Bariatric and metabolic surgery is a dedicated pathway for selected patients with excess weight or metabolic disease. MPGCARE coordinates multidisciplinary assessment at Medical Park and Liv Hospital in Türkiye. The hospital confirms the surgeon’s bariatric expertise, accepted ages, available methods and follow-up resources. General surgical problems such as gallstones, hernias or cancer require their own specialist pathway. Surgery does not guarantee a particular weight, diabetes remission or lasting results.

Conditions reviewed in a bariatric assessment

Bariatric operations: how do they differ?

Height, weight and body mass index (BMI)

BMI = weight (kg) ÷ [height (m) × height (m)]. Convert centimeters to meters first: 170 cm = 1.70 m. For example, 105 kg at 1.70 m gives 105 ÷ (1.70 × 1.70) = approximately 36.3 kg/m². This is a calculation example, not a surgical recommendation.

There is no single body weight in kilograms that qualifies everyone: the same weight produces different BMI values at different heights. Share age, measured height, current weight, weight history, previous weight-management treatments and associated illnesses. BMI is a screening measure; it does not directly measure body fat or replace the assessment of muscle mass, central adiposity, frailty or metabolic health. Children and adolescents need age- and sex-specific growth assessment and a specialist pathway, not adult thresholds alone.

Who may be considered for bariatric surgery?

Which method is suitable for me? BMI is one part of assessment, not an approval on its own. ASMBS/IFSO guidance recommends assessment for surgery at BMI ≥35 kg/m² regardless of associated conditions; it recommends metabolic surgery for type 2 diabetes at BMI ≥30 and consideration at BMI 30–34.9 when nonsurgical treatment has not achieved substantial, durable weight or health improvement. Population-specific thresholds may differ. The center applies its current clinical criteria and considers frailty, reflux, prior surgery, nutrition, mental health, pregnancy plans and the ability to attend lifelong follow-up. Pediatric decisions require a dedicated specialist pathway.

How is the operation selected?

The team compares the expected benefits and risks of each method with your reflux, diabetes, previous operations, nutritional status and follow-up access. Nonsurgical options and your preferences are discussed before deciding. Meeting a BMI threshold does not mean surgery is suitable or necessary for you.

What We Do

The multidisciplinary assessment may select CBC, glucose/HbA1c, kidney/liver function, iron/ferritin, B12, folate, vitamin D and calcium-related tests. ECG, sleep-apnea assessment, ultrasound or endoscopy are chosen for history, method and anesthesia needs; no universal testing package is implied. A bariatric dietitian and appropriate psychological/medical review help identify risks and alternatives. Nutrition, activity and prescribed medical management are nonsurgical options. A gastric balloon is a temporary endoscopic option, not bariatric surgery; it requires its own indication and removal/follow-up plan.

Diabetes: which operation may be suitable for me?

There is no single operation suitable for every person with type 2 diabetes. Sleeve gastrectomy and Roux-en-Y gastric bypass are established options for selected patients. The bariatric surgeon and endocrinologist review BMI, diabetes duration, HbA1c, current medicines, insulin use, reflux, previous surgery, nutritional risk and access to follow-up. Significant reflux may favor bypass over sleeve in some patients; sleeve can worsen reflux. Bypass also has specific risks, including nutrient deficiency and hypoglycemia. Other metabolic procedures require a separate discussion of benefits, risks and the center’s expertise.

Can I be assessed if I use insulin or my BMI is below 35?

Insulin use does not automatically exclude a person with type 2 diabetes. Longer diabetes duration and reduced insulin-producing capacity may affect the response, so remission cannot be predicted from weight alone. Selected adults with type 2 diabetes and BMI of at least 30 kg/m² may be considered under current metabolic surgery guidance, with population-specific adjustments where appropriate. This is an assessment criterion, not automatic approval.

Is surgery a treatment for type 1 diabetes?

Type 1 diabetes is different from type 2 diabetes. Bariatric surgery does not restore the lost insulin-producing cells or replace essential insulin treatment. A person with type 1 diabetes may be assessed for a separate weight-related indication by a specialist team, with careful plans for glucose monitoring, insulin, hypoglycemia and ketoacidosis risks. It must not be presented as a diabetes cure.

Which diabetes records and tests should I prepare?

Send the diabetes diagnosis and duration, recent HbA1c and glucose results, glucose-monitoring records, medicine and insulin details, hypoglycemia history, kidney results and known eye, nerve or cardiovascular complications. The physician may select HbA1c, glucose, kidney function, urine albumin and other tests according to the clinical history. C-peptide or diabetes autoantibodies may be requested when the diabetes type or insulin reserve needs clarification; they are not required for every patient.

Can I stop insulin or other diabetes medicines after surgery?

Do not stop or adjust treatment yourself. Glucose and food intake can change after surgery, so the diabetes team provides an individualized monitoring and medication plan before and after the procedure. Insulin, other glucose-lowering medicines and perioperative changes are reviewed by the treating team; this page gives no dose or stopping interval. Confusion, loss of consciousness, repeated vomiting, dehydration or rapid breathing require urgent local assessment.

Does diabetes remission mean a permanent cure?

No. The international consensus generally defines type 2 diabetes remission as HbA1c below 6.5% for at least three months without usual glucose-lowering medication, confirmed by the treating physician. HbA1c may be unreliable in some conditions and an alternative assessment may be needed. Remission is not guaranteed and diabetes can recur. Continued glucose monitoring and screening for kidney, eye, foot and cardiovascular complications remain important.

Who coordinates diabetes and nutrition follow-up after I return home?

Agree on a named bariatric team, endocrinologist and dietitian, plus a suitable clinician in your own country. The handover should cover the operation, glucose and medication plan, nutrition and supplements, laboratory monitoring, complication signs and scheduled reviews. Follow-up remains necessary even if diabetes improves; confirm that local clinicians can provide the required care before travel.

Nutrition and long-term follow-up: who is responsible?

Agree a named bariatric surgeon/team and bariatric dietitian before treatment, with a documented handover to a suitable local clinician after return. Food texture progression, protein, fluids and supplements are individualized by the team; this page gives no fasting or diet timetable. Long-term care monitors symptoms, weight, metabolic disease and nutrient levels, with lifelong reviews and at least annual monitoring after the initial specialist phase according to the method and findings. Persistent vomiting or neurologic symptoms can signal serious deficiency and need urgent advice, not just diet adjustment.

Confirm the written clinical scope

Ask the receiving hospital to document the proposed operation, surgeon and anesthesia review, required tests, hospital stay, pathology, medicines, dietitian support, scheduled reviews and rehabilitation. Clarify implant/mesh use, management of complications, readmission, revision, additional visits and who provides care after returning home. Confirm included services and exclusions before planning travel; a generic description does not establish an individual arrangement.

Risks and realistic expectations

Discuss bleeding, infection, anesthesia problems, blood clots, leak, organ injury and procedure-specific risks, including possible reoperation and rare death. Bariatric procedures may involve reflux, ulcers, obstruction, nutritional deficiencies or weight regain. Weight loss and diabetes improvement vary; lasting success, cure or rapid recovery is not guaranteed. Laparoscopic or robotic availability must be confirmed and conversion to open surgery may be needed.

Records, preparation and urgent symptoms

Prepare dated imaging/DICOM, endoscopy and pathology reports, previous operation/discharge records, medicine/dose and allergy lists, height/weight history, prior treatments and associated diseases. MPGCARE confirms the secure submission channel and translation needs. Fasting, bowel preparation and medicine changes are supplied only after the center validates the personal plan; do not stop anticoagulants or diabetes medicines yourself.

Severe or worsening abdominal pain, persistent vomiting, fever, bleeding, jaundice with illness, chest pain, breathlessness or a painful trapped hernia need urgent local care. After surgery, inability to keep fluids down, fainting or new weakness also needs prompt assessment. Do not wait for international travel. The physician decides travel fitness, accompanying-person needs and review timing.

Contact MPGCARE to coordinate a bariatric team assessment, an individual method discussion and a written long-term follow-up plan.

Medical information sources

ASMBS/IFSO: Clinical indications · ASMBS: Procedures · NIDDK: Risks · BOMSS: Long-term monitoring · CDC: BMI

ASMBS: Diabetes · ADA/EASD: Remission consensus

ADA: Metabolic surgery guidance