Obesity Center

As Biruni University Faculty of Medicine Hospital Obesity Center, we are here to answer all your questions about obesity and to guide you on the most suitable treatment journey. We offer personalized and permanent solutions with modern methods in obesity treatment.

What is Obesity?

Obesity is defined as excessive fat accumulation in the body that may impair health. It is a serious health problem that reduces quality of life and can shorten life expectancy. The commonly used measurement method for obesity is body mass index (BMI). BMI is calculated by dividing your weight by the square of your height.

World Health Organization BMI classification is as follows:

• BMI 18.5 – 24.9: Normal weight
• BMI 25 – 29.9: Overweight
• BMI 30 – 34.9: Class 1 Obese
• BMI 35 – 39.9: Class 2 Obese
• BMI 40 and above: Class 3 (Morbid) Obese

What Causes Obesity?

The emergence of obesity is usually due to a combination of multiple factors. It is not correct to attribute it to a single cause. The main causes are:

• Unhealthy Nutrition: Excessive consumption of high-calorie, processed, fatty, and sugary foods.
  
• Sedentary Lifestyle: Inability to expend calories taken in due to insufficient physical activity.
  
• Psychological Factors: Stress, depression, anxiety, and emotional eating or binge eating disorders.
  
• Hormonal Disorders: Some hormonal issues such as hypothyroidism (underactive thyroid), polycystic ovary syndrome (PCOS), Cushing's syndrome.
  
• Sleep Disorders: Negative effects on appetite-regulating hormones due to insufficient or poor-quality sleep.
  
• Certain Medications: Weight gain as a side effect of medications such as antidepressants, corticosteroids, some diabetes drugs.
  
• Genetic Predisposition: A family history of obesity may increase the risk.

What Are the Symptoms of Obesity?

The most obvious sign of obesity is an increase in body weight and a BMI above 30. However, there may be other symptoms accompanying obesity:

• Excessive sweating
• Menstrual irregularities (in women)
• Snoring and pauses in breathing during sleep (sleep apnea)
• Pain in weight-bearing joints, especially knees, hips, and lower back
• Shortness of breath, especially during exertion or climbing stairs
• Getting tired more easily than normal, constant fatigue and low energy
• Rashes or fungal infections in skin folds (groin, armpits, under breasts)

How Is Obesity Diagnosed?

To diagnose obesity, your doctor will perform a comprehensive evaluation. This evaluation may include:

• Medical History and Physical Examination: Your weight history, eating habits, physical activity level, medications you use, family history of diseases and obesity are questioned in detail. Height and weight are measured, general health status is assessed, and your BMI level is measured.
• Waist Circumference Measurement: Important for determining abdominal fat accumulation and associated risks such as heart disease and diabetes. Values above 88 cm for women and 102 cm for men are considered risky.
• Blood Tests: Blood sugar (fasting, postprandial, HbA1c), cholesterol and triglyceride levels, liver function tests, thyroid hormones (TSH) are checked to investigate conditions that may accompany or cause obesity.
• Additional Tests: If necessary, ECG (heart tracing), sleep test (if sleep apnea is suspected), endocrinology or cardiology consultations may be requested.

How Is Obesity Treated?

Obesity treatment should be planned individually and requires a long-term, multidisciplinary approach. The goal should be not only to help you lose weight but also to help you maintain that weight by acquiring healthy lifestyle habits and to overcome obesity-related health problems.

The choice of treatment method depends on the patient's BMI, age, general health status, comorbid conditions, previous treatment attempts, and patient expectations. The main treatment methods offered at our center are listed below.

Sleeve Gastrectomy (Gastric Sleeve Surgery)

Also known as stomach reduction surgery, this method involves removing approximately 70-80% of the stomach laparoscopically (closed technique). As the stomach volume is reduced, patients feel full with much less food. Additionally, the level of ghrelin hormone, which is secreted from the stomach and stimulates hunger, decreases, thus reducing appetite. Sleeve gastrectomy is the most commonly performed bariatric surgery worldwide and provides effective weight loss.

Gastric Bypass Surgery

In gastric bypass surgery, a small pouch is created in the upper part of the stomach and a portion of the small intestine is connected to this pouch. Thus, both the stomach volume is reduced and absorption is decreased because the intestinal pathway through which food passes is shortened. Gastric bypass surgery gives very successful results in blood sugar control, especially in patients with type 2 diabetes. Different techniques (Roux-en-Y, Mini Gastric Bypass) are available.

Intragastric Balloon

The intragastric balloon is a non-surgical, endoscopic method. A thin tube with a deflated balloon at its tip is passed through the mouth into the stomach, and the balloon is inflated with saline inside the stomach. The balloon occupies space in the stomach, creating a constant feeling of fullness and helping to reduce portion sizes. The gastric balloon is a temporary method; depending on the type, it is removed endoscopically after 6 months or 1 year. During this period, acquiring healthy eating habits significantly affects the success of the treatment.

Gastric Botox

Gastric botox, similar to the intragastric balloon, is a non-surgical, endoscopic procedure. Botulinum toxin (botox) is injected into certain areas of the stomach. The procedure slows down gastric muscle contractions, delaying stomach emptying and prolonging the feeling of fullness. The effect of gastric botox is also temporary (approximately 4-6 months). When combined with diet, it can support weight loss.

Supportive Therapies

For a successful and lasting obesity treatment, surgical or endoscopic methods alone are not sufficient. The supportive therapies offered by our multidisciplinary team are of great importance:

• Nutrition and Dietetics Counseling: Our expert dietitians prepare personalized nutrition programs before and after treatment and guide you in acquiring healthy and balanced eating habits.
  
• Psychological Support: Psychological support may be recommended to understand the underlying psychological causes of obesity, regulate eating behaviors, increase motivation, and facilitate the post-surgery adaptation process.
  
• Exercise Counseling: Physical activity is an indispensable part of the weight loss and weight maintenance process. Our experts can guide you on suitable exercise programs.
  
• Endocrinology Consultation: When necessary, we collaborate with our endocrinology specialists for the detection and treatment of underlying hormonal disorders.

Frequently Asked Questions

Who Can Undergo Obesity Treatment?

Individuals with a body mass index above 40, or those with a BMI above 35 with serious comorbidities such as type 2 diabetes, hypertension, sleep apnea, may be candidates for obesity surgery. The final decision is made by your physician after a detailed evaluation.

What Are the Risks of Obesity Surgery (Sleeve Gastrectomy and Gastric Bypass)?

Like any surgical procedure, obesity surgeries carry risks such as infection, bleeding, anesthesia risks, embolism, and leakage. However, these risks are quite low in experienced teams and fully equipped hospitals. Your physician will inform you about the risks.

How Long Does Recovery Take After Surgery?

Recovery after sleeve gastrectomy performed with laparoscopic (closed) technique is usually fast. The average hospital stay is 2-3 days. You can return to desk jobs within about 2-3 weeks, while physically demanding jobs may require 4-6 weeks of waiting.

Will I Regain Weight After Treatment?

Treatment methods help you lose weight, but for lasting success, lifestyle changes (healthy nutrition, regular exercise) and adherence to doctor/dietitian follow-up are essential. If these rules are not followed, weight regain is possible.

Why Choose Biruni Obesity Center?

At our Obesity Center located in Küçükçekmece, Istanbul, all treatments are performed by experienced surgeons with a multidisciplinary approach. In our fully equipped university hospital, we apply scientifically proven obesity treatments with state-of-the-art equipment.