# Information Form
WHAT IS OBESITY?
Obesity or obesity, commonly known as obesity, is a disease that arises from the accumulation of excess fat in the body and must be treated. Obesity occurs when the amount of energy taken from food exceeds the amount of energy consumed by metabolism and physical activity. Obesity is a curable disease that shortens human life, adversely affects the quality of life and also the cardiovascular system, respiratory system, hormonal system, digestive system and prepares the ground for many important diseases. Changes in the digestive system during obesity surgery procedures affect many enzymes and hormone systems and ensure the healthy and proper functioning of many mechanisms related to hunger and nutrition, especially the brain. Although the anterior abdominal wall was opened by open methods, these surgical procedures were performed in difficult conditions in overweight patients, but they did not become widespread even though they continued to be performed due to the difficulties they created for the surgeons and the high rates of complications observed in the patients.
SYMPTOMS OF OBESITY
The main factor in detecting and diagnosing obesity is the body mass index. The values obtained are independent of age and gender. Experts classified BMI values as normal weight, overweight, obese and morbidly obese. The most commonly used measurement for obesity is Body Mass Index (BMI) and waist circumference. BMI is calculated by dividing the body weight (kg) by the square of the neck (m²). This value is independent of age and gender. Experts classified BMI values as normal weight, overweight, obese and morbidly obese. It is important to know where the fat is stored, as well as the total amount of fat in the body. Accumulation of fat around the abdomen causes more risk than fat accumulation in the hips and other parts of the body. A simple but accurate method for risk measurement is waist circumference.
What are the Risk Factors Causing Obesity?
In the balance of a healthy life, the energy consumed and the energy consumed should be equal. The most remarkable increase in obesity in the pediatric age in the world is the most important cause of obesity, the most important causes of genetic factors rather than environmental factors and incorrect feeding habits draw attention. People with a family history of obesity, especially those with maternal obesity problems, have a higher risk of developing this disease than other people. There are two types of fat in our body, brown and white oils. While brown fats burn calories, white fats form the group of fats that keep the body warm. In the statement of obesity made by Massachusettes Institute of Technology; The fat cells that come with genes are claimed to belong to the white fat group. Excessive nutrition, intense carbohydrate consumption, especially high-fat foods and excessive consumption of foods that are among the causes of obesity. Foods with a high fat and sugar ratio trigger weight gain because they are quite high calories. Diseases that cause obesity: insulin resistance, polycystic ovary syndrome, thyroid diseases, pituitary gland diseases, and sleep apnea are among the causes of obesity.
What is Morbid Obesity?
Morbid Obesity is a condition that overweight can be a life-threatening condition that can cause fatal problems. Surgical intervention is almost impossible to return without Sleeve Gastrectomy. Body Mass Index over 35 and in addition to those with comorbid diseases should be considered as morbidly obese. Besides this calculation, fat increase, waist circumference width are among the calculation criteria to be considered. Regional obesity may be misinterpreted as obesity even though it is not obese. Criteria and complaints of the patient should be taken into consideration when planning Sleeve Gastrectomy.
Symptoms such as sleep apnea, snoring, excessive sweating, difficulty in paced movements, breathlessness, enlargement of the waist circumference, fatigue, weakness, onset of diabetes, high blood pressure and cholesterol levels, fatty liver and depression may also be indicative of obesity.
WHAT IS OBESITY TREATMENT?
Medical Nutrition (Diet) Therapy; Medical nutrition therapy plays a key role in the treatment of obesity. Nutritional therapy in obesity: It should be aimed to reduce the body weight to the required level (BMI = 18.5 – 24.9 kg / m2). It should be noted that medical nutrition (diet) treatment is specific to the individual. The targets set at the beginning may be the ideal weight of the individual, as well as slightly above the ideal weight. Slimming diets to be applied should be in compliance with adequate and balanced nutrition principles. The aim is to provide the individual with the right nutrition habit and to maintain this habit.
When the bodyweight reaches the required level (BMI = 18.5 – 24.9 kg / m2), weight gain should be prevented and the lost weight should be preserved.
Exercise Therapy; Although the effect of exercise therapy in achieving weight loss is still controversial, it is firmly accepted that physical activity reduces adipose tissue and abdominal fat and prevents muscle mass loss that can be seen when dieting. Exercise therapy can prevent weight gain of individuals who support medical nutrition therapy and prevent weight loss and regain the weight. Behavioral change treatment; Behavioral change therapy under the control of body weight is a form of treatment that aims to change or reduce negative behaviors related to eating and physical activity that cause excess weight gain and to become a way of life by reinforcing positive behaviors. Stages of behavior change treatment:
Self-observation, stimulus control, alternative behavior development, reinforcement, self-reward, cognitive restructuring, social support.
Pharmacological treatment; Drugs to be used in the treatment of obesity are not suitable for individuals with moderate to moderate excess weight. It is of great importance that the medications used are determined for their safety in terms of health, have an effect appropriate to the etiology causing obesity, do not have significant side effects in the short and long term and do not cause addiction, and the necessity of using these drugs in physician’s advice and control. In order to be successful in the treatment of obesity, the patient must agree to continue medical nutrition and exercise therapy as well as medication and come to regular controls.
Surgical treatment; Surgical approach in obesity is basically divided into two. The goal of bariatric surgery to reduce energy intake by food is to reduce the absorption of nutrients in the gastrointestinal tract. For this purpose, bypass, gastroplasty, gastric banding, gastric balloon and so on. methods. The purpose of reconstructive surgery; is the removal of existing fatty tissues localized in various parts of the body. This treatment is aesthetically weighted and if the patient does not meet the requirements of obesity treatment, fat accumulation occurs again.
It is aimed to achieve an ideal weight in 1-2 years with a weight loss of 10% of the weight every month after Sleeve Gastrectomy. Post-operative information, weight gain should be maintained by maintaining the healthy eating habits gained. The follow-up of doctors and communication is the key to success in this process after Sleeve Gastrectomy.
The close relationship with the doctor before and after the surgery is of great importance for the patient and the family. Sustainable relationship and accessibility are valuable in reducing anxiety before sleeve gastrectomy, accelerating recovery after surgery.
Surgical technique, postoperative care protocols and professional team with the next day can continue to a normal life of many operations less risky tube gastric (Sleeve Gastrectomy) is a surgical method.
What is Sleeve Gastrectomy?
Sleeve gastrectomy (tube stomach) surgery is a method of surgery that has been achieved in obesity patients while weakening with the removal of the majority of the stomach. With the partial laparoscopic application, it became very popular in this operation for shortening the length of hospital stay, shortening the recovery time, less scarring and reducing the possibility of a surgical hernia. In gastric tube surgery, the stomach is turned into a long tube-like a banana. Laparoscopically, 80% of the stomach is cut and removed by closed surgery. Food intake of such stomach is restricted. In addition, tube gastric surgery has the effect of reducing food absorption, even at a very low rate. Tube gastric surgery is performed at an average of 1.5 hours. Obesity surgeries are performed very often nowadays after tube gastric surgery to protect the exit and entry part of the stomach and ensure the continuity of the digestive system is exactly the same. After surgery, a very large part can lose weight. But what should he pay attention to in order to continue to lose weight in the long term and not to gain weight again?
Which Patients Perform Tube Gastric Surgery?
Obesity patients, who can not lose weight or overweight with weight-related insulin connection, joint discomfort compared to patients with similar complaints. Until ten years ago, in the very obese history, it was used as the first step surgery before gastric bypass surgery. In this way, lifting weight can be cleaned and bypass surgery was done. Tube gastric surgery is performed on patients with a body mass index greater than 40 or diabetes hypertension, hyperlipidemia, cholesterol content, and 35th body mass index. It is necessary to spend a long time with methods such as diet, exercise for weight loss. As a result of these efforts, this operation can be offered as an option for obese people who cannot lose weight. Stomach reduction surgery is a method for people who previously had advanced obesity problems and who could not achieve permanent weight loss by methods such as diet and sports. In order to adjust the degree of obesity, the most commonly used figure called “body mass index is obtained by proportioning our weight to height. If the psychiatric disease condition is controlled by the psychiatrist without the approval of the record, the disease is controlled in cases where the stomach reduction surgery can be applied here.35 and over there are co-morbid diseases, when over 40, even if there is no co-morbid disease is considered suitable for bile treatment. BMI alone can be misleading in those who have a lot of muscle mass. Tube gastric surgery wants to be done there in some cases: Body kits with an index above 40 kg / m² (morbidly obese, ie obese in the future). People with a BMI of 35-40 due to overweight obesity, such as end-2 diabetes, hypertension, sleep apnea, are considered to be morbidly obese and may need to have shrinkage surgery in the middle. In addition, obesity-related “new” type 2 sugar and metabolism disorder and BMI 30 3035 years, the date of the operation can be performed with the condition of the obesity doctor. High cholesterol. Diseases of the cardiovascular system. Heart Failure, Vascular Diseases; With the increase in cholesterol and fat ratios in the blood, it can cause the death of the underlying cells as a result of blockage or narrowing of the artery in any part of the body. Nevertheless, it may cause thromboembolism and obstruction of the veins due to elevated cholesterol levels. Respiratory System Diseases
Sleep apnea; In obese people, it can be seen that the snoring and sleep apnea persist due to the east leaning of the soft palate during sleep. This condition may cause problems such as sleep quality, irritability, daytime sleepiness and lack of attention. And difficult difficulty.
RECOVERY WEIGHT AFTER SLEEVE GASTRECTOMY SURGERY
Even though the weight loss after tube stomach (sleeve gastrectomy) surgery is very low, it may be certain that there is a possibility of recovery. The most common misconception is that after reaching the ideal weight, eating is the transition to the comfort phase. Healthy eating habits gained after gastric (sleeve gastrectomy) surgery and adopting an active lifestyle may maintain an ideal weight. After the gastric tube surgery, it was observed that the enlargement medium was the stomachs made by keeping the starting point of the stomachs very narrow. When this was the case the tube was too narrow, an adaptation process was given, which was there with no effect of increased intragastric pressure.
NUTRITION AFTER TUBE STOMACH (SLEEP GASTRECTOMY)
Obesity is a chronic disease characterized by the increase in fat tissue in the body as a result of energy from food and energy from the body. Obesity is an important health problem that can cause many chronic diseases, especially cardiovascular diseases and diabetes.
Tube gastric surgery is the removal of three-quarters of the stomach to narrow the stomach volume. Your remaining stomach volume is 100 ml. (1 tea glass) is roughly tubular.
This surgery basically reduces the amount of food taken by reducing the volume of the stomach. It is also a very effective operation on the appetite control and satiety sensation due to the hormone Ghrelin secreted from the removed part of the stomach. Nutrition After Sleeve Gastrectomy; liquid pure soft foods and solid foods. In the first week, only consumption of clear liquid food is important. The most important habit acquired during this period is the liquid intake called sipping. In the second week, the melting time begins with fiber intake and flavor type. In the third week, soft foods and in the fourth week, solid foods can be converted to a normal diet. In this period when feeding habits change, transition periods between periods, food tolerability, accurate information to the patient, close relationship with doctor and nutritionist and close follow-up can be smooth and smooth.
WHAT RISKS DOES SLEEVE GASTRECTOMY HAVE ?
Tube gastric surgery is as risky as all other surgical operations. However, it should be remembered that the risks will decrease after tube gastric surgery performed by experienced and expert surgeons.
Bleeding, infection, internal organ injuries, intestinal obstruction, postoperative hernia and leakage in the stapler line are among the risks of this surgery. In the case of an obese person, Sleeve Gastrectomy is at a much greater vital risk than surgery. The other scientifically proven fact is that people with morbidly obese are at greater risk of life and may have a mortality rate of 10 to 15 years earlier than their peers. The fatal risk of Sleeve Gastrectomy is around 0.1% (1 per thousand) and this rate is acceptable. The choice of materials used is one of the other factors that affect the risk of surgery. High-quality medical equipment, high technology, advanced surgical experience, ability to cope with complications, experienced teamwork minimize the risk.