Obesity continues to be a growing and significant public health problem in Türkiye, as it is worldwide. Professor Dr. Burak Kavlakoğlu, a faculty member at Atlas University Faculty of Medicine, Department of General Surgery, and a specialist in General Surgery and Obesity Surgery, emphasized that obesity should not be considered merely an aesthetic problem or excess weight, stating, “Obesity is a progressive and chronic disease in which genetic, hormonal, environmental, and behavioral factors all play a role. The goal of treatment is not only weight loss but also to prolong the patient's lifespan and control obesity-related diseases.”
Abdominal fat is a harbinger of serious diseases.
Prof. Dr. Burak Kavlakoğlu pointed out that visceral fat tissue, especially that which accumulates around organs in the abdomen, poses a significant health risk, stating that this condition increases the risk of developing type 2 diabetes, hypertension, cardiovascular diseases, fatty liver disease, sleep apnea, joint diseases, and some types of cancer.
Kavlakoğlu stated that obesity can also lead to infertility, polycystic ovary syndrome, reflux, depression, and a significant decrease in quality of life, adding that early diagnosis and appropriate treatment are of great importance.
Not every obese patient requires surgery.
Emphasizing that obesity treatment should be planned individually, Prof. Dr. Burak Kavlakoğlu stated, “Not every obese patient needs surgery. Healthy eating, regular physical activity, behavioral modification, medication, endoscopic methods, and bariatric surgery are all complementary treatment options. The most appropriate treatment should be determined according to the patient's characteristics.”
Kavlakoğlu stated that GLP-1 receptor agonists and GLP-1/GIP agonists, developed in recent years, can provide successful weight loss in suitable patients, and added that bariatric surgery is still the most effective treatment method for long-term weight control and correction of metabolic diseases, especially in severely obese patients.
The decision to operate is made through a multidisciplinary approach.
Prof. Dr. Burak Kavlakoğlu stated that the decision in obesity surgery is not made solely based on body mass index, and according to international guidelines, surgery is strongly recommended for patients with a body mass index of 40 kg/m² and above, and is also an important option for individuals with a body mass index between 35-39,9 kg/m² who have additional diseases such as diabetes, hypertension, or sleep apnea.
Kavlakoğlu emphasized that the decision to operate should be made by a multidisciplinary team that jointly evaluates the patient's age, metabolic status, psychological assessment, quality of life, and expectations.
Gastric sleeve surgery doesn't just reduce the size of the stomach.
Professor Dr. Burak Kavlakoğlu stated that sleeve gastrectomy, or tube stomach surgery, is the most frequently performed bariatric surgery method in the world, and added that this operation not only reduces stomach volume but also, “Following tube stomach surgery, the level of ghrelin, known as the hunger hormone, decreases, while the release of intestinal hormones that increase the feeling of fullness increases. Thus, the feeling of hunger is significantly reduced in patients, early satiety is achieved, insulin sensitivity increases, and blood sugar control improves. Therefore, tube stomach surgery is a surgical method with strong hormonal and metabolic effects.”
It plays an important role in controlling type 2 diabetes.
Professor Dr. Burak Kavlakoğlu stated that surgery, especially when performed in the early stages of the disease, can contribute to the complete resolution of type 2 diabetes or a significant reduction in the need for medication. He added that gastric bypass and other metabolic surgical methods can yield more successful results in some patients, and that the appropriate method should be determined individually for each patient.
Success is possible through teamwork.
Prof. Dr. Burak Kavlakoğlu stated that bariatric surgery is performed laparoscopically, meaning using a minimally invasive method, and that complication rates are quite low in experienced teams. He emphasized that for successful outcomes, it is necessary to choose multidisciplinary centers that include not only experienced surgeons but also specialists in anesthesia, endocrinology, nutrition, psychology, interventional radiology, endoscopy, and intensive care.
Postoperative success depends on lifestyle.
Emphasizing that surgery is the beginning of treatment, Prof. Dr. Burak Kavlakoğlu stated that a protein-rich diet, adequate fluid intake, vitamin and mineral supplementation, and regular physical activity after surgery form the basis of long-term success.
Kavlakoğlu stated, "Surgery alone is not what ensures success. Adopting a new lifestyle and adhering to a regular follow-up program are essential for lasting weight loss and a healthy life."
Complications are rare, and early diagnosis saves lives.
Professor Dr. Burak Kavlakoğlu stated that the rates of serious complications are quite low in experienced centers, adding that pulmonary embolism and gastric leakage are among the most important but rare complications.
Kavlakoğlu stated that symptoms such as fever, rapid pulse, abdominal pain radiating to the back and shoulder, and weakness should be taken into consideration if a gastric leak develops, and added that nowadays, most leaks can be successfully treated with endoscopic methods.
Metabolic surgery offers a treatment that goes beyond weight loss.
Professor Dr. Burak Kavlakoğlu stated that metabolic surgery does not only aim at weight loss, but also plays an important role in correcting type 2 diabetes, insulin resistance, hypertension, fatty liver, and blood lipid disorders.
Kavlakoğlu stated that changes in gut hormones increase insulin effectiveness and improve blood sugar control, adding that metabolic surgery is currently considered one of the most effective methods for treating type 2 diabetes in selected patients.
Treatment administered to the right patient at the right time improves quality of life.
Underlining that obesity is not a lack of willpower but a chronic disease that must be treated, Prof. Dr. Burak Kavlakoğlu said, “Today, nutritional therapy, exercise, medication, and metabolic surgery are not alternatives to each other, but complementary treatment options. Thanks to treatments planned specifically for the patient, based on scientific data, and carried out by a multidisciplinary team, not only weight loss but also an increase in quality of life, improvement in obesity-related diseases, and a longer, healthier life are possible.”
