Sixty-seven people in Europe have contracted botulism after undergoing weight-loss surgery using botulinum neurotoxin in Turkey. The news raises questions about the safety of such interventions. Over the past decade, Turkey has become a haven for low-cost implants and surgeries, but things haven’t always ended up being as cheap as planned.
Cases of botulism are iatrogenic, meaning they occur as a result of medical intervention. However, its origin is unknown. It is not clear whether it is produced by bad habits or by the toxin itself.
The use of botulinum neurotoxin for weight loss has not been studied outside of clinical studies. It is used without any scientific basis and may pose unknown risks. The use of this toxin by intragastric injection causes the muscular walls of the stomach to relax. Theoretically, this process slows the rate at which your stomach empties and increases the feeling of fullness, so you eat less and lose weight. However, no studies have demonstrated the functionality of this procedure. If effective, the intervention should be repeated every 5-6 months, as the effects of the toxin are reduced.
I have had patients undergone bariatric surgery in Turkey who did not know what technique was used, did not receive any reports or post-operative instructions. Two days after the operation, they flew home. I have no doubt that there are clinics that follow the correct protocol, but my experience is this: patients do not know what to do after the intervention, there is a lack of post-operative tests, nutritional guidelines and medical management.
Bariatric surgery is recommended for patients with a body mass index (BMI) of 35 or greater when dietary changes are ineffective, regardless of comorbidities, and is also considered for patients with a BMI of 30 to 34.9 who have metabolic disease.
The patient’s psychological state should also be evaluated to determine if there is an eating disorder or ingestion of toxic substances. A multidisciplinary team consisting of a surgeon, nutritionist, and psychologist or psychiatrist should evaluate candidates and provide post-surgery follow-up.
Although bariatric surgery is necessary and successful for most people who undergo it, many people do not have enough information before deciding to undergo surgery.
Regardless of the quality of the surgery, patients will need to make lifelong changes to their diet, physical activity, and lifestyle. You should also consider the risks associated with the surgery.
Dietary changes most often begin before surgery. It is recommended to consume a liquid diet for at least two weeks before and after surgery to minimize risks. Solid foods will be reintroduced in stages. When the digestive system is affected, patients may experience vomiting, diarrhea, difficulty swallowing, and dumping syndrome (rapid gastric emptying that occurs within 10 minutes to 2 to 3 hours after eating).
Nutritional intake must be monitored to avoid nutritional deficiencies. Patients should follow a diet plan according to their needs, lifestyle, and social and economic situation.
It’s tempting to think that it’s easy to change your body shape through surgery. Therefore, psychological follow-up is recommended. The body changes quickly, but the mind needs professional help to absorb the changes. Generally, excess skin remains on the body. As with any intervention, post-operative testing is required.
Bariatric surgery is a much more complicated process than rumored. Health is not just about weight.
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