Wrong

Surgery increases the risk of suicide.

Actually

Depression or anxiety disorders are common in obese/overly obese individuals applying for bariatric surgery. This is generally seen as the reason for this being that they have low self-confidence and their quality of life is lower than individuals of normal weight. While bariatric surgery provides psychological and social improvement in the majority of patients, some patients with previously undiagnosed psychological disorders may not be able to overcome life stress and commit suicide. Two large studies on this subject showed a slight increase in the suicide rate of patients who underwent bariatric surgery. Thus, while psychological evaluation is included in comprehensive bariatric programs before the surgical procedure, behavioral therapists are consulted for patient consultation after the surgical procedure.

Wrong

Bariatric patients experience serious health problems due to vitamin and mineral deficiencies.

Actually

Patients undergoing bariatric procedures may experience vitamin and mineral deficiencies in their bodies as a result of decreased food intake or intestinal absorption. Thus, the nutrients to be supplemented vary depending on the degree of absorption caused by bariatric procedures. While it is known that malabsorption (low absorption) bariatric procedures increase the risk of protein deficiency, the resulting deficiency of vitamins/minerals and protein deficiency can negatively affect health. With appropriate diet, nutritional supplements (vitamins, minerals = micronutrients) and in some cases protein supplements, post-surgical nutritional deficiencies can be prevented and a nutritional guide suitable for various bariatric procedures can be created. Before and after the procedure, patients should be informed about nutrition and the supplements they will need and should be monitored by a barytric nutritionist. Additionally, patients should have their vitamin and mineral levels checked regularly. If any health problem occurs due to vitamin and mineral deficiencies, monitoring the patient by the bariatric team can prevent the problem. Health problems caused by such deficiencies are generally seen in patients who do not communicate regularly with their surgeon and bariatric team.

Wrong

Many obese patients become addicted to alcohol after surgery.

Actually

In fact, only a small percentage of obese patients report having alcohol problems after surgery. Most (but not all) people who abuse alcohol after surgery are those who had an alcohol addiction problem before surgery. After bariatric surgery, sensitivity to alcohol (especially when drinking alcohol during rapid weight loss) increases; Thus, the effects of alcohol are felt with less alcohol consumption than before the surgery. Research shows that patients who undergo bariatric surgery (such as gastric bypass or gastric sleeve) absorb alcohol into their bloodstream faster than patients without surgery. For all these reasons, obese patients are advised to take some alcohol precautions:

Avoid alcoholic beverages during rapid weight loss.

“Remember, even small amounts of alcohol can cause poisoning (toxicity) during this period.

“Avoid driving or running after drinking alcohol.

"If alcohol is a problem in your life, get help

If you think drinking alcohol might be a problem for you after surgery, consult your doctor or bariatric surgeon.

Wrong

It is easy to resort to surgery. For obese people, diet and exercise programs are sufficient to lose and maintain weight.

Actually

People who are extremely obese (morbidly obese) have difficulty losing weight long-term through diet and exercise. The National Institutes of Health Experts Panel has recognized that long-term weight loss and maintenance is nearly impossible for the morbidly obese and that bariatric surgery is the only solution. Bariatric surgeries are effective in maintaining long-term weight loss; because in these transactions; The yoyo syndrome, that is, weight regain, which occurs in people who lose a lot of weight quickly and with a diet, does not develop.

During the diet, energy expenditure at rest and during activity is very low. At the same time, appetite constantly increases with the feeling of hunger. For example, the body of a person who weighs 80 kilos from 100 kilos burns fewer calories than the body of someone who weighs 100 kilos. Again, someone who loses weight from 100kg to 80kg by dieting will naturally consume fewer calories than those who weigh the same (80kg). The reason for this is biological difference.

Unlike dieting, weight loss in people undergoing bariatric surgery does not reduce energy expenditure to lower levels. Some studies even show that these operations can increase energy expenditure. Additionally, unlike dieting, some bariatric surgeries cause biological changes that help reduce energy intake. Decrease in energy intake with surgery; food

It is due to anatomical changes in the stomach or intestines that limit the intake or cause malabsorption of nutrients. Also bariatric surgery; It reduces the feeling of hunger, reduces appetite and increases the production of gut-derived hormones that interact with the brain and create a feeling of satiety. For these reasons, bariatric surgery provides long-term weight loss, unlike dieting.

Pro

Most people who have metabolic and bariatric surgery regain weight.

Actually

About 20 percent of patients may begin to gain weight about two years after surgery, although not by much (after losing weight, they gain about 5 percent of their lost weight). Weight gain during this period is not a return to normal, but only a few kilos. In fact, since the effect mechanisms of the operation continue to work, this situation can be corrected by correcting the errors in a very short time. The biggest mistake patients make is that they think they have gotten rid of obesity with surgery and refuse follow-up; Lack of adequate support from a nutritionist and psychologist or lack of such an opportunity by surgical teams. However, long-term scientific studies have shown that most patients who undergo bariatric surgery lose and maintain significant weight. "Successful weight loss"; It is defined as losing 50% or more of body weight. Often, successful results are not just about losing weight; The improvement in the patient's quality of life is also determined by the improvement in accompanying diseases. Meeting the patient's postoperative expectations is also an indicator of success. The ability to return to its original state and require a new operation; Although there is no statistical difference after gastric sleeve and gastric bypass, it is 5-10%.

Pro

The chances of dying from metabolic and bariatric surgery are higher than the chances of dying from obesity.

Actually

As body weight increases, lifespan becomes shorter. Extremely obese individuals have a higher risk of dying from obesity-related diseases such as type 2 diabetes, hypertension and heart disease.

Data from the American Society for Methobolic and Bariatric Surgery' (ASMBS), Bariatric Centers of Excellence, involving nearly 60,000 bariatric patients, show that the risk of death within 30 days following bariatric surgery is 0.13%, or approximately 1 in 1,000 people. This rate is considerably lower than most other operations, including gallbladder and hip replacement surgery. Therefore, despite bariatric patients' poor preoperative health, the chance of dying from surgery is extremely low. Scientific research shows that the risk of death from any cause; It shows that it is less for patients who have undergone bariatric surgery than for those who have not undergone surgery. In fact, some data show that the risk of death from certain diseases is reduced by 89% thanks to bariatric surgeries. For example, cancer mortality for bariatric patients is reduced by 60%. It reduces the rate of death due to diabetes by 90% and the rate of death due to heart disease by 50%. Additionally, there are numerous studies showing that life-threatening obesity-related diseases are improved or completely eliminated in patients who undergo bariatric surgery. The benefits of bariatric surgery regarding mortality far outweigh its risks. As with all surgical operations, you should make the decision for bariatric surgery by discussing it with your surgeon, family members and loved ones.

There is no death in my personal series. In my series of 1000 cases, I saw the much-feared possibility of leakage in a case that I had already converted to bypass surgery due to stenosis and detected it at that time. This case recovered uneventfully. As a result, leakage, which is seen at a rate of 2% in the world and 8-10% in our country, is 0.1% in my personal series.

Pro

Obesity is an addiction similar to alcoholism or drug addiction.

Actually

Although a small percentage of people who are overweight are people with eating and behavioral disorders (overeating and binge eating), obesity is a complex disease that depends on many different factors. The first step in the treatment of addictions such as alcohol and drugs; is to keep the person away from drugs or alcohol. Since we need to eat to live, this approach does not work for obesity. There may also be other issues that affect a person's weight, such as psychological problems. Weight gain usually occurs when there is an energy imbalance, or in other words, the amount of food consumed (energy) exceeds the number of calories burned (energy expended). Energy imbalance can be caused by overeating or not getting enough physical activity and exercise. However, it may also be due to causes other than overnutrition or inactivity that affect energy balance and/or fat metabolism. These:

chronic insomnia
Regardless of calorie content, it reduces body fat (sugar, high fructose corn syrup, trans fat,Consumption of foods that cause metabolic/hormonal changes (e.g. processed meats and processed wheat),
Low consumption of certain foods (fruits, vegetables, legumes, nuts, seeds, quality protein)
Stress and psychological distress
Some types of medications
environmental pollutants
One of the reasons why obesity is considered a "progressive" disease is because obesity causes obesity. Weight gain causes a series of hormonal, metabolic and molecular changes that increase the risk of body fat accumulation and obesity. With excessive insulin secretion and insulin resistance increasing as fat mass increases; The carbohydrates (sugars) taken are converted into fat without being used. As the size and number of fat cells increases, the body's fat storage capacity also increases. These defects in fat metabolism mean that most calories consumed are stored as fat. Worse, obesity affects the regulators of appetite and hunger, leading to an increased desire to eat more and more often. In short, there are many causes of obesity and it is not right to call obesity disease just food addiction. Defining and treating obesity solely as an addiction may be valid for a small percentage who are not very overweight, but this method is certainly not valid for the morbidly obese and larger percentage.