Living with Morbid Obesity or Having Bariatric Surgery?

Morbid obesity refers to conditions where the body mass index (BMI) is 40 or higher. Obesity at this level significantly increases the risk of heart disease, diabetes, sleep apnea, and early death.

What are the vital risks of morbid obesity?

Morbid obesity is not just excess weight; it is a condition that seriously affects life expectancy and organ health. The long-term effects of obesity at this level on the body are as follows:

• Life expectancy can be shortened by an average of 10–15 years.
• The risk of early death increases by 5–10 times compared to normal weight.
• The risk of heart attack is 3–4 times higher, and stroke risk is 2–3 times higher.
• The probability of developing Type 2 diabetes is around 70–80%.
• Hypertension, sleep apnea, and fatty liver are very common.
• The success rate for permanent weight loss with diet and exercise alone is less than 2%.

What are the risks of bariatric surgery?

Like any surgery, bariatric surgery also carries certain risks. However, these risks can be minimized with an experienced team and appropriate patient follow-up.

Possible risks include:

• Surgery-related death risk is approximately 0.1–0.3% (1–3 people per 1000 patients).
• Risk of serious complication (bleeding, leak, infection) is 2–5%.
• Long-term vitamin and mineral deficiencies may develop but can be managed with regular follow-up and supplementation.

What are the long-term benefits of surgery?

Bariatric surgery offers significant advantages not only for weight loss but also for the improvement of metabolic health:

• Approximately 60–70% of excess weight can be lost permanently.
• Complete/partial remission can be seen in approximately 70% of patients with Type 2 diabetes.
• There is a significant reduction in cardiovascular risks.
• Sleep apnea, hypertension, and joint pain may regress.
• Life expectancy can be significantly prolonged on average.

Surgery or waiting?

The most important question for morbidly obese patients is usually, “Should I wait, or should I have surgery?” This comparison may facilitate decision-making.

• Short-term risk: The probability of complications in the first weeks after surgery is low but not zero.
• Long-term risk: Living with morbid obesity without surgery keeps the risk of heart attack, stroke, diabetes, and early death high.

The short-term surgical risk is lower than the long-term obesity risks for most patients. The final decision should be made with individualized assessment.

Who might be a suitable candidate?

Bariatric surgery is not suitable for every individual; evaluation is based on certain criteria:

• Those with BMI ≥40 or those with BMI ≥35 and additional diseases like diabetes, hypertension, or sleep apnea
• Those who have tried lifestyle changes but failed to achieve permanent results
• Those who can adhere to regular follow-up and a nutrition program after surgery

What are the types of bariatric surgery?

Not all bariatric surgeries are the same; each method has different advantages and suitability conditions:

• Sleeve Gastrectomy
• Gastric Bypass
• Mini Gastric Bypass
• SASI Bypass

The choice is made based on the patient’s medical condition, the presence of reflux/diabetes, and the doctor’s recommendation.

How is the process managed?

A disciplined follow-up process is planned from before the surgery. Every stage is important for safe weight loss and healthy recovery.

• Pre-operative: Blood tests, endoscopy, cardiology–anesthesia evaluation, dietitian, and psychiatrist consultation
• Post-operative (first year): Regular check-ups, nutrition plan

How should one adapt to life after surgery?

Adopting healthy habits after surgery makes the success of the operation permanent:

• Consume small, protein-rich meals; consume liquids separately from meals.
• Start with short daily walks; the goal should be 7,000–8,000 steps.
• Monitor water intake, avoid smoking and alcohol.
• Do not neglect the supplements given by your doctor.

What should be a realistic expectation?

Bariatric surgery is not a miraculous solution; it is a powerful health tool when used correctly. Success increases with regular follow-up, nutritional compliance, and activity. The goal is a healthier, more active life with reduced risks.