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What Is Obesity?

Obesity is defined by the World Health Organization (WHO) as excessive fat accumulation in the body in a way that disrupts health. If the daily energy is more than the energy consumed, the excess energy is stored as fat to body and the organs.

Obesity is a rapidly growing disease in today's industrial society. BMI (body mass index) ) is commonly used to determine obesity based on the World Health Organization’s obesity classifications. A person’s BMI is calculated y dividing the individual’s body weight (kg) by the square of the height (in meters). If the BMI is

  • 18.5 – you are underweight
  • 18,5-24,9 – you have normal weight
  • 25.0-29.9 – you are overweighted
  • 30,0-39,9 – you are OBESE
  • Over 40.0 – you are MORBID OBESE (SERIOUS)
  • 50 and above – you are SUPER OBESE


Body fat ratio around the waist area is also associated with the metabolic side effects of the result of obesity and should be measured in addition to BMI.

In women 88 cm and in me 102 cm of body fat around the waist area is directly related to the risk of cardiovascular disease.

Obesity rate according to the date provided by the Turkey Statistical Institute, shows an increase in the obesity rate of 15.2% in 2008 to 31.1% in 2014 and which reached to 19.9% in the last years. The rate of increase was 32.3% in women and 24% in men.

Obesity is one of the most important causes of preventable death. It is possible to get rid of obesity by obesity surgery. Obese individuals have more fat cells both in number and size.

Male individuals are more prone to central fat distribution and women are more prone to peripheral (environmental) fat distribution. The central distribution is associated with diseases such as metabolic syndrome, hypertension and diabetes.


Reason For Obesity

  • Genetics
  • Metabolic Diseases
  • Enviromental Conditions
  • Life Style
  • Social-Economic Status
  • Culture

The most important struggles facing people with severe obesity is actually discrimination. The availability of suitable clothing options, car cabin sizes are examples of discrimination against the obese people. The society unfortunately show severe obese people as lethargic, obese and without self-discipline. Therefore, psychological problems such as depression have an extraordinary incidence on this population.

As a result of obesity or sometimes because of the following diseases obesity can be observed

  • Degenerative joint disease
  • Backache
  • Hypertension
  • Sleep apnea
  • Gastroesophageal reflux disease
  • Kolelithianis
  • Type 2 diabetes
  • Hyperlipidemia
  • Hiperkolesterolne
  • Asthma
  • Hypoventilation syndrome
  • Fatal cardiac arrhythmias
  • Heart failure
  • Migraine headache
  • Pseudotumor cerebri
  • Venous stasis ulcers
  • Deep vein thrombosis
  • Fungal skin rashes, skin abscesses
  • Stress urinary incontinence
  • Infertility, dysmenorrhea (painful menstruation)
  • Increased risk of cancer (uterus, breast, colon, prostate ..)

The success rate of severe obese patients who try to diet and exercise to lose enough weight and get rid of obesity and to maintain this weight loss is only 3%.

Bariatric and metabolic surgery is the most effective treatment for obesity.

The American Heart Association (AHA), American Diabetes Association (ADA) 2015 joint statement reported that type 2 diabetes, hypertension, bone resorption and joint diseases, sleep apnea, heart-related diseases and all-cause deaths were reduced by metabolic and bariatic surgery.


The Gastric Sleeve surgery is widely used in the treatment of obesity. Approximately 80% of the stomach is removed. As a result of this surgery , the GHRELIN hormone which causes hunger is removed from the stomach. The stomach is left as a tube (stomach reduction) after the Gastric Sleeve surgery and the patient feels less hunger.

Patients who underwent Gastric Sleeve surgery (stomach reduction) lose a significant portion of their excess weight during the first 6 months. The total weight loss we see in the first 2 years is 65-70%.

With the Gastric Sleeve surgery the diabetes control is obtained in a 50-55% range. It will probably not be sufficient for a diabetic patient with significant long-term metabolic changes identified. In this case, the Gastric Bypass surgery is performed by a way of two-stage surgeries that involve a stage one surgery to the small intestine in order to decrease the intra-gastric pressure and eliminate the problem of long-term stomach enlargement and in the second stage via gastric tube by eliminating the hunger hormone to getting rid of the weight gain.


The upper end of the intestine is anastomosed side by side to the lower intestine. 1/3 of the food passes through the natural way and 2/3 passes through the new way (last 1 meter of the small intestine). 95% does not need iron or vitamin support. At the end of the 5-year period, patients lose 74% of their excess weight. Diabetes control is 86% after 5 years. GLP-1 levels increase significantly after tube gastric surgery and Transit Bipartition.


  • BMI > 40
  • Or if the BMI is 35-40, the comorbid medical conditions matter

In Addition To Above The Following Should Be Seen

  • Failure in medically supervised diabetes
  • Psychological stability
  • Lifestyle change and drug treatment failed