The experience that Bianca, Dr. Bogdan Smeu's patient, went through in the Center of Excellence in Bariatric Surgery at Ponderas Academic Hospital, is one that demonstrates that the benefits of the surgery are not only related to weight loss, but can improve the associated diseases until they are cured. In most cases, obesity surgery contributed to the improvement of metabolic suffering, remission of type-2 diabetes and hepatic steatosis. In case of Bianca, in addition to the spectacular weight loss and the regaining of hormonal balance, the benefit was also at the hormonal level, with the function of thyroid gland returning to normal.

"Family understood me and helped me!"

"From the moment I decided to do the surgery and until I actually arrived in the bariatric surgery room, 4 days passed. Before, I weighed 96 kilograms and I actually couldn't stand it anymore. My father has a good friend who told him about someone who had the surgery. He told him that it’s easy, that the recovery is simple and the results are spectacular. My father told me and that was it! My father knew how much I suffered because of weight, he knew that I was depressed, that I couldn't find myself anymore. I was also after the second birth, the second cesarean section... I wasn’t OK at all!", says Bianca, 29 years old.

Bianca's medical problems started from a thyroid dysfunction, a hormone deficiency compensated to some extent with medication, which was the trigger for the weight gain. Two pregnancies were added to this, which also brought excessive kilograms.

"I was eating disorderly, I was attracted to fried, fatty foods, I needed sweets. Probably also on the background of an anxious mental state. I decided that a radical intervention was needed, and the stomach reduction surgery was recommended to me by Dr. Bogdan Smeu, the doctor who took care of me and who induced an exceptional state of comfort and confidence in myself, so I had not the slightest hesitation" continues Bianca.

Bariatric surgery wasn’t Bianca's first attempt to get rid of excessive weight. Before the gastric sleeve, she had repeated but failed attempts to follow restrictive diets. Even if she was losing weight, the excessive kilograms kept coming back. She also did cosmetic surgery on the limbs, which led, over time, to an even greater increase in the abdominal fat mass.

Liposuction interventions before bariatric surgery are not indicated. As a general rule, some obese patients, who have undergone bariatric surgery, can do surgeries to remove the excessive skin, after the weight loss process ends, and their weight stabilizes and the patient reaches the desired weight. Aesthetic surgery treats the effect of caloric excess and not its cause, and this is why it’s recommended that weight loss and maintenance at the desired weight be achieved before a body remodeling procedure", explains Dr. Bogdan Smeu, primary general surgeon, Surgeon of Excellence in Metabolic and Bariatric Surgery.

"They didn't recognize me at customs in the passport photo!"

Now Bianca weighs 48 kilograms, she has a perfectly balanced life and an excellent state of health, which has improved considerably. 14 months have passed since the laparoscopic surgery performed by Dr. Bogdan Smeu. During this interval, Bianca lost 48 kilograms. Basically, the young woman halved her body weight, reaching an ideal weight from second-degree obesity. Moreover, the weight loss was uniform, and the fat deposits in the abdomen (circumference before the surgery was 98 cm) disappeared.

"I recently traveled abroad and I had problems at customs. Actually, they didn't recognize me in the passport photo. I simply didn’t realize how big the transformation was. I lost weight constantly, continuously and I didn’t perceive how radical the change in physiognomy was. In the end, I briefly told the customs employees about the surgery and that's how I was able to pass, on the condition that I change my documents urgently", says Bianca while smiling.

"The patient has reached the ideal weight, as it is in the standards and as we anticipated that it would happen after the gastric sleeve. When we assess a patient before the surgery, we calculate both the body mass index at the time, as well as the ideal value it should have. The data are summarized in tables, based on previous studies. The difference between the two values also shows us what is excessive body mass, and it establishes a target that we aim to reach after the effective surgery, during the monitoring of the patient", adds Dr. Bogdan Smeu. "In this case, we also took into account thyroid dysfunction, a favorable factor for obesity, hypofunction of the thyroid having a direct impact on the rate of basal metabolism, which falls far below normal, which makes burning very low, so the accumulation of adipose tissue is favored", adds the surgeon. 

"I have a healthy life, I’m a different person!"

Bianca has now regained her health, she has the capacity to exercise and she feels good in her own skin.

„I succeeded, and I’m very proud of it, not only to eat a little, but also very healthy. I completely gave up fried and fatty foods, I eat lean meat, vegetables, and fruits. I have three main meals a day and two snacks. I can eat about 80-100 grams of food at a meal, I always choose vegetables and fruits and I notice that I’m full of energy and I maintain my weight without any problems. There’s no longer the feeling of hunger, I no longer have cravings, and if I have, it’s very easy for me to control myself. But the greatest joy is that I no longer need thyroid medication. Practically, the hypothyroidism disappeared, due to the weight loss. My thyroid secretes exactly the required amount of hormones and helps me to have a normal metabolism. The tests I did prove this!”, completes Bianca.

The post-operative recovery was easy and fast, and the adaptation to the new lifestyle happened very quickly.

„This experience changed me. I’m another person. And the ease of this transition is the effect of the way I was treated at Ponderas Academic Hospital. Care and attention are taken to the maximum possible. Regarding Dr. Bogdan Smeu, I can say that he is an incredible person. Warm, and attentive, he encouraged me and smiled at me all the time. I can't tell you how much patience he had to explain everything I asked him. There is a wonderful team out there that does wonders for people like me!”, concluded Bianca.

Hormonal balance and obesity

Obesity can also be a hormonal disorder and it is associated with several endocrine abnormalities, including infertility and/or thyroid dysfunction. There is a direct link between hypothyroidism and obesity. Thyroid hormone deficiency occurs relatively frequently in obese patients. At the same time, thyroid dysfunction is a favorable factor for excessive weight.

Bianca's case is not an exception. Medical practice and clinical studies have proven that the management of obesity through the gastric sleeve also has the benefit of regulating thyroid function. Normalization occurs gradually, as body mass is reduced, and the effect of bariatric surgery on hormonal rebalancing has been proven.

The Center of Excellence in Bariatric Surgery

The only Center of Excellence in Metabolic and Bariatric Surgery in Romania, with double international accreditation: European and American, is located in Ponderas Academic Hospital. The Center has all the required resources for the complete treatment of obesity and its associated problems, and the team, with multiple specializations, can provide all the necessary investigations before the surgery, the surgical (laparoscopic) treatment, and the post-operative monitoring program.

The approach to each case is customized, and standardized protocols are followed for patient safety and for maximum efficiency of the surgical intervention. Special attention is given to the direct communication between the patient and the doctor, their needs always being taken into account, which is why the medical team includes a psychologist who offers the necessary support. Patients benefit from

Author: Silvana Patrascanu, Senior Medical Editor

Consultant: Doctor Bogdan Smeu, general primary surgeon