Dr. Instructor Member Erhan Gönen warned that obesity, one of the leading health problems of our time, has an impact on the heart. Dr. Instructor Gönen, who said that obesity is as important a risk factor as smoking and alcohol in recent studies, said, “Obesity has many harmful effects on the heart. These can be direct and indirect effects according to their mechanisms. Simply put, the heart has to pump blood to a larger body mass and this increases the workload of the heart. The heart responds to this increased workload by increasing its size and this is the starting point of the deterioration of its functions. When pathological conditions such as insulin resistance, high cholesterol, and dysfunction of vessel wall cells, which are associated with obesity, are added to the table, the risk of heart disease increases considerably. The fact that obese patients are not suitable for diagnostic devices designed for individuals with normal weight, the difficulties encountered in obese patients in evaluating the tests, and the inactivity of patients also increase the risk of heart disease.


Gonen, who made statements about heart diseases seen in obese people, used the following statements:

“Coronary artery disease is the most feared heart-related problem in overweight individuals on the background of risk factors. Although patients are known to be at risk, their complaints such as chest pain and shortness of breath may be attributed to their excess weight and diagnosis may be delayed. Complication development rate in procedures performed in diagnosed patients is higher in obese patients. As a result of malformation of the heart, a picture of heart failure may develop. Hypertension is also more common in obese patients. And it is more difficult to evaluate the efficacy of treatment as a result of the use of inappropriate measuring instruments. If there is snoring at night in an obese patient with hypertension, obstructive sleep apnea syndrome (OSAS), which is characterized by respiratory arrest during sleep, should be considered. Just like the heart vessels, there may be narrowing of the vessels going to the brain and legs. Obese patients are also more likely to have rhythm problems.”


Dr. Instructor Member Gonen also gave information about how obesity surgery affects heart health and said, “First of all, contrary to what is wrongly known, the purpose of these surgeries is not aesthetic concerns. Both American and European treatment guidelines recommend performing these surgeries when certain conditions arise. It was observed that the malformation of the heart improved and the contraction and relaxation functions began to normalize from the first year in patients who had undergone surgery and adhered to lifestyle changes. It has been confirmed in many studies that the incidence of heart attack decreases and blood pressure control becomes easier. It has become easier to control the symptoms of OSAS patients. When we sum up all these, we can say that these operations significantly reduce the risks of heart diseases.


Pointing out that obesity surgeries do not trigger a heart attack, contrary to general belief, Dr. Instructor Member Gönen said, “This is a very general expression and it would not be correct to use it in this way. First of all, even a simple eye surgery has a low risk of heart disease. The important thing here is that the benefit we will gain is much greater than the risk we take. Therefore, we should make a person-based assessment and go to the operation by correctly managing the risks of the patient. This applies not only to bariatric surgery but to all operations. A patient who does not have any additional risk factors and does not have bad results in preoperative tests has a low risk of heart. Such a risk increase in obesity surgeries is only as much as other intra-abdominal surgeries, there is no specific risk increase for these operations. However, if the person does not comply with lifestyle changes and does not take into account the doctor’s recommendations, just like normal people in the postoperative period, the risk naturally increases.


Dr. Instructor Member Gonen listed the points to be considered for heart health as follows:

“Combating the changeable risk factors in our lives is the first and most effective method of prevention. What are modifiable risk factors? We cannot change our age, gender or genetic predisposition. But we can move more, quit smoking, diet and experience weight loss and lower cholesterol values. We should not use drugs and food supplements that do not have scientific evidence, and we should not prefer them to the treatment recommended by our doctor.”

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