with endoscopy and removed after 12 months with endoscopy.
- Allurion Balloon: This is a self-ejecting balloon like a small pill. There is no removal process since it dissolves itself in time.
- Adjustable Balloon: This is inserted with endoscopy and can be inflated according to the patient’s weight loss situation. Thereafter, the balloon is adjusted based on the patient’s process.
Gastric balloon applications do not require hospitalisation. The procedures are completed within a day in the hospital together with pre-operative checks such as dietician and general surgery consultations.
GASTRIC BYPASS:
This application method, also called Roux-en-Y (Roo-en-wy), is a surgical intervention aimed at reducing the amount of food you eat at once and reducing the absorption of nutrients. In surgery, the upper part of your stomach is cut and the rest of the stomach is sealed. The resulting pouch is the size of a walnut, and the stomach can only hold walnut-sized food. A portion of the small intestine is then cut and sutured directly onto this pouch. Food passes into this small stomach sac and from there directly into the sutured small intestine. In this way, food goes directly to the middle part of the small intestine, bypassing most of your stomach and the first part of the small intestine. This method is called Gastric Bypass. Gastric Bypass can be performed with open surgery, robotic surgery, or laparoscopic surgery methods.
Since food intake decreases, vitamin and mineral support is given by the surgeon and a dietician should be used during the treatment process after the surgery. In this way, the patient can healthily continue the weight loss process without experiencing vitamin and mineral deficiency.
The Gastric Bypass method can be especially preferred in patients with type 2 diabetes, who have been using insulin for many years and who have a very high body mass index. This method can also be preferred as a second operation in patients who have had sleeve gastrectomy surgery and gained weight again. It can be applied to patients with very serious damage (reflux) in the oesophagus.
Within a year of the operation, the patient loses most of their excess weight. Chronic diseases that occur in the patient due to weight regress at a serious rate. If you do not pay attention to your diet and sports and gain weight again, Gastric Bypass surgery cannot be revised because the anatomical structure has been changed. For this reason, the patient should change their lifestyle, eat healthy (as recommended by the surgeon and dietician) and stick to his regular exercise regime.
TUBE STOMACH SURGERY (SLEEVE GASTRECTOMY):
This surgery is one of the most applied and reliable surgical methods for patients. With tube stomach surgery (stomach reduction surgery), approximately 80% of the stomach is removed (usually by the laparoscopic method) and a long tube-like pouch remains. This small stomach cannot hold much food, so food intake is reduced. In addition, the appetite-regulating hormone ghrelin (most of the part where hunger hormones are secreted is removed) is secreted less, which reduces your desire to eat. With this method, the entrance and exit section of the stomach is protected and the continuity in the digestive system is intact. Gastric sleeve surgery, which restricts food and calorie intake by reducing the stomach, does not affect the nutrient absorption in the intestines as in some other surgical methods. Treatment methods in which nutrient absorption is affected may cause a person to be prone to many diseases as they affect vitamin and mineral absorption. Patients are given vitamin and mineral supplements. For this reason, sleeve gastrectomy surgery is one of the reliable methods because it treats obesity and also protects the general health of the patient. You will not have any serious pain after the closed surgery. There may be a feeling of tension and pressure on the first day and this feeling easily passes with painkillers. In sleeve gastrectomy surgery, you usually start walking on the evening of the surgery. From the 2nd day, your pain will decrease. In sleeve gastrectomy surgeries performed with laparoscopic surgery, there are small incision scars in the abdomen. These scars may become invisible within a few months.
With sleeve gastrectomy, you can lose up to 55% of your weight in one year. The complication rate is significantly less than Gastric Bypass. After the surgery, problems such as Type 2 diabetes, sleep apnea, high blood pressure, blood lipid values such as cholesterol, triglyceride, knee pain, and leg varicose veins, which were previously formed in the patient due to weight, decrease significantly. It is observed that the general health status of the patient improves rapidly.
Since sleeve gastrectomy surgery is performed with the closed method, the patient can stand up on the same day. Generally, depending on the condition of the patient after the operation, your treatment process continues for an average of 4 days in the hospital. After surgery, you will usually not be able to eat for a day or two to allow your stomach and digestive system to recover. Then you need to follow the diet program prepared for you by the surgeon and dietician. The diet starts with liquids first and then you continue to have your food in the form of pureed very bland foods. You will switch to normal nutrition (solid diet) in a short time. You will be given information on how much and what you can eat. In a few weeks, you can return to your daily life with your new healthy diet and new lifestyle.
In the first few months after your weight loss surgery, you will need to have medical check-ups (laboratory tests, blood tests, and various examinations) to check your health.
Revision Surgeries that Can Be Done After Stomach Surgery:
If the patient gains weight again after gastric surgery or if complications such as stenosis and leakage occur in any area at the surgery site, the surgical interventions performed again to correct these arecalled revision surgeries. If the patient has Gastric Bypass, there is no revision. Gastric sleeve surgery usually has a revision because the anatomy of the digestive system is not changed in this method.
After gastric surgery, the patient is given a radio-opaque liquid. It is determined whether there is any leakage in the stomach. After the surgery, the patients are followed very closely for the first 3-4 days. If the patient has a high fever and a new stomach ache after leaving the hospital, this may be the cause of the leak. You should call your doctor immediately.
In order not to have revision surgery due to weight gain after all stomach surgeries, the patient must comply with the new lifestyle. It is necessary to take their food as recommended by the surgeon and dietitian and to do regular sports as recommended. Again, it is necessary to use the vitamin and mineral supplements recommended by the doctor as recommended.
What are the Risks of Stomach Surgery?
Stomach surgeries are major surgical operations. As with any other major operation, there are health risks that may arise depending on the person’s constitution. The risks in gastric surgery may increase according to the age and weight of the patient. We can list the risks that may occur as follows:
• Ulcer in the stomach-jejunum junction, entanglement, or obstruction in the intestines may occur after Gastric Bypass surgery. This complication rate is lower in sleeve gastrectomy surgeries.
• Diarrhea, vitamin and mineral deficiency and protein deficiency are much more common after gastric bypass surgery compared to sleeve gastrectomy surgery.
• Flushing, dizziness, nausea, gallstones, incisional hernia, low blood sugar, and stomach ulcer due to malnutrition may be seen.
• Bleeding, wound infection, adverse reactions to anesthetic agents, blood clots (embolism), lung and respiratory problems, and leakages that may occur in the digestive system can be observed.
• Death (rare) (The risk of death in the early period in cardiovascular surgery is 2 percent, and the risk of death in gastric surgery is one in a thousand.)
These risks are complications that may occur in other major surgeries. With today’s technology, the rate of these complications is very low, especially in sleeve gastrectomy surgeries. Your doctor will give you information on all kinds of issues.
As a result:
Gastric sleeve gastrectomy and other gastric surgeries can provide long-term weight loss. The amount of weight you lose depends on the type of surgery and changes in your lifestyle habits. It is possible to lose half of the excess weight, or even more, within two years.
• Allows you to lose excess weight, provides a serious reduction in life-threatening health problems related to weight,
• It provides a serious reduction in heart diseases and high blood pressure,
• Improves sleep apnea,
• Reduction and improvement in type 2 diabetes health problems, providing sugar control,
• Reduces liver health problems, reduces the rate of kidney diseases,
• Provides reduction in stomach ulcers,
• Provides reduction in osteoarthritis (joint pain), reduction and improvement in knee pain,
• Provides freedom of movement in your routine activities,
As a result of stomach surgery, your health problems caused by weight will improve significantly. Your quality of life improves.
What is bariatric surgery?
Bariatric surgery refers to a group of procedures that help with weight loss by altering the digestive system. It can limit how much you can eat or reduce nutrient absorption — or both.
What are the types of bariatric surgery?
- Gastric sleeve (sleeve gastrectomy): Removes part of the stomach, reducing its size.
- Gastric bypass (Roux-en-Y): Creates a small pouch and bypasses part of the small intestine.
- Duodenal switch: A more complex procedure with both restriction and malabsorption.
- Adjustable gastric band: Places a band around the stomach (less common now).
Who is eligible for bariatric surgery?
You may qualify if:
- Your BMI is 40 or higher, or
- Your BMI is 35–39.9 with serious health conditions (like type 2 diabetes, hypertension)
- You’ve tried diet and exercise without lasting success
- You’re committed to long-term lifestyle changes
How much weight will I lose?
- Gastric sleeve: Lose ~60–70% of excess weight
- Gastric bypass: Lose ~70–80% of excess weight
- Results vary based on individual habits, surgery type, and follow-through
Is bariatric surgery safe?
Yes, it’s generally very safe, especially with modern techniques. But like all surgery, it carries risks: bleeding, infection, blood clots, or leaks from staple lines. Long-term risks can include nutrient deficiencies or gastrointestinal issues.
Will I need to take vitamins forever?
Yes. Most patients need lifelong supplementation of:
- B12, iron, calcium, vitamin D, and sometimes protein. This is especially true for gastric bypass or duodenal switch patients.
How long is the recovery?
- Most people return to light activity/work in 1–3 weeks
- Full recovery may take 4–6 weeks
- You’ll be on a special diet: liquids → purees → soft foods → solids
Can I regain the weight?
Yes, weight regain is possible if lifestyle changes aren’t maintained. Surgery is a tool, not a cure — success depends on diet, physical activity, and follow-up care.
Does it help with other health conditions?
Yes — bariatric surgery can dramatically improve or resolve:
- Type 2 diabetes
- Sleep apnea
- High blood pressure
- High cholesterol
- Joint pain and mobility issues
Will I have excess skin after surgery?
Possibly. Significant weight loss can lead to loss or sagging skin, especially in the arms, abdomen, and thighs. Some people choose to have body contouring surgery later.