Obesity Center & Bariatric Surgery - Acıbadem Healthcare Services
Obesity Center & Bariatric Surgery

Obesity Center & Bariatric Surgery

What is obesity?

Obesity can be defined as an excessive accumulation of fat tissues that affects negatively general health. According to global data, the incidence of obesity has tripled in 50 years. Currently, nearly 35% of all adults have overweight, and 23% are considered obese. It is not just a cosmetic issue but a medical problem, as excessive weight increases the risk of developing other serious diseases. Once adipose tissue has been accumulated in the body, it excretes hormones and chemicals that increase appetite, elevate the limits of feeling full and cause obesity to progress further. Therefore, after a certain point, it might be difficult to solve the problem without help. The good news is that obesity is preventable, and it is treatable when the patient is motivated and seeks a qualified medical team.

Causes of Obesity

In brief, overweight and obesity are caused by the excessive intake of calories. It means that the calories you consume are more than the calories you expend. The surplus amount of calories is stored as body fat. In other words, anyone who eats too much and moves too little is at risk of developing overweight and obesity. However, some genetic causes, medical conditions like hypothyroidism, and medications like anti-seizure drugs might also contribute to weight gain.

Obesity Risk Factors

Excess weight gain is usually influenced by multiple behavioral, environmental and genetic factors. A few of them are:

  • Sedentary lifestyle. When physical activity is not enough, energy imbalance is inevitable.
  • Unhealthy diet. Consuming too much food or foods high in sugar, fat, and salt leads to extra weight.
  • Genetics and family predisposition. Some inherited genes may contribute to increasing hunger, food intake, and fat storage.
  • With ageing, changes in hormones, metabolism and activity levels contribute to easier weight gain.
  • Anxiety often makes people eat more or reach for fast foods. Besides, chronic stressreleases stress hormones causing the body to hold on to extra weight.
  • Some medical conditions. Diseases such as Cushing’s syndrome, polycystic ovary syndrome, hypothyroidism, arthritis, etc., may contribute to weight gain by slowing the metabolism, increasing the appetite or limiting the mobility.

How is Obesity Measured?

Body mass index (BMI) is a simple and commonly used tool for the evaluation of obesity. It considers the patient’s weight and height. To calculate your BMI, you can divide your weight in kilograms by your height in meters, then divide the result by your height again. The final result is matched to a BMI classification chart as follows:

Classification of Obesity According to the Body Mass Index

Value IntervalResult
BMI lower than 18.5 kg/m²Underweight
BMI between 18.5 – 24.9 kg/m²Normal (healthy weight)
BMI between 25 – 29.9 kg/m²Overweight
BMI between 30 – 34.9 kg/m²Class I Obesity
BMI between 35 – 39.9 kg/m²Class II Obesity
BMI over 40 kg/m²Class III Obesity (Morbid obesity)

Complications of Obesity

Overweight and obesity can bring serious health consequences. Along with potential digestive problems, it may lead to high levels of cholesterol and blood pressure, paving the way to heart diseases and stroke. Excessive weight puts extra pressure on the joints, causing musculoskeletal disorders, especially osteoarthritis. Raised BMI is a risk factor for various non-communicable diseases, such as type 2 diabetes, sleep apnea and some types of cancer. Moreover, it is associated with decreased quality of life, depression, anxiety and social isolation.

How Can You Prevent Obesity?

  • Regular physical activity – at least 150 minutes weekly for adults.
  • A healthy diet rich in vegetables, fruits, whole grains, legumes, avoiding fast and processed foods

You can follow a moderate exercise routine or take regular walks with your pet. Prepare your meals at home and consume more plant-based foods. Avoid chronic stress and sleep at least 7-8 hours every night. If all these do not help to maintain a healthy weight, contact a comprehensive obesity center where a team of professionals can assess your case and prepare a personal weight-loss program to achieve your goals.

Obesity Screening

Children and adults should be screened with BMI evaluation at least once a year. In case of rising values, the physician may recommend diet and exercise to avoid further weight gain.

Obesity Diagnosis

BMI is a good starting point in weight assessment. However, it does not consider important factors such as age, gender, muscular mass, or body fat distribution. For the effective diagnosis and treatment of obesity, it is important to know where fat accumulates in the body. Obesity can generally be separated into two categories – apple and pear-shaped. In apple-type obesity, fat accumulates in the belly, whereas in pear-shaped obesity, fat accumulates around the hips. Fat stored around the waist, also called abdominal fat, is more likely to increase the risk of developing dangerous health problems, especially cardiac disease or diabetes. Men with a waistline of more than 94 cm are considered to have increased risk, while waistlines over 102 cm are seen as high risk. In women, a waistline above 80 cm is associated with increased risk and above 88 cm means high risk.

Diagnosing obesity considers the health history and current health status of the patient. A wide range of factors helps to determine an effective treatment plan. That is why we recommend an expert consultation for better outcomes.

Obesity Treatment

Obesity is a challenging and complex disease that needs comprehensive treatment by an experienced medical team. The treatment process is determined individually for each patient, and it might involve:

  • Custom-made diet and exercise program. When your own efforts for weight control are insufficient, a specialist or, in the best case, a team of specialists can do a lot to help you achieve a steady weight loss.
  • If diet and exercise are not enough, your doctor may recommend weight-loss drugs that decrease the appetite or increase the feeling of fullness.Bear in mind that medications for weight loss are not harmless, and they must be prescribed by a specialist considering your overall condition.
  • Nonsurgical obesity treatments. Some non-invasive, endoscopic outpatient procedures might be effective in patients with overweight when diet and exercise have failed.
  • Bariatric surgery. There are various surgical methods aiming to reduce the volume of the stomach or decrease the absorption of food, or both.

Nonsurgical Weight Loss Procedures

These are quick and reversible weight loss techniques performed without incisions or hospital stay. They are most effective in patients with a BMI of 27-35 who are still not appropriate for obesity surgery but cannot manage their weight by diet and sports. At Acibadem Obesity Clinic, we perform the following non-invasive techniques:

  • Gastric botox. Botulinum toxin (botox) application is performed within 20-25 minutes. It works by limiting muscle contractions. Thus, the food stays longer in the stomach, the patient feels full and does not need to eat as much as usual.
  • Gastric balloon. The procedure is performed within 20-30 minutes. It involves the placement of an expandable balloon filled with saline fluid in the stomach. The device limits the volume of the stomach leading to reduced food intake. Swallowable gastric balloon does not require general anaesthesia and hospitalization – the patient can go home the same day. On the other hand some gastric balloons are placed and removed by endoscopy under anesthesia.

Gastric botox and Gastric Balloon have nearly similar results. Six months after the procedure, the average weight loss is 7% – 15% total body weight. It could be more or less, depending on the patient’s motivation to stick to the recommended lifestyle changes. These methods are not suitable for patients with BMI over 40 who need to lose more bodyweight. Bariatric surgery may offer a solution in these cases.

What is Bariatric Surgery?

Bariatric surgery, also called obesity surgery and weight-loss surgery, is a treatment for morbid obesity. When it is performed to deal with a chronic condition like diabetes, it is called metabolic surgery. The operation makes effective changes in the digestive system to assist in weight loss. Bariatric surgery uses different techniques to reduce the stomach volume or reducing the absorption surface of nutrients from the intestines, or a combination of both.

Candidates for Bariatric Surgery

Bariatric surgery may be an option for patients with BMI over 40 when diet and exercise alone have not worked. It may be applied to patients with BMI over 35 who have one or more weight-related health problems, such as hypertension, type 2 diabetes, sleep apnea, non-alcoholic fatty liver disease, osteoarthritis, etc. Metabolic surgery should also be considered to be an option to treat T2D in patients with class I obesity (BMI 30.0–34.9 kg/m2 ) and inadequately controlled hyperglycemia despite optimal medical treatment by either oral or injectable medications (including insulin).There are also some contraindications for bariatric surgery, like serious heart disorders, current drug or alcohol dependence, cancer treatment, mental disorders, and pregnancy. Candidates for obesity surgery must be aware that they will have to make permanent lifestyle changes to achieve and sustain good results.

Types of Bariatric Surgery

There are different procedures, and which one will be applied is determined according to the patient’s condition and expected results. At Acibadem Obesity Clinic, surgical options include:

  • Sleeve gastrectomy. This method is usually the first choice and the most commonly used procedure for bariatric surgery. Sleeve gastrectomy helps patients lose weight in two ways: first, the stomach volume is reduced and second, it stops producing a hormone associated with hunger called ghrelin. The surgeon removes approximately 80% of the stomach, leaving a long and narrow pouch. Because of its shape, the operation is called gastric sleeve or gastric reduction surgery. At Acibadem Obesity Center, we perform it laparoscopically through 4 or 5 small incisions. The operation usually lasts 50-60 minutes. The patient can drink clear liquids 4 hours after surgery and must follow strict diet recommendations next weeks. Hospital stay is 3 days; control examinations are required at 1 week, 1 month, 3 months, 6 months and 1 year post surgery.
  • Mini gastric bypass. This procedure is the light version of the traditional gastric bypass but more complex than the gastric sleeve. It works both by restricting the stomach and causing malabsorption, as the absorption area in the small intestine is reduced.
  • Gastric bypass. Also called Roux-en-Y gastric bypass, this method involves creating a small pouch in the upper section of the stomach and attaching part of the small intestine to it. Hence, the food changes its stream, ‘bypassing’ most of the stomach and part of the small intestine. This procedure helps to reduce both the amount of consumed food and the absorption of calories. At Acibadem Obesity Clinic, gastric bypass surgery is typically performed with laparoscopic techniques, through small incisions in the abdomen.

Patients undergoing bariatric surgery should stick to a regular diet and exercise program. Therefore, the long-term success of obesity treatment depends strongly on the patient’s motivation to make life-long changes.

Benefits of Bariatric Surgery

Patients undergoing obesity surgery can expect to lose about 60%-80% of their excess body weight within two years after the operation. These results are permanent if the patient follows the recommended program and healthy lifestyle habits. An average of 80-90% of all patients undergoing bariatric surgery achieve their weight-loss goals.

Along with weight loss, obesity surgery provides significant improvement in many medical conditions:

  • High blood pressure is regulated. 70% of patients stop taking hypertension drugs.
  • Blood cholesterol improves. Over 80% of patients report normal levels 2-3 months after the operation.
  • The risk of developing cardiac diseases is reduced due to decreased workload of the heart.
  • Diabetes is reversed. About 70% -85% of patients with type 2 diabetes are able to maintain normal blood sugar levels without medications.
  • Asthma and respiratory problems are improved, with some patients recovering completely.
  • Obesity-related sleep disorders such as sleep apnea are cured.
  • Joint and back pain caused by the excess weight is relieved.

Is Bariatric Surgery Safe?

Obesity surgery can be a lifesaving solution for people with severe obesity. However, it is a major surgery that carries certain risks and side effects, such as blood clots, infections and bleeding. All these are manageable conditions. Besides, the long-term advantages of bariatric surgery exceed potential risks. At Acibadem Obesity Clinic, we perform an extensive evaluation with a multidisciplinary team of experts, to ensure that each patient receives the most suitable medical procedure. Bariatric surgery is generally safe when performed in an experienced centre able to manage potential complications.

Why choose Acibadem Obesity Clinic?

Recently, patients from all over the world have been travelling for bariatric surgery in Turkiye. They are attracted by the opportunity to receive obesity treatment immediately, at an affordable price, with world-class results. Acibadem Obesity Center stands out among healthcare facilities for its:

  • Experienced multidisciplinary team. Obesity treatment is a team play. The comprehensive process may involve specialists in gastroenterology, endocrinology, psychiatry, diet and nutrition, surgery, plastic surgery, nurses and other medical fields. At Acibadem Obesity Center, they work in close cooperation for the best of each patient, to achieve success rates above 90%.
  • State-of-the-art equipment. We are known for our continuous investments in the latest tools and devices facilitating medical professionals. It allows our surgeons to perform bariatric surgery using advanced laparoscopic techniques and robotic surgery.
  • A-class patient service. Our International Patient Center provides 360-degree service all the way, from medical appointments, travel and accommodation details to language interpretation and follow-up visits.