Obesity and Sleeve Gastrectomy: Why Is It Important, Who Is Eligible, and How Does the Process Proceed?
The Impact of Obesity on Health and Its Global Reflections
Obesity is not only an aesthetic problem; it is among the most important causes of preventable disease-related mortality worldwide. Especially after lung cancer due to smoking, obesity ranks among the leading causes of death on a global scale. Due to its chronic and multidimensional nature, it paves the way for the development of many serious health problems, primarily cardiovascular diseases, type 2 diabetes, and depression, and significantly impairs the quality of life.
The World Health Organization (WHO) defines obesity as a health problem characterized by an increase in body fat beyond healthy limits and excessive fat accumulation, which can lead to various physical, mental, and social problems. Diseases associated with obesity frequently include types of cancer, metabolic syndrome, hypertension, sleep apnea, and joint disorders.
Causes of Obesity and Approaches to Treatment
A sedentary lifestyle and unhealthy eating habits are among the main factors that increase the risk of obesity. Although behavioral treatment approaches recommend diet and exercise plans, this process may not be sustainable for most individuals. Due to difficulties in adherence to treatment, weight loss may be limited, and as a result, health status may further deteriorate.
Various treatment options have been developed in modern medicine, and surgical approaches that can provide effective weight loss in advanced cases of obesity are increasingly coming to the fore. Among these, sleeve gastrectomy stands out for its success rates and safety.
What is Sleeve Gastrectomy?
Sleeve gastrectomy is a procedure in which approximately 75-80% of the stomach is surgically removed. The remaining stomach takes on a thin, tube-like shape. In this way, individuals reach satiety with smaller portions, and total calorie intake is significantly reduced. This method not only supports weight loss but also contributes to the improvement of a wide range of health problems associated with obesity.
Sleeve gastrectomy can provide improvement or regression in the following health problems related to obesity:
Type 2 diabetes
High blood pressure
Sleep apnea
Fatty liver disease
Polycystic ovary syndrome (PCOS)
Reflux disease
Joint disorders
Who Is a Suitable Candidate for Sleeve Gastrectomy?
This operation is primarily recommended for individuals with a body mass index (BMI) of 40 and above, or those with a BMI over 35 who have additional health problems. In cases generally defined as "morbid obesity" or "super obesity," surgical options offer effective and safe solutions. In addition, sleeve gastrectomy can be performed in individuals who have not achieved the desired weight loss with diet and exercise and who have serious health problems related to obesity.
Most patients who undergo sleeve gastrectomy can lose about 50-80% of their excess weight within the first year. Studies have reported that complication rates related to the operation are low and that improvement rates in chronic diseases such as diabetes are high.
Global Approach to Surgical Treatment
Long-term studies on obesity surgery (for example, the Swedish Obese Subjects Study, SOS) have shown that bariatric surgery provides sustainable and effective weight loss. Surgical methods are accepted as one of the main options for obesity treatment in many countries. Thanks to technical advances, most surgeries are performed using closed (laparoscopic) methods; this both shortens recovery time and reduces the risk of complications.
How Is the Surgery Performed?
Sleeve gastrectomy is usually performed laparoscopically, that is, using a minimally invasive method. By entering through a small incision in the abdomen, the stomach is divided with special medical devices called staplers, and the desired portion is removed. The stomach is reshaped into a thin and narrow tube. Thanks to the extensive reduction in stomach size, both the stomach volume decreases and some of the hormones responsible for hunger (such as ghrelin) are not produced; this helps control appetite and calorie intake.
The recovery process is generally rapid. A significant portion of patients can get up within a few days after surgery and return to daily life within a few weeks.
Weight Loss and Health Improvements After Surgery
The most common positive effects observed after sleeve gastrectomy are as follows:
Losing most of the excess weight within the first year
Marked regression or disappearance of obesity-related diseases such as type 2 diabetes, high blood pressure, and sleep apnea
Improvement in blood lipids such as cholesterol
Reduction of pain in knee and leg joints
Increase in quality of life and mobility
Sustainable weight loss is achieved at a higher rate compared to non-surgical treatment methods. The rate of weight loss may vary for each individual, but various studies report that a significant portion of patients can lose 50-80% of their excess weight within the first year after surgery.
Risks and Safety of the Surgery
As with any surgical intervention, there may be some risks in sleeve gastrectomy. Complication rates are quite low with current surgical techniques, and most cases are mild or moderate. Although serious complications are rare, safety is increased through detailed preoperative evaluation and follow-up by an expert team. The length of hospital stay after surgery is usually short; most patients can be discharged within 3-4 days.
Nutrition and Lifestyle Changes
It is very important to follow nutritional guidelines to maintain healthy weight loss after surgery. In the first weeks, liquid foods are consumed, followed by pureed and then solid foods in the following period. Since individuals' stomach capacities are reduced, a feeling of fullness occurs more quickly; leaving a waiting period between liquid and solid foods during meals is recommended to protect the stomach. In addition, protein, vitamin, and mineral supplementation may be necessary. Doctor-supervised exercises during this period both support weight loss and help prevent muscle loss and skin sagging.
About Sleeve Gastrectomy Fees
The cost of sleeve gastrectomy may vary depending on the experience of the surgical team, the facilities of the center, and the medical materials to be used. A doctor's examination is absolutely necessary for final pricing. For comprehensive information, it is best to consult a healthcare center or a specialist physician.
In conclusion, sleeve gastrectomy is an effective and modern option in the fight against obesity, aiming to improve quality of life and reduce associated health problems. After a comprehensive evaluation under the guidance of a specialized healthcare team, it is recommended to create a solution plan tailored to the individual's needs.
Frequently Asked Questions
1. What is sleeve gastrectomy and how is it performed?
Sleeve gastrectomy is a surgical procedure that reduces stomach volume, enabling the person to eat less and lose weight. Using the laparoscopic (closed) technique, a large part of the stomach is removed and the stomach is left in the form of a tube.
2. Who is a suitable candidate for sleeve gastrectomy?
Generally, individuals with a body mass index of 40 and above or over 35 with accompanying health problems are suitable candidates for surgery. A doctor's evaluation is required for a definitive decision.
3. How much weight loss is expected after sleeve gastrectomy?
Although there are individual differences, most patients can lose 50-80% of their excess weight within the first year. The rate of weight loss varies depending on the person's age, gender, metabolism, and lifestyle.
4. Is there a risk of regaining the lost weight after surgery?
Lifestyle changes and doctor recommenCompliance with these principles ensures weight maintenance. If inappropriate eating habits redevelop, weight gain may reoccur.
5. What is the risk of complications in sleeve gastrectomy?
With advancing techniques, complication rates are low; most patients recover from surgery without problems. In rare cases, issues such as leakage, bleeding, or infection may develop.
6. Does sleeve gastrectomy provide benefits for diseases such as diabetes and hypertension?
In many patients, especially those with obesity-related diseases such as type 2 diabetes and hypertension, there may be a marked improvement or sometimes complete resolution after surgery.
7. How should nutrition be after surgery?
Initially, feeding is done with liquid foods; over time, pureed and then solid foods are introduced. Your personal nutrition program will be arranged by your dietitian and doctor.
8. Is exercise necessary after surgery?
Exercise is recommended to support weight loss and prevent muscle loss. Your doctor will guide you regarding the appropriate timing and types of exercise.
9. Does the feeling of hunger decrease after surgery?
Yes, since the part of the stomach that produces a significant portion of the hunger hormone called ghrelin is removed, the feeling of hunger is noticeably reduced in many patients.
10. How long does sleeve gastrectomy take?
The operation usually takes between 1-2 hours, but the process may vary depending on the patient's health status and the surgeon's experience.
11. When can one be discharged and return to normal life?
Most patients are discharged within 3-4 days after surgery and can return to their daily lives within a few weeks.
12. Is vitamin and mineral supplementation necessary after the operation?
Mostly yes. Your doctor will recommend vitamin and mineral supplements as needed.
13. What determines the cost of the surgery?
The cost of the surgery varies depending on the place of application, the experience of the healthcare team, the technique used, and medical supplies. A doctor's consultation is required for precise information.
14. Is sleeve gastrectomy a permanent solution?
The weight loss achieved through surgery is generally permanent, but maintaining success requires the continuation of healthy lifestyle habits.
15. Are problems such as hair loss or skin sagging seen after surgery?
If weight loss is rapid, temporary hair loss or skin laxity may sometimes occur. Balanced nutrition and exercise have a positive effect during this process.
References
World Health Organization (WHO): Obesity and overweight factsheet
American Society for Metabolic and Bariatric Surgery (ASMBS)
Swedish Obese Subjects (SOS) Study – New England Journal of Medicine
Centers for Disease Control and Prevention (CDC): Adult Obesity Facts
The Lancet, "Global, regional, and national prevalence of overweight and obesity", 2022
National Institutes of Health (NIH): Bariatric Surgery Guidelines