Obesity is one of the biggest health problems worldwide, especially in western societies. In many scientific studies, obesity has been shown as the most important cause of many diseases that increase mortality and morbidity. The most commonly used measurement method for obesity is BMI (Body Mass Index). It is the value obtained by dividing the weight by the square of the height.

18.5-24.9 kg/m2 Normal individuals

25-29.9 kg/m2 Overweight

30-40 kg/m2< Obese

40 kg/m2< Morbidly obese

However, an increase in BMI does not always mean obesity. A person with more muscle tissue may have a high body mass index. Expert judgment is important to understand the source of body weight gains. If the waist circumference is 102 cm in men and 88 cm or more in women, obesity should be considered.

The main purpose of obesity surgery is to prevent the development of diseases caused by obesity (DM, cardiovascular diseases, sleep apnea syndrome, etc.) as well as losing weight. Diseases, if they occur, is to treat.

Alone or many factors together can cause obesity. These are genetic predisposition, endocrine and metabolic diseases, social and cultural differences. Basically, if the amount of energy entering the body is more than the amount burned, it causes obesity.

It is estimated that around 1.7 billion people worldwide are overweight. In the United States, the situation is more serious. About 2/3 of the population is overweight, and about half of them are classified as obese.

Obesity surgery has been widely performed in the world in recent years. The first effective bariatric surgery was performed in the United States in 1954 by Kremen and Linner (jejunaileal bypass).

The surgeries are divided into 3 according to the mechanism of action;

1. Restrictive Surgery (adjustable gastric banding, sleeve gastrectomy)
2. Surgeries that Disrupt Absorption
3. Restrictive and Absorption Combined Surgeries (duodenal switch, SADI-S)

WHO SHOULD HAVE SURGERY TREATMENT?

When choosing patients suitable for surgery, we decide according to the following criteria.

• Having a body mass index above 40 or between 35-40 and having a concomitant disease (hypertension, diabetes mellitus, sleep apnea, arthritis)
• Presence of obesity for at least 3 years
• Absence of hormonal diseases (Hypothyroidism, adrenal gland diseases)
• Failure to lose weight for at least 1 year despite medication and diet therapy
• Not addicted to alcohol or drugs
• The patient should understand the method to be applied and be in a position to adapt after the surgery.

Non-Surgical Procedures

Intragastric Balloon Application (Gastric Balloon Application)

In the treatment of obesity, there are endoscopic procedures as well as surgical procedures. Among them, the most used Intragastric Balloon (Stomach Balloon) Application.

To Whom Can It Be Done?

• It can be applied to anyone who can tolerate endoscopy.

• It can be applied to patients who cannot tolerate surgery, patients who do not have a hiatal hernia larger than 3 cm (stomach hernia) and gastric ulcer, and individuals who have had previous gastric surgery, psychiatric disease, and individuals who do not have alcohol or drug addiction.

Indications

– In order to weaken the patients before the operation, to reduce the risk of complications and death, if major surgery is to be performed in those with a BMI (BMI) of 40 and above, and those with a BMI (BMI) of 35 and additional diseases,

– It is applied to patients who cannot lose weight despite diet and exercise programs with BMI (BMI) above 30 kg/m2.

1. Method is not surgery.

2. The procedure is performed in the endoscopy unit in 15-20 minutes under sedoanalgesia.

3. The patients stay in the hospital for 1 day and are provided with food in the early post-procedure period.

4. Thanks to the newly developed balloons  ( Adjustable Gastric Balloon System), the  patient has the opportunity to stay in the gastric balloon for 1 year.

5. With the help of appropriate diet and exercise programs, it is possible to lose 30-50 kg of weight in 1 year.

 6. The balloon can be inflated with the help of the Adjustable Gastric Balloon System in patients whose weight loss is insufficient or stopped within a year  .

7. After the old balloon is removed, the new balloon can be put back into the stomach if the patient wishes.

8. It is more economical than bariatric surgery.