Why weight-loss surgeries?

Obesity is a major health problem worldwide and has reached an epidemic proportion in the western and eastern society. Evidence continues to accumulate that obesity is a major risk factor for many diseases and is associated with significant morbidity and mortality.

The most widely accepted measure of obesity is the body mass index (BMI). This number is calculated by dividing a patient’s mass (kg) by his or her height (m2).

A normal BMI is considered in the range of 18.5-24.9 kg/m2.

A BMI of 25-29.9 kg/m2 is considered overweight.

A BMI of 30 kg/m2 or higher is classified as obese; this classification is further subdivided into class I, II, or III obesity.

Considering other factors (eg, total muscle mass, waist circumference) besides the BMI may be important. For example, an extremely muscular individual may have an elevated BMI without being considered overweight. Waist circumference has been shown to be an excellent indicator of abdominal fat mass. A circumference of greater than 88 cm (35 in.) in women or greater than 102 cm (40 in.) in men strongly correlates with an increased risk of obesity-related disease.

Bariatric surgery or Gastric Bypass Surgery is currently the only modality that provides a significant, sustained weight loss for morbidly obese patients, with resultant improvement in obesity-related comorbidities.

 Etiology

Obesity is a complex, multifactorial chronic disease influenced by the interaction of several factors, such as genetic, endocrine, metabolic, environmental (social and cultural), behavioral, and psychological components. The basic mechanism involves energy intake that exceeds energy output.

Epidemiology:

The number of overweight individuals in the world is estimated at 1.7 billion. In the United States, the problem is at epidemic proportions. As much as two-thirds of the population in the United States are overweight, and half of the people in this group can be classified as obese.

Bariatric Surgeries

One of the treatments for obesity is a surgery that is usually performed by laparoscopic techniques. People with BMI between 25 and 30 need no surgery and will return to ideal weight with a proper diet and exercise. Some people with BMI above 30 and most above 35, are allowed to laparoscopic and endoscopic procedures. Failure to follow a healthy lifestyle or inherit obesity will have unavoidable risks, and this will have a profound effect on patients’ physical health. Pressure from body mass to sensitive bones such as the knee and ankle can make walking difficult for these patients and even disable them. After overweight exceeds a certain level in these patients, diet and regular exercise may no longer be effective and patients should try other ways to lose weight. The problems that this disease has for people are divided into physical and mental categories. Apart from diabetes, hypertension and heart disease, most overweight/Obese people are also at risk for bone diseases and knee/ankle arthrosis. Apart from this, various mental illnesses also threaten these people. Diseases such as depression and mental distress completely threaten these patients and may even affect their social relationships. Some patients with a special diet and exercise achieve proper physical health, but for others, the only way to treat obesity is through obesity surgery. Obesity surgeries can work by eliminating 50 to 60 percent of patients’ weight by doing their best for only six months. Of course, this is only possible with a special diet and constant exercise after each surgery. Other benefits of obesity surgery include many improvements in diseases such as type 2 diabetes and hypertension. These surgeries give individuals the ability to control these diseases by applying specific changes in the physiological structure of the stomach and intestine and they can minimize drug used related to their overweight. These surgeries can help these people gain confidence, influence their social relationships and make significant changes in their lives. Obesity can result in lots of diseases like cardiovascular, type 2 diabetes, severe pain in back, kinds of cancer and losing life expectancy. Bariatric surgeries include some cure for losing weight and there are several kinds of it.

These surgeries may perform in two ways:

Type 1: Decrease the size of the stomach. Moreover, you can strict and reduce the amount of food that makes you feel full.

Type 2: This type accompanied by shortening or bypassing the intestine to decrease the amount of food or calories absorption.

One of the most frequent Types of bariatric surgery is given as following:

Sleeve Gastrectomy

This surgery is another way of reducing the stomach’s sizes and making the patient eat less. Sleeve gastrectomy is not reversible like the gastric band and it’s done laparoscopically. And it’s actually removing a large part of the stomach by creating a small incision. It totally changes the shape of the stomach and also decreases the number of hunger hormone that is called ghrelin. And it is done for a patient with BMI over 40 or someone with BMI in 35-40 range and related complications like high blood pressure, heart disease, fatty liver, sleep apnea or type 2 diabetes. You should take a calcium supplement and multivitamin daily and vitamin B injection monthly otherwise you get nutrient deficiencies. It was the helper for up to 85 percent of the patient and they have lost up to 60 percent of their excess weight in two years. It has less risk than gastric bypass and after the surgery, the stomach has a natural normal function but in a smaller size. It can improve lots of related disorder and your life expectancy. About 0.5 percent of patients experience related complications like losing hair, some kind of nervous condition, unexpected pain or infection.

Are you considering gastric sleeve weight loss surgery because despite trying exercise and diets for many years, you have a lot of weight to lose?

You are interested to know the pros and cons, the risks and benefits, what makes you a good candidate for gastric sleeve weight loss surgery in Iran, and what long-term instructions you need to make to keep the results.

In this operation, surgeons remove a part of your stomach and join the remaining parts together to make a new banana-shaped stomach that is named “sleeve.”

There are generally four types of weight loss surgery:

1- Stomach bypass surgery

2. Stomach sleeve operation
3. Adjustable gastric banding

4- Intestinal bypass surgery (biliopancreatic deviation or biliary deviation)

What Happens during gastric sleeve surgery?

After general anesthesia, your surgeon will make a few small cuts in your belly and insert a laparoscope device (which is an instrument with a tiny camera that sends pictures to a monitor). The operation takes about 2 to 3 hours.

The surgeon will then insert other medical instruments through the cuts and remove 3/4 of your stomach. Finally, he’ll reattach the rest of your stomach to form the “sleeve” or a banana-shaped tube.

You might stay in the hospital about 2 or 3 days.

The result of this operation is permanent.

Weight loss surgery is suitable for the following people:

• People with a BMI of 35 to 40 or more
• People with a BMI of 35 to 40 or more and suffering from obesity-related diseases.
• People with a BMI of 30 to 35 or more and suffer from obesity-related diseases.

Is Gastric sleeve weight loss surgery different from Gastric Bypass surgery or Bariatric weight loss surgery?

In gastric bypass (also known as Bariatric weight loss surgery), the surgeon makes a small pouch that skips most of your stomach, going straight to the intestine.

Gastric sleeve surgery is the best weight loss procedure for people who have a BMI (body mass index) approximately 40 or higher.

Some people are too heavy for sleeve gastrectomy, so other weight loss procedures such as gastric bypass surgery or Bariatric surgery may be a good alternative.

Specialists in Iran and all over the world are presently offering gastric sleeve surgery as a reliable therapy for obesity. Nowadays, it has been picking up in prevalence comparative with other techniques, for example, gastric bariatric surgery or the Lap-Band. For the correct up-and-comers, a gastric sleeve is an incredible way to help losing and keep off excess weight. The gastric sleeve surgery cost in different countries starts from $9,600 to $26,000. Not all overweight individuals meet all requirements for the gastric sleeve. There are a few rules that must be reached before a patient is endorsed for medical procedure.

Gastric sleeve surgery is recommended for individuals in the range of 18 and 65 years old with a weight record (BMI) of 40 or higher. Individuals with a body mass index of 35 can likewise qualify. For most patients, the necessity of sleeve weight loss surgery requires at least one medical disease related with obesity. Some known weight-related conditions are diabetes, rest apnea, hypertension, asthma and joint osteoarthritis.

Some important Tips for gastric sleeve surgery:

We advise you to consider these important tips and use them to your benefit. If you had some problems after the gastric sleeve surgery, go to the hospital or clinic that operated you or consult with your agency. You must go and see a doctor if you have problems, do not postpone it because it might be very dangerous.

For a safe pregnancy, you should know that your weight will balance out before getting pregnant. Most ladies can get pregnant after a gastric sleeve surgery. The average expense of a gastric sleeve surgery in our company is around 2500$, yet it can fluctuate generally from one country to others. It has been shown that gastric sleeve surgery is a safe and furthermore powerful method for getting thinner. Being one of the most current and affirmed medical procedures for weight reduction.

The post-operative complications are uncommon. Nonetheless, the most probable side effects are stomach perforation, blood clot, wound contamination, stomach ulcer.

Ryan Medical Tourism company is a leading facilitator of weight loss surgeries in Iran.

At Ryan Medical Tourism company, weight loss procedures are provided by highly qualified and experienced surgeons who have undergone intensive specialist training in their specialty.

Ryan Medical Tourism healthcare facilitator team offers sleeve gastrectomy as a good weight loss surgery option.

Other points to keep in mind after your operation:

Everything should be chewed completely before swallowing.

Don’t drink while eating, as this habit might cause your new stomach to get overfill.

Drink liquids 20 to 30 minutes after finishing a meal.

Avoid high-calorie drinks and foods.

Take administered vitamin and mineral supplements every day.

After 2 or 3 months, you can move on to regular meals. But keep in mind, you will not be able to eat as much as you used to.

New Eating Habits after gastric sleeve weight loss surgery:

The first day after sleeve gastrectomy, you should drink just clear liquids. By the time you leave the hospital, you can eat pureed foods and protein shakes and continue to do so for about 2 to 4 weeks.

Keep in mind that you should change your past eating habits forever. After that first month, you’ll switch to eating soft solid foods very slowly.

How much weight do you lose after gastric sleeve weight loss surgery?

People generally lose 50-70% of their excess weight over 12 to 18 months.

In other words, sleeve gastrectomy results in 25-30% of your total body weight loss.

Of course, exercising and eating right add to your weight loss.

Endoscopic sleeve gastroplasty is a more current kind of negligibly intrusive weight reduction methodology. In sleeve gastroplasty, a stitching gadget is embedded into your throat and down to your stomach. The endoscopies at that point places stitches in your stomach to make it littler. This strategy might be a choice in case you’re fundamentally overweight — a weight index or BMI of at least 30 — and diet and exercise haven’t worked for you.

Endoscopic sleeve plication:

Sleeve gastroplasty prompts noteworthy weight reduction. It encourages you to get more fit by restricting the amount you can eat. Furthermore, the technique is insignificantly obtrusive, diminishing the danger of employable inconveniences and permitting speedy come back to day by day exercises.

Endoscopic sleeve gastroplasty is accessible to individuals whose weight file (BMI) is over 30, who haven’t been fruitful in keeping up weight reduction with changes in life style, and who don’t qualify or wish to seek after customary bariatric medical procedure.

Yet, gastric sleeve surgery isn’t for each and every individual who is overweight. A screening cycle assists specialists with checking whether the methodology may be valuable for you. Furthermore, you should be happy to focus on sound way of life changes, customary clinical development and take an interest in conducting treatment.

Sleeve gastroplasty isn’t proper for any individual who has an enormous hiatal hernia or a condition related with gastrointestinal dying, for example, gastritis or peptic ulcer infection.

Sleeve gastroplasty is performed to assist you with getting more fit and possibly bring down your danger of genuine weight-related medical issues, including:

1. Coronary illness and stroke
2. Hypertension
3. Nonalcoholic greasy liver ailment (NAFLD) or nonalcoholic steatohepatitis (NASH)
4. Rest apnea
5. Type 2 diabetes
6. Osteoarthritis (joint torment)

Sleeve gastroplasty and other weight reduction strategies or medical procedures are ordinarily done simply after you’ve attempted to get more fit by improving your eating routine and exercise propensities.

Up until this point, endoscopic sleeve gastroplasty has indicated an ideal security profile. Agony and sickness may happen for a few days after gastric sleeve surgery.

These symptoms are typically dealt with torment and queasiness prescriptions. Many people feel better following a couple of days.

What’s more, despite the fact that it’s not intended to be a transitory methodology, sleeve gastroplasty can be changed over to other bariatric medical procedures.

At the point when joined with a way of life alteration, sleeve gastroplasty results in about 15% to 20% all out body weight reduction at one to two years.

On the off chance that you fit for sleeve gastroplasty, your medical care group will give you explicit guidelines on the most proficient method to get ready for your procedure. You may need to have different lab tests before this medical procedure. You may have limitations on eating, drinking and the medicines you can take.

You may likewise be needed to follow a physical movement program.

It’s useful to prepare for your recuperation after sleeve weight loss surgery. Recuperation from endoscopic sleeve gastroplasty takes just a couple of days.

1- How is diabetes improved with sleeve weight loss surgery?

During sleeve weight loss surgery, 75% of the stomach is removed and only a small volume remains in the form of a tube. As the stomach shrinks, the amount of food consumed decreases and the patient begins to lose weight. Weight loss will be followed by fatigue and constant tiredness. These hormones secrete insulin, which ultimately improves the patient’s type II diabetes.

If diabetes is in its early stages, the patient will be relieved of diabetes medications (such as insulin and metformin) for years after surgery. For patients with long-standing diabetes, gastric sleeve surgery can control their blood sugar levels by limiting the amount of food they eat. If diabetes has been present in the patient for more than 10 years and is so advanced that the person needs insulin injections, sleeve weight loss surgery can reduce the type of medication to oral medications.

A few things to keep in mind:

The effect of gastric sleeve surgery on the treatment of type 2 diabetes is great, but you should keep in mind that:

This effect will depend on your medical history and previous control over your diabetes.

Modify your diet slightly.

Have ongoing activities.

After surgery, your general health, including the endocrine glands, should be checked regularly by your doctor.

A study in the United States of 20,000 patients undergoing sleeve weight loss surgery found that about 84 percent of patients had their diabetes cured, their blood sugar improved, and their need for diabetes medications reduced or even eliminated.

Whereas in gastric sleeve surgery, in addition to the effects of weight loss in controlling diabetes and blood pressure, the hormonal effects of the small intestine regulate insulin and blood sugar; therefore, sleeve weight loss surgery is also known as metabolic surgry.

2- The effects of sleeve surgery in obesity and hypertension:

Nowadays, many people suffer from obesity and they have the problem of hypertension, and it is estimated that more than two-thirds of these people cannot be cured by exercise or diet until they lose weight. And it is said that the best way to lose weight and treat hypertension is to have sleeve weight loss surgery by a weight loss specialist surgeon.

When you have obesity, your heart has to work harder to support your weight. The harder and faster your heart works, the higher your blood pressure goes. When you are carrying extra weight, your heart has to work harder. Then the problem of hypertension appears.

Pre- sleeve surgery:

Fundamentally your obesity is affecting your liver. In case you’re fat, your liver doubtlessly has an aggregation of fat cells both in and around it. This makes it bigger than it must be.

Your liver is right close to your stomach. A too-huge liver makes sleeve weight loss surgery harder for your primary care physician to do, and more perilous for you to have done.

Getting ready for the operation, you’ll be given a particular eating regimen to follow, starting fourteen days before your planned gastric sleeve surgery date.

It’s a precise eating diet that diminishes calories just as sugars, for example, desserts, potatoes, and pasta. You will eat lean protein, vegetables, and low-or no-calorie liquids. Two days before sleeve surgery, you will change to a reasonable, fluid eating regimen. This may incorporate one no-sugar protein shake every day, notwithstanding stock, water, decaffeinated espresso or tea.

1^st week eating regimen:

For the 1st week after gastric sleeve surgery, you’ll proceed with a similar clear fluid diet you followed in the days before your medical procedure. This will assist with staying away from postoperative confusions, including gastrointestinal obstructions, gastric perforation, diarrhea, clogging, and dehydration.

Your body needs an ideal opportunity to recuperate, and this diet will help with this goal.

Tips to remember include:

• Drink a lot of clear fluids. In this procedure that you experience, staying hydrated is really important so consult with your surgeon on electrolyte fluids usage, for example, low-calorie Gatorade.
• Try not to drink anything with sugar. Sugar can cause dumping condition. Liquids with excess sugar enter the small intestine rapidly. The outcome is vomiting, fatigue, diarrhea, and regurgitating.
• Caffeine may add to heartburn and gastro esophageal reflux, and should likewise be avoided.
• Carbonated drinks combined with sugar or seltzer water will increase abdominal distention and swelling. These should all be evaded postoperatively and potentially even long term.

2^nd week eating regimen:

During the second week after sleeve gastrectomy, you can change to a full-fluid eating regimen.

Sugar-free shakes, for example, Guarantee Light Breakfast drinks

Shakes made with protein powder.

3^rd week eating regimen:

During week three, you can include delicate, pureed nourishments to your eating regimen. Eat gradually and chew food completely. Any low-fat, without sugar food that you can puree, including lean protein sources and non-fibrous vegetables, are worthy.

4^th week eating regimen:

Presently that you’re one month post-medical procedure, you can begin adding strong nourishments to your eating routine.

Major problems of gastric sleeve surgery:

1- Digestive problems:

 Possible gastrointestinal problems due to gastric sleeve surgery include: Gastric reflux disease (GERD), Indigestion (Dyspepsia), Gallstones, Intolerance to some foods, Nausea and vomiting, Deficiency of vitamins and minerals.

2- Sagging skin:

 In most obese patients, the skin is stretched for a long time to accommodate their excess weight; For this reason, it will lose its elasticity. Gastric sleeve surgery causes most patients to lose a lot of weight quickly and their skin will not be able to adapt to this rapid change.

3- Weight gain after sleeve surgery:

After two years, approximately 1 in 20 people who have had sleeve surgery become overweight at their lowest weight, and after 5 years, each sleeve patient loses 50% of their stomach weight again. Achieves.

Recovery in gastric sleeve surgery:

• Duration: 4 to 6 weeks is not needed for complete recovery.
• Duration of hospitalization: 2 to 3 days;
• Duration of work leave: 1 to 3 weeks;
• Pain: Similar to the pain experienced after any surgery that can be controlled with medication
• Diet: Slow transition from dilute liquids to solid foods;
• Activity: Slow transition to normal activities and sports;

Challenges: Most side effects such as nausea, digestive problems go away with lifestyle changes

Some surgeons allow the patient to go home on the same day of surgery. If you prefer to go home for recovery, ask your surgeon if this is possible.