Bariatric surgery in Turkey is becoming very popular due to the world class clinics and cheap operations compared to western European countries. Getting your weight loss surgery in Turkey can save you thousands pounds or euros and is the Bariatric capital of the world. If you are struggling with obesity and have serious health problems an operation can transform your life.
The operations offered can help weight loss by restricting the amount of food your body can hold. This can reduce the number of calories you can absorb.
Bariatric surgery was first performed in 1954 by Dr A.J. Kremen. It was a gastric bypass, with his team connecting the patients upper and lower intestine, bypassing a large area and therefore reducing the number of calories the patient can absorb.
It is not only the general public who have chosen weight loss surgery, but a number of celebrities have also opted for it too. Such as Rosie O’Donnell, who underwent gastric sleeve surgery in 2013 and Sharon Osbourne who had lap band surgery in 1999.
Nowadays most surgery uses minimally invasive techniques with the most common being the gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch.
Each type of surgery has its advantages and disadvantages, which we will look at in the following article.
When Should I Consider A Bariatric Operation?
You should consider a bariatric operation if you are obese with a BMI (body mass index) of over 40, or between 35 and 40 with an underlying health condition that could improve if the weight was lost. Such as type 2 diabetes or high blood pressure.
If the extra weight is affecting your day to day quality of life and you have tried other weight loss methods, such as dieting and exercise, but have struggled to lose weight then surgery could be a viable option.
How Do I Qualify For Weight Loss Surgery.
Over 200,000 Americans have bariatric surgery every year, yet an estimated 24 million are heavy enough to qualify for an operation.
You will be suitable for bariatric weight loss surgery if your BMI is over 40 or is between 35 and 40 and you have one of the following health conditions:
- Diabetes
- High blood pressure
- High cholesterol
- Fatty liver disease
- Sleep apnea
You may also be suitable if you have a BMI between 30 and 35, and have uncontrolled diabetes.
If you believe that you are suitable then quickly fill out the questionnaire so we can get you the best quote from from approved bariatric surgeons.
After you get the quote and select the clinic the surgeon will contact you and look at your medical history, so a plan of action can be made for you. The plan action will not only include a discussion about the best bariatric surgery options for you but also practical arrangements. Including all aspects of your stay if you are travelling from outside turkey including flights, hotel accommodation and transport.
Clinics in Turkey attract the best surgeons in the world so not only are are practical living arrangements taken care of but also your ongoing support in a complete care package which is the envy of the world.
Different Types Of Weight Loss Operations.
What is the best operation for you? Here I will outline the options with pros and cons so you can make the best decision.
Gastric Bypass / Roux-en-Y Gastric Bypass
A gastric bypass or Roux-en-Y Gastric Bypass is considered to be the best type of weight loss surgery. Once completed the patient will have a smaller stomach area so significantly smaller meals will be eaten and absorbed, resulting in weight loss being achieved.
The operation itself works by creating a small stomach pouch (roughly one ounce or 30 millimetres in volume) by dividing the top of your stomach from the rest of your stomach.
Next, your small intestine is divided, with the bottom end brought upwards where it is then connected to the newly created stomach pouch.
To complete this operation the top portion of the small intestine is connected to the small intestine further down. The reason for this is to ensure the stomach acids and digestive enzymes from the bypassed stomach and the first portion of the small intestine are allowed to mix with the food you eat.
Advantages
- Is shown to help patients achieve significant long-term weight loss
- Will restrict the amount of food you can consume
- Has been shown to increase energy expenditure
- Produces changes to your gut hormones, which can help reduce your appetite while increasing satiety
Disadvantages
- This is the most difficult type of bariatric surgery. Therefore the risk of complications is higher
- Patients who have undergone this operation may have nutrient deficiencies for the rest of their lives
- Due to the difficulty and risk of complications, a longer hospital stay is likely
- You must follow a diet plan, and attend follow up appointments to ensure successful weight loss results are achieved
Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy or the gastric sleeve as it is often called is an operation that involves removing approximately 80% of your stomach. The remaining portion of the stomach resembles a banana.
This new smaller stomach will significantly reduce the amount of food you can consume, therefore reducing the number of calories absorbed.
As your stomach is now smaller the stomach cells that control your hunger will also be reduced, this means that after the operation patients will not feel as hungry.
Advantages
- This operation will reduce the amount of food your stomach can hold
- A good alternative to the gastric band operation, with quick and significant weight loss likely
- This operation does not require any foreign objects to be used, as is the case with an adjustable gastric band, or the re-routing of your food stream when undergoing a gastric bypass
- A short length of time spent in hospital post-surgery (only 2 days)
- Changes to your gut hormones will help suppress your appetite and improve satiety
Disadvantages
- This is a non-reversible procedure
- The risk of long-term vitamin deficiency is high, with patients likely to need to use a multivitamin their entire lives after surgery
- There is a greater risk of complications than an adjustable gastric band
Adjustable Gastric Band
The adjustable gastric band is often called a lap band operation. It involves placing an inflatable band around the upper portion of your stomach.
This creates a smaller stomach pouch above the band, which is claimed to increase satiety.
The feeling of fullness will depend on the size of the opening between this newly created pouch and the rest of your stomach. However, this opening can be adjusted by filling the band by injecting it with sterile saline, which is administered by injection through a port placed under your skin.
While it is claimed that this operation can restrict how much food you are eating, there are some who believe this operation does not work as the food can pass through the opening quickly.
Unlike the gastric bypass and sleeve gastrectomy, there is no change in the number of nutrients and calories absorbed. However, if you are eating less food, then fewer calories will be absorbed.
Advantages
- A reduction in the amount of food your stomach can hold
- No cutting of your stomach or rerouting of your intestines is needed
- Very short hospital stay (usually less than 24 hours)
- This operation is reversible and adjustable
- Has the lowest risk of complications occurring
- Risk of nutrient deficiency is low compared to other forms of weight loss surgery
Disadvantages
- Weight loss results are not as dramatic as other operations
- Foreign object placed inside your body
- The band may slip or may erode into your stomach in rare circumstances
- Mechanical problems have been noted in a small percentage of patients
- Overeating may cause a dilation (stretching) of your oesophagus
- You must follow a strict diet post-surgery
- This operation has the highest rate of revision
Biliopancreatic Diversion With Duodenal Switch (BPD/DS)
There are two components that go into a biliopancreatic diversion with duodenal switch operation.
Firstly, a small tubular pouch is created by removing a portion of your stomach. Next, a large portion of your small intestine is bypassed.
With this operation, the last portion of the small intestine is connected to this newly created stomach, which means that roughly three-quarters of the small intestine is bypassed when eating.
The section of the small intestine that was bypassed is then connected to the last portion of the small intestine so that the bile and pancreatic enzymes it produces are able to mix with any food consumed, helping to break it down.
Initially, this procedure will reduce the amount of food consumed, however, over time the patient will be able to consume almost normal food portions.
Unlike the other weight loss surgeries available, this operation will skip much of the small bowel, and because the food doesn’t mix until further down the small intestine than usual fewer calories and nutrients are absorbed.
Of all the operations available, this is said to be the most effective option for those with diabetes, this is because the gut hormones produced help to control your blood sugar levels.
Advantages
- Shown to offer the greatest weight loss results of all the different types of bariatric surgery
- Patients will be able to eat normal meals eventually
- The amount of fat absorbed will be reduced
- Changes to your gut hormones will reduce appetite and improve satiety
- The most effective surgery to help fight diabetes
Disadvantages
- Has been shown to have the highest risk of complications
- Longer hospital stay than an adjustable gastric band and laparoscopic sleeve gastrectomy operations
- Can cause long term vitamin deficiencies
- You will need follow up appointments to ensure you are following strict dietary guidelines to avoid deficiencies
Gastric Balloon
The gastric balloon is a soft expandable balloon that when inserted orally and placed into your stomach can be expanded using sterile saline fluid.
When it is fully expanded the balloon will be too large to pass into your stomach, so will, therefore, make you feel fuller.
Using this gastric balloon can help reduce the size of your food portions, which will reduce the number of calories consumed and aid with your weight loss efforts.
Advantages
- If successful, long-term weight loss can be achieved
- A minimally invasive procedure that can be done as a day case, this means minimal interruption to your life
Disadvantages
- Only advisable for use over a 6 month period. Any longer and the acid content of your stomach may deflate the balloon
- You may experience nausea but this will subside after a few days
- There is a risk that the balloon may burst. However, if this occurs then it should pass through your bowel and be expelled naturally
Weight Loss Surgery Revision
Weight loss surgery revision is when a patient has another bariatric operation despite already having an operation in the past.
This usually occurs when the patient has encountered complications during the original surgery or have not seen the weight loss results they would have expected from the first surgery.
Although rare, a small percentage of patients who undergo weight loss surgery may need further treatment.
Over time peoples anatomy can change, while personal changes such as having children, a new job and other factors can have an impact on your appetite and activity levels.
Research has found that two years after a gastric sleeve, if you overeat your stomach can double in size, therefore negating the benefits of the surgery.
Sometimes patients will look for a revision of weight loss surgery simply to keep up with the Joneses. Simply meaning that they are not as pleased with the results they are seeing when compared to their friends and family who have undergone similar surgery.
How Dangerous Is Gastric Bypass Surgery?
Any operation will have some risk attached to it, but you have to ask yourself whether the potential risks of bariatric surgery outweigh its benefits.
In a study weight loss surgery was shown to be a better option than diet and exercise for obese people . But how dangerous is it?
Potential risks of gastric bypass surgery include:
- Excessive bleeding
- Infection
- Adverse reactions to anaesthesia
- Blood clots
- Lung or breathing problems
- Leaks in your gastrointestinal system
- Bowel obstruction
- Dumping syndrome that can cause diarrhoea, nausea or vomiting
- Gallstones
- Hernias
- Low blood sugar (hypoglycemia)
- Malnutrition
- Stomach perforation
- Ulcers
- Vomiting
It should be noted that the percentage rate of complications continues to fall. In 1993 the percentage of complications was 10.5%, but in 2006 this figure was down to 7.6%.
One of the biggest concerns regarding weight loss surgery is the risk of death, however, a study looking at the death rate of patients between January 1, 1995, and December 31, 2004, found that out of 16,683 operations, only 440 deaths were recorded. A percentage of 2.6%.
It is worth noting that the risk of fatality increased with the age of the patient and whether they had any underlying health conditions.
What Does A Gastric Bypass Do?
A gastric bypass is a type of bariatric surgery that helps with your weight loss goals by changing how your stomach and small intestine handles the food that you eat.
Once the surgery has been performed your stomach will be smaller than before. Obviously this will mean that you will become fuller without consuming much food.
The food you eat will also no longer travel into certain parts of your stomach and small intestine, so this food will not be absorbed. This means that fewer calories will be absorbed, resulting in weight loss being observed.
Can You Drink Alcohol After Gastric Bypass?
The short answer to the question would be yes, however in order to incorporate alcohol into your life post gastric bypass you will need to do it gradually and with a few modifications.
There are a few issues with drinking alcohol after bariatric surgery.
For example, research has found that due to the changes to your metabolism post-surgery your blood alcohol levels will peak much quicker and higher than normal.
As you are consuming less food too, then you can get drunker much faster than in the past, which is important to remember before getting behind the wheel of your car.
Low blood sugar is also a concern, as the surgery itself can lead to rapid weight loss and low carbohydrate intake, which reduces the sugar or glycogen in your body.
Alcohol can also reduce the amount of glycogen present in your body leading to an increased risk of low blood sugar.
Low blood sugar or hypoglycaemia is a serious condition that can cause a loss of consciousness, brain and nerve damage, and even death if untreated.
One of the more worrying issues is that patients with a history of addiction, perhaps with food will turn to alcohol instead, which is not a good idea. Alcoholism is incredibly dangerous and has a host of its own problems, including high blood pressure, heart disease, stroke, liver disease, and digestive problems.
I would suggest following these guidelines to help reintroduce alcohol into your life after surgery:
- Alcohol should be avoided during the first six months after bariatric surgery
- Carbonated beverages and sugary drink mixers should be avoided
- You need to remember that your tolerance to alcohol will be lower than before surgery
- Never drink and drive
- Only consume alcohol with a meal to slow the absorption of alcohol
- Seek guidance from a doctor if you are drinking to cope with stress or your emotions
Can You Ever Eat Normally After Gastric Bypass?
Yes, you will be able to eat normally after a gastric bypass, but it will be a gradual process to allow the healing process post-surgery.
After surgery, your doctor or a dietician will talk to you about what diet you will need to follow, what foods you can and can’t eat, along with how much you can eat each meal.
This diet is designed to:
- Ensure your stomach heals without overstretching from the food consumed
- Change your eating habits, eating smaller portions to ensure the food is digested safely and comfortably
- Help with your weight loss efforts
- Make sure no complications occur
The day after your surgery you will only be allowed clear liquids. Once you get used to this you will be allowed other liquids such as broth, unsweetened juice, tea and coffee and milk.
About a week later you can move onto strained and pureed foods, with no solid pieces of food whatsoever. You can blend solid foods with a liquid such as water, milk or unsweetened juice.
During this period you will be allowed 3-6 meals a day, with each meal consisting of 4-6 tablespoons of food.
The following are foods suitable to be pureed:
- Lean ground meat, poultry and fish
- Cottage cheese
- Soft scrambled eggs
- Cooked cereal
- Soft fruits and cooked vegetables
- Strained cream soups
After another few weeks and after discussion with your doctor you will now be allowed to move onto soft foods, which can be slowly introduced into your diet. Foods should be small, tender and easily chewable.
You are allowed 3-5 daily meals, with each meal consisting of one-third to one-half a cup of food. This food should be chewed until it is the consistency of the puree before it can be swallowed.
Soft foods you can add to your diet at this time include:
- Ground lean meat or poultry
- Flaked fish
- Eggs
- Cottage cheese
- Cooked or dried cereal
- Rice
- Canned or soft fresh fruit, without seeds or skin
- Cooked vegetables, without skin
Once you hit the eight-week mark post-surgery you can now move onto solid foods.
You should be eating 3 meals daily, with each meal consisting of one to one and a half cups of food. If you feel completely full while eating then you are advised to stop immediately.
At this stage, you will be able to try a variety of different foods to see how you tolerate them. It is best that you speak to your dietician to see what foods are best.
New foods should be tried one at a time, as certain foods may cause pain, nausea or vomiting post-bariatric surgery.
As the opening that leads from your stomach to your small intestine is very narrow it can be blocked by larger pieces of food, so it is advised that you take smaller bites of food and to ensure it is chewed thoroughly.
You will likely need to start using a multivitamin and to use it every day. This is because you will not be able to absorb as many nutrients from your food as you should.
What Foods Can You Not Eat After Gastric Bypass Surgery?
Some people may struggle with certain foods after gastric bypass surgery, but the types of food will vary from person to person.
Foods that often cause problems include dry meat, soft white bread, stringy or very fibrous vegetables, sweetcorn, nuts, dried fruit, pips and seeds. The advice would be to try these foods cautiously and see how you react.
If you cant tolerate the food then you should wait a few weeks before trying again.
It has been shown that eating foods or drinks that contains high amounts of sugar and fat may cause ‘Dumping Syndrome’, with symptoms that include diarrhoea, nausea, light-headedness and cramping.
The advice if you suffer these symptoms is to sit or lie down until the symptoms pass.
These high fat and high sugar foods are also high in calories, which will make losing weight that much more difficult to achieve. Another reason why they are best avoided.
How Painful Is Weight Loss Surgery?
After the surgery you will likely experience pain at the incision site, or from the position your body was in during the surgery. There have also been reports that patients have encountered neck and shoulder pain after laparoscopic bariatric surgery.
Being able to control any pain or discomfort after surgery is important for recovery so you will be able to administer pain medication yourself by pushing a button or cord. This is known as patient-controlled analgesia (PCA).
Once you start to be able to tolerate fluids your medical team will be able to administer oral pain medication.
It is important that you keep the medical staff informed about any pain you are feeling. This is to ensure you are able to move, breathe and move around freely when needed.
If you are in too much pain to move about then this can affect your recovery.
How Much Weight Can I Lose?
The amount of weight you can lose after undergoing bariatric surgery will vary from person to person and will depend on a number of factors.
These factors include the age of the patient, your starting weight, your ability to exercise and the type of weight loss surgery performed.
Typically you should expect to see a 65-85% reduction in body weight with a gastric bypass. You would expect a loss of 60-85% drop with a gastric sleeve and a 40-60% reduction with a lap band.
How Quickly Will I Lose Weight?
Again, the speed at which you lose the weight post-surgery will depend on a number of factors.
However, what is known is that any weight lost will be rapid, especially over the first few months after surgery . The average weight loss for the first 30 days is 5-15 pounds a week, with men losing the weight at a faster rate than women.
Most people will lose around 20% of their body weight after two months. This rate of weight loss will start to slow after around the six-month mark.
What Is The Average Cost?
The three most popular bariatric surgeries are lap band, sleeve gastrectomy and a gastric bypass, with the gastric bypass shown to be the most expensive option.
Cost of Weight Loss Surgery United States.
A survey was conducted in 2015 showing that the average cost of gastric bypass surgery in the USA was $25,571. In some states, the cost was $15,000, while in others the cost was $35,000.
Cost of Weight Loss Surgery United Kingdom NHS and Private.
In the UK you may be entitled to weight loss surgery on the NHS, there are some criteria you must meet to be eligible for surgery:
- Your BMI is over 40, or between 35-40 with a serious health condition
- You have tried other weight loss methods but have not seen any results
- You need to agree to make healthy lifestyle changes after surgery
- You are fit and healthy enough for surgery while under general anaesthetic
If you are not eligible for surgery on the NHS then you can always opt for private weight loss surgery. The typical prices are:
- Gastric band surgery – £4,000 to £8,000
- Gastric bypass – £8,000 to £15,000
- Sleeve gastrectomy – £8,000 to £10,000
While the cost of surgery is important it should not be your main concern. In fact, a lower price may not necessarily mean a better option.
Medical tourism has become incredibly popular with many patients choosing to go abroad for surgery, with mixed results.
You need to remember that bariatric surgery is major surgery and while the chance of encountering a major complication is low you don’t want to be worrying that you haven’t chosen the best surgeon to operate on you just to save a little bit of money.
What Are the Most Common Complications?
There are always risks attached to any form of surgery, and bariatric surgery is no different.
Some of the risks you need to be aware of include:
- Blood clots. After the operation, you will receive treatment to reduce the risk of blood clots, but they can still occur sometimes. Symptoms of a blood clot include lower leg pain, swelling and redness, sharp, stabbing pain in your chest, shortness of breath, or feeling faint or dizzy.
- Infection. While you are healing after the operation your wound can become infected. Signs of infection include pain around the wound, red, hot and swollen skin, and pus coming from the wound.
- Gastric band slipping out of position. This is not a common complication but it is worth noting. If your gastric band moves after the operation you may experience heartburn, nausea and vomiting.
- Leaky gut. There is a small risk that after a gastric band or sleeve gastrectomy that food could leak out into your tummy. This can cause a serious infection that can cause symptoms that include fever, a fast heartbeat, tummy pain, chills and shivering, as well as fast breathing.
- Blocked gut. Your stomach or small intestine can become narrower or blocked after surgery. This could mean that food could get stuck, or that your gut could become kinked or twisted. If you have difficulty swallowing, are repeatedly vomiting, have tummy pain and are not going to the toilet as often then you may have a blocked gut.
- Malnutrition. A common complication is that after the operation your gut may not be able to absorb as many vitamins and minerals from the food you eat. This could lead to you becoming malnourished. Eating a balanced diet can help reduce the risk of malnutrition, but you may need to take a multivitamin for the rest of your life.
- Gallstones. Developing gallstones is a common complication that can occur within the first year or two of your surgery. These small, hard stones can form in your gallbladder if weight is lost quickly. The main symptom of gallstones is severe tummy pain, but a high temperature, a fast heartbeat, jaundice, itchy skin, chills and confusion are also symptoms.
- Excess skin. This is the most often discussed complication of weight loss surgery and occurs when weight is lost quickly. These excess folds and rolls of skin will occur in particular around the breasts, tummy, hips and limbs. If you encounter this issue then a tummy tuck can be used to remove this excess skin.
- Death. The chances of dying during or after weight loss surgery are incredibly rare, with only 1 in 1,400 people dying in the UK within a month of the operation.
Before you have the operation it is always advisable to speak to your surgeon so they can talk to you about any potential risks of the surgery.
What Is Candy Cane Syndrome?
One rare complication reported by those who have undertaken a Roux-en-Y gastric bypass is Candy Cane Syndrome.
Candy cane syndrome occurs when there is an excessive length of roux limb proximal to the gastrojejunostomy. When this occurs it creates a possibility of food particles being lodged and remaining in the blind redundant limb.
The symptoms of candy cane syndrome include:
- Regurgitation of food
- Acid reflux
- Significant weight regain
- Postprandial pain that is only relieved with vomiting
- Nausea
- Epigastric fullness
After resection of the excess roux limb was performed, the symptoms encountered were immediately resolved.
Bariatric Surgery Near Me That Accept Medicaid?
If you have health insurance then bariatric surgery may be covered as long as you meet the criteria laid out in your policy.
It should be noted that some policies may exclude coverage for weight loss surgery, so this is something you will need to check yourself. Many employers will exclude it as it makes the insurance less expensive.
Medicaid is a type of insurance that provides coverage to millions of Americans, including those with a low income.
If you meet certain criteria then Medicaid can cover the cost of weight loss surgery, including gastric bypass, lap band and gastric sleeve surgery:
- Are over the age of 13 if female, or 15 if male
- Have a BMI of over 35 with an associated health condition
- A letter from a health professional stating that weight loss surgery is necessary
- You can pass a psychological exam
- Documentation showing that they are not able to manage a health condition without surgery
- They must complete and show documentation that they have undertaken a medically supervised weight loss program for 6 months. This must occur with the last 12 months prior to any surgery
- You must understand that a diet and lifestyle change is needed after surgery
- Nutritional and psychological services must be made available after surgery
There are certain people who will not be suitable for Medicaid help, which includes those who have used steroids long-term, have malignant cancer or are pregnant.
When it comes to weight loss surgery revision your insurer may be able to cover the cost, but they may not be able to either, they all have different requirements.
In general, they will cover revisions to a gastric band, sleeve or bypass if you are regaining weight, as long as your BMI is over 40, or if it is over 35 and you have a medical problem related to obesity.
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