Metabolic and Bariatric Surgery

The prevalence of obesity, one of the most important health problems, has been dramatic over the years. Presence of accompanying diseases as well as obesity, treatment and recovery time may cause complicated process.

What is Obesity?
World Health Organization (WHO) obesity is higher than normal body fat mass while defining the form, body mass index (BMI) is also guiding among the diagnostic criteria. This value is our height in meters of our body weight in kilograms. It is a mathematical calculation that still finds its effectiveness with the ratio to the square. If 18.5-24.9 kg / m² is normal and healthy, 25-29.9 kg / m² is overweight, ≥30 kg / m² individuals are considered obese. Obese individuals grading BMI is ≥40 kg / m², is defined as morbidly obese.

What is Metabolic Syndrome?
According to guidelines, metabolic syndrome, insulin resistance-induced abdominal obesity, which is vicious is a cycle; diabetes, dyslipidemia, hypertension, non-alcoholic steatohepatitis, coronary artery disease (CAD) is an endocrinopathy with systemic disorders. Diabetes, impaired at least one of the states of glucose tolerance and insulin resistance and dyslipidemia, hypertension and presence of at least two of abdominal obesity conditions are diagnostic criteria. The incidence in our country is higher in women than in men.

Medical Treatments and Factors
Nutrition in maintaining body weight loss or in the treatment of metabolic diseases plays a very important role. Specific for patients’ body compositions nutrition programs, if necessary, treatment with regular controls as well as medical treatment plan can be created. Nowadays, in some cases, surgical techniques can also be used.
There are many bariatric surgical treatment methods in obesity treatment. Bariatric selection criteria in operations are separated within themselves; one’s long failing besides dietary interventions, BMI is 40 kg / m² or 35 kg / m² and comorbid accompanied by a disease is the factor.
Medical treatment of metabolic syndrome can be provided by metabolic surgery techniques. Today in non-obese or obese individuals, especially type 2 diabetes, whose surgery is decided, these surgical techniques can be applied.

Pre and Post-operative Process
Patient evaluation is essential in the per-operative period. Anthropometric measurements, weight-disease history, nutritional history, psychological history, hemogram examinations, physical activity level-frequency, non-alcohol use etc. As a result of the evaluations, the patient’s suitability for the operation decision is made and the operation technique is planned.
In the post-operative period, different medications depending on the surgical techniques and medical condition, supplementation and medical nutrition treatments are organized by the expert team. Early during the period, patients are monitored at regular intervals and with regular follow-ups in the late post-op period.

Who Should be in the Surgical Team?
The presence of a multidisciplinary team in the surgical field is very important. Coordinated work in this team based on the principle; general surgeon, endocrinologist, cardiologist, anesthesiologist specialist, dietician, psychologist, surgical service nurses, anesthesiologist specialists are required.

Nutritionist Elif Mızrak