Category: Klinik Obezite

Categories
Klinik Obezite

KO-E-037 My pathway towards weight loss: my responsibilities

Weight loss surgery is the first step

My weight-loss journey: My Responsibilities

Weight-loss surgery is the first step.

For bariatric patients, weight-loss surgery is only one of the first steps toward a healthy life. A healthier lifestyle and significant weight loss depend on how strictly you adhere to the follow-up program in the months and years after surgery.

Take your time to reach your goals

To achieve healthy and sustainable weight loss with bariatric surgery, you should do the following:

  • Stick to an active and healthy lifestyle by including physical activity and exercises in your daily routine.
  • Talk about your health history, questions or concerns with your health team openly and honestly. Learn everything about surgery as much as possible before deciding.
  • Be informed about suitable nutritional options and take nutrients, vitamins, and mineral supplements according to the recommendation of your health team. The Get Ready application will help you to succeed.
  • Consider psychological support, which may help you to stick to a healthier lifestyle and require behavioral changes.

Your Decisiveness

At the moment you decide on bariatric surgery, you also accept the following lifestyle changes:

Changes in Diet: Following bariatric surgery, your diet will change gradually from fluids to small meals. For the rest of your life, you should take simple vitamin and mineral supplements every day.

Exercise: Before and after surgery, it is very important to include physical activities in your daily life to maximize and maintain weight loss. A routine exercise program is the key to long-term success.

After surgery, you should follow the diet, vitamin/mineral intake, physical activity and other recommendations given by your health team. Following strictly the follow-up program will enable you to have a lifelong success.

 

Categories
Klinik Obezite

KO-E-039 My pathway after surgery

 

My journey after surgery

A new and healthy life waits for you

In the first 6 months, it is very important that you strictly follow the instructions of your health team. Your health team will prepare an after-surgery diet protocol, vitamin and mineral supplements, and a physical exercise program. Besides, you should make a few follow-up visits to your health specialists. The Get Ready application will provide all the information you will need during this short-term follow-up period.

Contact your health team.

If you have any concerns related to how to follow the after-surgery instructions, please do not hesitate to contact your health team. If you feel a need for psychological support or support from persons in a similar position, do not hesitate to contact relevant centers. Contact our bariatric clinic for further information. During the short-term follow-up, the Get Ready application will request that you fill out some questionnaires, which will help your health team serve you better.

You can instantly contact our team from the message section of this application you use.

In addition, the contact information of our team is as follows:

Ali Durmuş MD: +90 532 691 4994    

Coordination: Betül Yüksek: +90 505 120 8262   

Aesthetic Coordination: Hatice Dalaz : +90 555 877 1562

Dietitian İrem Yılmaz:  +90 532 700 1871 

Dietitian Göksu Asay: +90 538 081 4474 

Patient Consultant Duygu Tunç : +90 534 013 2000

Categories
Klinik Obezite

KO-E-027 My weight loss care journey for the long run

Bariatric surgery will impact your daily life – for the rest of your life. You will always need to pursue a healthy lifestyle. 

‘

My weight-loss journey for the long term

Bariatric surgery will affect your daily life throughout the rest of your life. It is important that you maintain a healthy lifestyle.

  • “Honeymoon phase”

During the first months after your surgery, it may seem easy to follow the recommendations of your health team. You will not stay too much hungry, and you will eat in very small amounts. It may be challenging to meet your daily food intake requirements. You will be in close contact with your health team. During this period, your weight may seem to decrease rapidly and spontaneously. Many patients define the first year after surgery as the “honeymoon phase”.

Unfortunately, “honeymoon” does not last forever…

It may change toward the end of the first year. Usually, after the first year, the feeling of hunger returns to some degree, the volume of consumed food increases and you may find it difficult to stick to your program. Your diet is essential throughout your journey. However, some patients believe that completing the first year is more important. Following the diet recommended by your dietitian for the long term is very important for maintaining your weight loss for the rest of your life.

Here are a few tips to continue your journey while you are approaching the end of the first year:

Eat solid foods: Patients should eat softer foods after surgery, but you will experience a substantial change in the food amount you eat and your hunger intensity if you do not switch to solid foods. Juicy and crunchy foods transit more rapidly through your stomach and your hunger quickly returns back which leads you to eat more.

Limit carbohydrates: With time you can start adding carbohydrates in reasonable amounts to your diet. However, you should be very careful. Some patients add cereal for breakfast, whole grain pasta for lunch or brown rice for dinner. All are acceptable, but it is better to limit your carbohydrate intake to one meal per day.

Protein, protein, protein: Protein is the center of your diet and will always be. You should meet most of your protein needs (60-80 g per day for most individuals) by eating three protein-based meals every day. Eating solid protein is an effective way to meet your protein needs and be full for a long time.

Limit snacks: If you prefer snacks, make smart choices. Keep protein-based snacks (cheese sticks, a bowl of yoghurt or nuts) and do not keep unhealthy snacks at home. This will satisfy you and prevent you from overeating until the next meal.

Keep an eating diary: When you take notes about what you eat, you will become more aware of what you are eating. It is very easy to eat a few bites of snacks at the workplace, take a bite from your child’s dinner plate, and eat cookies at a social event. You will never remember these if you do not take notes about them. If you feel challenged, start keeping a diary. You will see that you can rapidly identify what you need to improve.

Plan your meals: Planning your weekly meals may help you to control what you are eating and the ingredients you are using to prepare your meals. In busy times, keeping a diary may help you to avoid high-calorie foods that slow your weight loss process.

Drink your fluids: You should always drink 2 liters of fluid every day. Water is the best.

 

While reading these tips, please do not forget that you do not need to be perfect. Nobody is perfect. It is sufficient that you do not deviate much from the rules. If you drifted a little, put yourself back on the right path again. The more you follow the rules, the more you will be successful!

  • Follow-up program for bariatric patients:

Under normal conditions, after the first 6 months, you will have follow-up control visits in the 9th and 12th months. In the second year after surgery, there will be two planned follow-up visits at 6-month intervals. Then, you will have one follow-up visit per year.

Categories
Klinik Obezite

KO-E-029 Introduction to my preparation journey

Introduction to my preparatory journey

During the critical months before surgery, it is very important that you understand what bariatric surgery means for your health and quality of life and how to best prepare yourself for this surgery. Every day you can collect information about how you can prepare your body for surgery and how you can gradually modify your eating and exercise habits.

The Get Ready application will help you to prepare yourself for hospitalization and guide you to what you should know before surgery.

If you feel unsure to follow the instructions of your health team and change your eating and exercise habits, there is a risk that surgery will not lead to weight loss. From the moment you learn that you are eligible for surgery, you should start to follow a healthier lifestyle including a healthier diet, being more active and limiting alcohol consumption and smoking (it is better that you stop alcohol consumption and smoking completely as the surgery date approaches). These efforts not only prepare you for a successful surgery and recovery but will also be the start of a brand-new and healthier lifestyle.

 

Categories
Klinik Obezite

KO-E-041 Post-bariatric reconstructive surgery

If you have lost a great amount of weight after bariatric surgery, skin sags may develop in certain places of your body. Some bariatric surgery patients prefer reconstructive surgery to remove this excess skin.

Plastic surgeons use contouring technics such as abdominal lifting to remove excess skin. These procedures are proven successful in supporting patients to restore their body shape and enjoy daily activities.

Patients should meet certain health criteria before reconstructive surgery following bariatric surgery. Please ask your family physician or surgeon whether you are a suitable candidate for reconstructive surgery. If you are not, please try to learn what you can do to improve your health condition in order to be evaluated as eligible for reconstructive surgery.

Requirements for plastic surgery:

  • A good general health condition
  • At least one year should be passed after bariatric surgery
  • The weight loss process has to be completed at least six months ago.
  • A BMI value of 25 or less is required for better short-, medium- and long-term outcomes.
  • No vitamin/mineral deficiency
  • No smoking for better wound healing
  • No active pregnancy, no pregnancy planning for the next year
  • A balanced diet and regular exercise
  • Realistic expectations

 

Procedures to be assessed

Depending on the amount of lost weight and the location of excess skin, you can consider one or more of the following post-bariatric reconstructive procedures:

  • Abdominoplasty: Abdominoplasty is an effective post-bariatric reconstructive procedure, which not only removes excess skin but also tightens the abdominal muscles so that a thin waistline and a flat stomach is formed. Please take into consideration that abdominoplasty leaves a long and prominent wound scar on your lower abdomen.
  • Brachioplasty: Brachioplasty starts with an incision in the lower part of the upper arm. Then, excess skin is removed to form a tightened and firm appearance. Please note that brachioplasty leaves a long wound scar starting from the upper part of your upper arm and extending to the lower part.
  • Gluteoplasty (Brazilian butt lift): The hip area commonly requires body contouring after the weight loss process. The plastic surgeon lifts and reshapes this part of the body to create smoother and tighter contours.
  • Mastopexy (Breast Lift): As the breasts consist mostly of fat tissue, they can be significantly affected by weight loss. Breast augmentation and mastopexy are two body contouring techniques, which help lift the breast line after weight loss.
  • Thigh lift: Excess skin remains in the thigh area of many patients following bariatric surgery. Thigh lift surgery may be useful for these individuals. There are many thigh lift techniques. The difference between them is the type of incision:
    • Vertical thigh lift: The incision starts from the inguinal area and extends to the inner side of the knee. Excess skin is removed from the inner side of the thigh. A wound scarring may remain after healing.
    • Medial thigh lift: is the most popular thigh lift technique. This type of surgery is ideal for individuals who have moderate fat and excess skin in the medial part of their thighs. An incision is made on the folding line of the inguinal area and the skin is tightened after the lifting process.
    • Outer thigh lift: an incision is made from the hip to the inguinal area.
    • Spiral thigh lift: is a new thigh lift procedure, during which the posterior, anterior, lateral, and medial areas of the thigh are reshaped. The incision starts just under the hip and extends towards the folding line in the inguinal area. This surgery is usually performed in patients, who need the removal of a great amount of skin and fat from related areas.

 

Many people want to learn whether reconstructive surgical procedures are reimbursed by health insurance or the state health system. Some procedures are reimbursed some are not.

Categories
Klinik Obezite

KO-E-043 Managing pain

Pain management

You may feel pain in the incision site or surgery site depending on the position of your body. Some patients may experience neck and shoulder pain after laparoscopy. Your comfort is important for your health team.

Although some discomfort can be experienced after every surgical intervention, pain should be kept under control for your healing process. If you feel comfortable, you will do activities like walking, deep breathing and coughing more freely. All of these are very important for quick recovery.

Some tips to help you feel more comfortable

  • If you have pain, which prevents your mobility, deep breathing, and your comfort in general, report your condition to your nurses and physicians.
  • Everybody is different; therefore, inform your nurses always how you feel. This will make it easier for your nurses to help you.
  • Make a plan ahead for pain; if you are comfortable lying down, you may still need an analgesic agent to get up and walk around.
  • Be one step ahead of your pain. Do not wait until that pain becomes worse. The analgesic agents provide the best results when they are used to prevent pain.
  • If the analgesic agents are used for a specific medical purpose like surgery, the risk of becoming dependent on them is very low.
Categories
Klinik Obezite

KO-E-047 Weight loss surgery and pregnancy

Bariatric surgery and Pregnancy

Bariatric surgery can improve your fertility status. Several studies demonstrated that women, who had obesity-related fertility problems and underwent surgery, started to ovulate regularly for the first time after many years. However, it is important to wait at least 12 months after surgery before you get pregnant and be sure that your metabolism is re-balanced.

It is safe to get pregnant 12-24 months after bariatric surgery.

Following surgery, your body passes through stressful changes and experiences serious nutritional changes, which can be a problem for a growing baby. Physicians recommend avoiding pregnancy for about 12-24 months after surgery to prevent nutritional deficiencies. 

If you become pregnant

If you plan to become pregnant after your weight is balanced following surgery, it is highly recommended that you stay under the follow-up of a multidisciplinary team. It is very important that you take multivitamins and mineral supplements and are monitored by a specialist for any nutritional deficiency. A careful evaluation of the gastrointestinal complaints and a relevant consultancy in addition to a different approach for gestational diabetes is required.

Categories
Klinik Obezite

KO-E-049 My surgery details: gastric bypass (Roux-en-Y)

 

Categories
Klinik Obezite

KO-E-067 Sleep apnoea

Sleep Apnea

Obstructive sleep apnea (OSA) or sleep apnea for short is a sleep disorder, in which breathing stops repeatedly for a short time during sleep. “Apnea” means a pause in breathing lasting at least ten seconds. It occurs when the muscles at the back of the throat are unable to keep the airways open despite the breathing attempt of the individual.

Sleep apnea may lead to the interruption of sleep and decrease oxygen levels. In people with sleep apnea, the interruption of sleep and low oxygen levels together may lead to hypertension, cardiac diseases, emotional and memory disorders. In addition, sleep apnea increases the risks during driving due to impaired cognitive abilities.

Sleep apnea has two types of respiratory interruption:

Apnea: Apnea is considered the relaxation and collapse of the muscles and soft tissues in the throat leading to a complete obstruction of the airway and preventing airflow for 10 seconds or longer.

Hypopnea: is a partial airway obstruction, which decreases the airflow by more than 50% for 10 seconds or longer.

Obesity and Sleep Apnea

According to the estimations, 80% of patients with clinical obesity – mainly males – have also sleep apnea. However, millions of people are unaware of this condition and misinterpret the symptoms. There are several studies focused on the effects of bariatric surgery on the severity of sleep apnea. Patients who are on the waiting list for bariatric surgery show a serious predisposition to sleep apnea every hour. One year after successful surgery, the severe obstructive index scores declined to moderate levels.

 

Categories
Klinik Obezite

KO-E-057 Introduction to obesity

Surgical treatment options for obesity

Whether it is recognized as a risk factor for other diseases (World Health Organization) or as a disease itself (World Obesity Federation), obesity is a serious health problem for both affected individuals and society. Obesity is defined as an excess fat mass, which has a negative impact on health, social and psychological life of people.

In 2016, 39% of adults ≥18 years of age were overweight and 13% were obese. In the near future, almost 50% of the USA citizens will be considered obese.

Body-mass Index (BMI)

The body-mass index is a simple weight-height ratio indicator, which is widely used for the classification of overweight and obesity in adults. It is calculated by division of the weight (in kg) by the height (in m) of the individual and its unit is kg/m2. It provides the most versatile overweight and obesity measurement for the general population. It is calculated in the same way for adults of all genders and ages.

Individuals with BMI values over 30 are considered obese. The severity of obesity increases with the BMI value. People with a BMI value above 35 and concomitant obesity-related diseases or with a BMI value above 40 can be considered for obesity surgery.

In severe obesity cases, there is a surgical solution called bariatric surgery. It can be considered for individuals with the following criteria:

  • A BMI value above 30 or a BMI value equal to 35 and concomitant Type 2 diabetes mellitus.
  • Age between 18 and 60 years.
  • Absence of psychiatric disorders, which may present a risk for surgery.
  • Absence of any specific risk for surgery.

Bariatric surgery should only be considered if the person has tried and failed to lose weight for several months by using specific medical treatments (diet monitoring, physical activity, and psychotherapy). The decision for surgery should be taken following the discussions between the patient, responsible physician, surgeon, endocrinologist, dietitian, and psychologist or psychiatrist.

Weight loss goals

The goal of obesity treatment is to achieve and maintain a healthy weight. To understand and change your eating and activity habits, you should work with a team consisting of health professionals including a dietitian, psychologist or obesity specialist.

Bariatric surgery does not guarantee you a specific amount weight loss. Surgery is just a catalyst for weight loss. Achieving the weight loss targets is the patient’s own process. Success depends on the motivation of the patient and effective behavioral change.