Obesity Center & Bariatric Surgery

At Acıbadem Obesity Clinic, obesity is successfully treated with personalized diet and exercise plans, non-invasive methods, and bariatric surgery.

What is obesity?

Obesity can be defined as an excessive accumulation of fat tissues that negatively affects general health. According to global data, the incidence of obesity has tripled in the past 50 years. This is not just a cosmetic issue but a medical problem, as excessive weight increases the risk of developing serious diseases. Once adipose tissue has 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 can be difficult to solve the problem without help. The good news is that obesity is preventable, and is treatable when the patient is motivated and has a qualified medical team.

Causes of obesity

In brief, overweightness and obesity are caused by the excessive intake of calories, when more calories are consumed than expended. The surplus calories are stored as body fat. In other words, anyone who eats too much and moves too little is at risk of developing overweightness and obesity. However, genetic causes, medical conditions such as hypothyroidism, and medications such as anti-seizure drugs can also contribute to weight gain.

Obesity risk factors

Excess weight gain is usually influenced by multiple behavioral, environmental, and genetic factors. Examples include:

• Sedentary lifestyle. Without sufficient physical activity, an energy imbalance is inevitable.
• Unhealthy diet. Consuming too much food, or foods high in sugar, fat, and salt, leads to extra weight.
• Genetic predisposition. Some inherited genes may contribute to increased hunger, food intake, and fat storage.
• Age. Age-related changes in hormones, metabolism, and activity level contribute to easier weight gain.
• Stress. Anxiety often makes people eat more or reach for fast foods. In addition, chronic stress releases stress hormones, which cause the body to hold on to extra weight.
• Medical conditions. Diseases such as Cushing’s syndrome, polycystic ovary syndrome, hypothyroidism, and arthritis may contribute to weight gain by slowing metabolism, increasing appetite, or limiting mobility.

How is obesity measured?

Body mass index (BMI) is a simple and commonly used tool to evaluate obesity. BMI considers weight and height. BMI is calculated by dividing weight in kilograms by height in meters, then dividing the result by height again. The result is matched to a BMI classification chart as follows:

Classification of obesity according to body mass index

Complications of obesity

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

How to prevent obesity

Overweightness and obesity are highly preventable with healthy choices. A healthy diet rich in vegetables, fruits, whole grains, legumes, and low in processed or fast foods can help maintain a healthy weight. Healthy choices might be following a moderate exercise routine or taking regular walks with a pet, preparing meals at home, consuming more plant-based foods, avoiding chronic stress, and sleeping at least 7–8 hours every night. If this is not sufficient to maintain a healthy weight, patients should contact a comprehensive obesity center where a team of professionals can assess their case and prepare a personal weight-loss program.

Obesity screening

Children and adults should be screened with a 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 for weight assessment. However, it does not consider important factors such as age, gender, muscular mass, or body fat distribution. For 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, increases the risk of developing dangerous health problems, especially cardiac disease or diabetes. In men a waistline over 94 cm is considered at increased risk, and over 102 cm is considered high risk. In women, a waistline over 80 cm is considered at increased risk and over 88 cm is considered high risk.

When diagnosing obesity, the patient’s health history and current health status are considered. A wide range of factors are considered to determine an effective treatment plan. Therefore, 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 may involve:

• Customized diet and exercise programs. When a person’s own efforts for weight control are insufficient, a specialist or, ideally, a team of specialists can do a lot to help them achieve steady weight loss.
• Medications. If diet and exercise are not enough, a doctor may recommend weight-loss drugs that decrease appetite or increase the feeling of fullness. Medications for weight loss are not harmless, and they must be prescribed by a specialist considering the patient’s overall condition.
• Nonsurgical obesity treatments. Some non-invasive, endoscopic outpatient procedures can be effective in overweight patients when diet and exercise have failed.
• Bariatric surgery. There are various surgical methods to reduce the volume of the stomach, decrease absorption of food, or both.

Nonsurgical weight loss procedures

These are quick and reversible weight loss techniques performed without incisions or hospital stays. They are most effective in patients with a BMI of 27–35 who are not candidates for obesity surgery but cannot manage their weight by diet and exercise. Acıbadem Obesity Clinic offers the following non-invasive techniques:

• Gastric Botox. Botulinum toxin (Botox) application takes 20–25 minutes. This limits muscle contractions, causing food to stay in the stomach longer. This makes the patient feel full and not need to eat as much as usual.
• Gastric balloon. The procedure is takes 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, reducing food intake. A swallowable gastric balloon does not require general anesthesia and hospitalization; the patient can go home the same day. Other gastric balloons are placed and removed via endoscopy under anesthesia.

Gastric Botox and gastric balloons have similar results. Six months after the procedure, average weight loss is 7–15% of total body weight. This can vary depending on how well the patient maintains the recommended lifestyle changes. These methods are not suitable for patients with a BMI over 40 who need to lose more body weight. Bariatric surgery may offer a solution in these cases.

What is bariatric surgery?

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

Candidates for bariatric surgery

Bariatric surgery may be an option for patients with a BMI over 40 when diet and exercise alone have not been sufficient. It may be also used for patients with a 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, or osteoarthritis. Metabolic surgery may also be considered to treat type 2 diabetes 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). Bariatric surgery is contraindicated for conditions such as serious heart disorder, 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

Which bariatric surgical procedure will be used is determined based on the patient’s condition and expected outcomes. At Acıbadem Obesity Clinic, surgical options include:

• Sleeve gastrectomy. This method is usually the first choice and the most commonly used procedure for bariatric surgery. A sleeve gastrectomy helps patients lose weight in two ways: by reducing stomach volume and by preventing the production of ghrelin, a hormone associated with hunger. 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 Acıbadem’s Obesity Center, it is performed laparoscopically through four or five small incisions. The operation usually lasts 50–60 minutes. The patient can drink clear liquids four hours after surgery and must follow strict diet recommendations in the following weeks. The hospital stay is three days, and control examinations are required at one week, one month, three months, six months, and one year post surgery.
• Mini gastric bypass. This procedure is the light version of the traditional gastric bypass, but is still more complex than the gastric sleeve. It works by restricting the stomach and causing malabsorption by reducing the absorption area in the small intestine.
• 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. The food changes its stream, bypassing most of the stomach and part of the small intestine. This procedure reduces both the amount of consumed food and the absorption of calories. At Acıbadem Obesity Clinic, a gastric bypass surgery is typically performed with laparoscopic techniques, through small incisions in the abdomen.

Patients undergoing bariatric surgery should maintain a regular diet and exercise program. 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 of the operation. These results are permanent if the patient follows their recommended program and maintains healthy lifestyle habits. An average of 80–90% of patients undergoing bariatric surgery achieve their weight-loss goals.

Along with weight loss, obesity surgery provides significant improvement to 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 the 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 excess weight is relieved.

Is bariatric surgery safe?

Obesity surgery can be lifesaving for people with severe obesity. However, it is a major surgery that carries risks and side effects, such as blood clots, infections, and bleeding. These are manageable conditions, and the long-term advantages of bariatric surgery exceed the potential risks. At Acıbadem 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 center that is capable of managing potential complications.

Why choose Acıbadem Obesity Clinic?

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

• Experienced multidisciplinary team. Obesity treatment is a team effort. The comprehensive process may involve specialists in gastroenterology, endocrinology, psychiatry, diet and nutrition, surgery, plastic surgery, nurses and other medical fields. At Acıbadem Obesity Center, they collaborate closely to do the best for each patient, and achieve success rates above 90%.
• State-of-the-art equipment. Acıbadem is known for its continuous investments in the latest tools and devices to facilitate medical professionals. This allows surgeons to perform bariatric surgery with advanced laparoscopic techniques and robotic surgery.
• A-class patient service. Our International Patient Center provides 360-degree service for everything, including medical appointments, travel and accommodation details, language interpretation, and follow-up visits.