Frequently Asked Questions

It would be useful to look at the bright side first. First of all, almost all patients lose weight significantly. Most of them will definitely regress or go into complete remission if their diabetes is not based on very long years, hypertension and high cholesterol levels may improve. In addition, since the knees are relieved of a considerable load, they recover and conditions requiring orthopedic surgery may disappear. Sleep apnea improves and sleep makes sense. Fat in the internal organs, especially in the liver, disappears. Fertility increases in women who have infertility problems and cannot have children, and sexual functions improve in men. Psychologically, it is almost like a vaccine of happiness. Almost all of the patients who undergo these surgeries become more self-confident, more hopeful and much healthier people. Most importantly, due to all these improvements, the life span of our patients is extended by 10-15 years in a scientifically significant way. On the other hand, it would not be correct to say that bariatric surgery has zero problems in the long term. Very rarely (1 - 4%), stenosis may develop in the joining and cutting suture lines after both sleeve gastrectomy and gastric by-pass (gastric by-pass or duodenal switch) surgeries. The clinical signs of “stenosis” are excessive weight loss, increased reflux complaints and decreased tolerance to solid foods, especially “lump meats”. Recognition of these conditions is not difficult and these strictures can be dilated with endoscopic balloon applications. Very rarely, re-surgical intervention may be required for strictures and these are not easy procedures.

The most important problem in the long term is that there may be a tendency to regain weight. This was often the case with the band, i.e. handcuff method, which is about to be abandoned. However, after gastric sleeve or gastric by-pass, the probability of weight gain at a level that would make a patient morbidly obese again in a patient who also follows the recommended diet and exercise programs is below 3-4%. Nevertheless, 7-8 years after the surgeries, the stomach left behind may enlarge and this may result in a decrease in the restrictive effect on food intake and “some” weight regain. If the weight regain is at the level of morbid obesity; in such cases, it may be necessary to convert the sleeve gastrectomy to gastric by-pass or duodenal switch.

Our hair has various stages of development. Of these, anagen, the growth phase, is the phase in which 90% of the hair is present at normal times. Telogen, or stagnation phase, covers 10% of the hair. It takes approximately 120 days for a hair to pass between these two phases. However, due to infections, chronic diseases, surgeries, high fever, shock diets, protein deficiency, iron or zinc deficiency, drug use, hormonal problems, etc., more of the hair passes into the telogen phase and noticeable hair loss can be seen. What should be known about hair loss after sleeve gastrectomy surgery is that this process is completely temporary. If there are no serious problems with nutrition, hair loss usually starts between 3-6 months and usually stops after 6 months. If the type of surgery is a type of surgery that also prevents the absorption of vitamins and minerals, that is, a surgery from the bypass group, the risk of hair loss may be slightly higher. In general, new hair starts to grow within 12-18 months and there is almost no hair loss. It is not possible to reverse the hair that has entered the telogen phase. In other words, the cycle will not be completed without hair loss. The most effective preventive measure is to strictly follow the dietary guidelines given by the surgeons and dieticians of patients who have undergone bariatric surgery and to use supplementary vitamins. Problems in food intake and vitamin deficiencies can aggravate the situation.

Vitamins are taken orally for the first month, then 2 a day for the first year and 1 a day after the first year, taking into account blood tests.

The first year/one and a half is the period in which weight loss is inevitable and the patient will “MUST” lose between 20 and 100 kilograms, depending on their initial weight, whether they follow various recommendations and their exercise status. In this period, the most important task falls primarily to the patients and, from our point of view, to our dieticians and psychological support teams. This does not always go as desired. Failure of our patients to follow the recommendations and some prohibitions may set back the success. After 1 - 1.5 years, weight loss will stop. After that, the main goal is to ensure that the weight is no longer regained. Patients who adopt the right eating habits and routine exercise in the first 1.5 years and stay in contact with us with our follow-up protocols are extremely unlikely to regain weight. However, it should not be forgotten that obesity is a chronic, multifactorial disease. With surgery, only changes are made in the upper digestive system, but unfortunately, the genes, habits and behaviors of the patients cannot be changed. Since the stomach is an expandable organ and the restrictive effect of the surgery on food intake decreases after 3-4 years, the way of living and eating of the patients eventually becomes the most important factor again. For these reasons, a group of patients will definitely gain weight again and may even be candidates for surgery again due to obesity. According to the data, this frequency is at a considerable level of 3-4% of patients. Patients also have a great responsibility to prevent this from happening. As a bariatric surgery team, our duty is to be with all our patients in all matters and at all times.