“Bariatric surgery poses a risk of death...” “I would have to use powerful drugs after surgery...” Misconceptions such as these, which are spread among the public rapidly, can cause people suffering from obesity to avoid undergoing gastrectomy procedures. As a result, such patients are forced to live with serious health problems such as diabetes, high blood pressure, sleep apnea, COPD and hernias, all of which occur due to excessive weight. On the other hand, patients who regard bariatric surgery as “a magic wand” which will quickly bring them back to their ideal weight are also in for disappointment. Contrary to what is widely believed, the risk associated with bariatric surgery is not higher than the one associated with other stomach operations when the procedures is carried out in a fully equipped hospital by expert staff and through use of the current technologies. Furthermore, it becomes possible for patients to lose 70 to 95% of their excess weight within 2 years on the condition that they comply with the diet and exercise programs recommended by the specialists. However, compliance with the said diet and exercise programs is a must! Therefore, specialists have adopted the mission of correcting the common misconceptions related to bariatric surgery. Professor Bilgi Baca, a general surgeon at Acıbadem Altunizade Hospital, has shared with us the common misconceptions related to bariatric surgery and issued important warnings.
False: Anyone who is overweight can undergo bariatric surgery
Correct: It is believed that anybody who is overweight can undergo bariatric surgery. For instance, there are cases where a person who is 20 kilograms over their ideal weight wants to undergo bariatric surgery. However, this type of surgery is performed to enable people to lead a healthy life rather than serve cosmetic purposes; therefore, it is not applied on everyone. According to the criteria specified by the World Health Organization, the candidates for surgery are people whose Body Mass Index (BMI) is over 40 kg/m2 or those with 35-40 kg/m2 weight and people whose condition is accompanied with diseases such as diabetes, high blood pressure and sleep apnea syndrome. In addition to these criteria, the candidates are reviewed in detail in order to determine the underlying causes of their obesity and gain insight as to their dietary habits and psychological condition.
False: Bariatric surgery poses risk of death
Correct: Thanks to the advanced modern techniques and contrary to popular belief, the risk associated with bariatric surgery is not higher than the one related to other stomach operations when the procedure is performed as prescribed by the World Health Organization in a fully equipped hospital. In case there are additional, accompanying risk factors such as diabetes, high blood pressure, sleep apnea and blood clot formation in vessels, it is ensured for the risk to be reduced to acceptable levels through special measures for the said conditions.
False: My friend lost a lot of weight, so I want to undergo the same operation as well
Correct: There are various types of bariatric surgery. The most common among these are sleeve gastrectomy (tube-shaped stomach), gastric bypass (reduction and connection of the stomach to the small intestine) and adjustable gastric band (stomach stapling). Professor Bilgi Baca, a general surgeon, notes that while they do take the patient’s wishes into consideration, the final decision is made by specialists after many evaluations, and says, “This is because the core factor in surgical success is to apply the best method for the patient. Otherwise, the procedure may not be sufficiently successful”.
False: I can achieve my ideal weight with surgery
Correct: Professor Bilgi Baca, a general surgeon, notes that patients should not regard surgery as a magic wand. Surgery is performed to provide support to people who are unable to lose weight despite healthy diets and exercise, and unable to move due to excessive weight. Therefore, adopting a healthy diet and exercising regularly is critical after surgery. When patients comply with the diet and exercise programs issued by the specialists, they lose 40% of the excess weight within 6 months and 75 to 90% of it within 2 years.
False: It is not possible to undergo bariatric surgery a second time
Correct: Patients who gain weight after surgery due to not complying with the given diet and exercise program worry that they will not be able to undergo surgery again. Contrary to popular belief, it is possible to undergo bariatric surgery a second time. Professor Bilgi Baca, a general surgeon, says, “Depending on the previous operation, the same method can be used or another method may be chosen. For instance, if the patient has gained weight after sleeve gastrectomy, it is possible to perform gastric bypass after evaluation of the stomach condition on the basis of imaging.
False: I will have to use drugs for the rest of my life after surgery
Correct: Bariatric surgery provides aid in weight loss through reduction of absorption and/or limiting of nutrient intake. In some techniques such as gastric bypass and bilioenteric bypass which affect absorption, it is possible for patients to need iron supplements and vitamin supplements such as Vitamin B12 or D. Since these are introduced intravenously every 2 to 3 months or taken orally for a temporary period, they do not emburden the patient.