Cristian Bosolac was operated on by Professor Doctor Catalin Copaescu 7 years ago. After gastric bypass surgery, most of the chronic health problems improved considerably. When he decided to do the surgery, Cristian Bosolac was 35 years old, he had 140 kilograms and a body mass index of over 37kg/m2, meaning second degree obesity and diabetes, with him being already dependent on insulin.

The struggle with excessive kilograms

When he was 18 years old, Cristian gave up performance sports and focused on continuing his studies. The lack of constant physical activity was one of the factors that led to the accumulation of excessive kilograms. He tried to follow diets aimed at weight loss, but without results, although he also consulted a nutritionist. Even more than that, after periods of dieting, in which he managed to lose a few kilograms, he returned to his usual diet and quickly regained what he had lost, always adding a few more kilograms.

Diabetes was not the only problem. Cristian had moving difficulty, breathing difficulty, and sleep apnea. Moreover, he was constantly tired, he suffered from lumbar pain, and had a very low level of self-esteem. Like any overweight young man, he tended to get isolated and blame himself for the excessive kilograms.

"The decision to do the surgery was sudden"

"The surgery changed my life for the better. I became a different person in just a few months after the surgery. I think that the decision to do the surgery was the best one I made for myself and all I can say is that since the moment I found out that there were solutions and until I arrived on the surgery table, only 5- 6 days have passed", says Cristian Bosolac.  

The surgery was performed laparoscopically by Professor Doctor Catalin Copaescu. After a first checkup, a complete set of analyses followed. Following them, he was diagnosed with high blood pressure, enlarged spleen, second-degree hepatic steatosis, pancreas infiltrated with fat and kidney hypertrophy, plus gastritis that always gave him pain, all in addition to diabetes and obesity. Simply saying, an organism that suffered deeply as a result of excessive fat, with the vital organs and their functions affected.

The investigations also highlighted a body mass index of 37.2 kg/m2, which indicates second-degree obesity with an excess of adipose tissue of almost 15% and a weight surplus of almost 40%. For his 187 cm height, Cristian should have weighed at most 77-78 kilograms. But he weighed 130 kilograms, and he had an abdominal circumference of 130 centimeters, with the largest fat deposits located at this level.

"For Dr. Copaescu, I was a trivial case. It wasn't necessary to convince me, I didn't need too many explanations. I admit that 7 years ago I didn't even know much about what it meant metabolic surgery, but the fact that I had real chances to lose weight and that this could help me get rid of insulin injections were, for me, sufficient arguments to do the surgery", says Cristian. After a short pause, he added: "I remember that the doctor called me to a seminar on bariatric surgeries. I don't remember all the details, but I know that I had a feeling of comfort in the presence of Dr. Copaescu. I had full confidence that the surgical solution he proposed was the optimal one. And so it was!", concludes the patient.  

It’s good to know that choosing a certain type of bariatric surgery depends on the condition of each individual patient. Professor Dr. Catalin Copaescu explains: "We determine the most suitable type of bariatric surgery for each patient, depending on a series of factors that the medical team analyzes in detail. It’s about the body mass index, sex, age, lifestyle, type of body distribution of obesity, duration since the onset of type-2 diabetes, and other associated conditions. All this is analyzed, and in the end, one or another type of surgery is chosen. In this case, the gastric bypass was the ideal solution". 

After the surgery

The gastric bypass surgery, considered to be one of the most effective bariatric surgical procedures, took place on June 30, 2015, through a laparoscopic approach. During the surgery, a small portion of the stomach is isolated, immediately following the esophagus, which joins the small intestine. Food reaches only the upper part of the stomach, in this "small stomach" and passes directly into the intestine, where it will come into contact with the digestive juices produced in the rest of the stomach.

The immediate effect of the surgery is the ingestion of a very small volume of food, the fats and sugars in the food are no longer absorbed because the portion of the small intestine where their assimilation occurs is "out of order".

A complementary effect is the very fast appearance of the feeling of satiety.
After the surgery, Cristian lost about 40 kilograms within three months. One year after the surgery, he had reached the ideal weight of 78 kilograms. Practically, he lost 60% of the body mass he had before the bariatric surgery, namely the entire excessive weight.

Recovery and monitoring after surgery

"The surgery changed my life for the better. I have effectively become a different person. I went home three days after the surgery and started to lose weight. I had no dietary restrictions, but I could only eat very little, without any suffering due to the feeling of hunger. And when I saw and felt how I was losing weight, it was more than encouraging. The most fantastic thing was that the day after the surgery I stopped needing insulin", said Cristian.

He was monitored according to the protocols, and this included a visit to the doctor 10 days and 1 month after the surgery, then every three months during the next year. Now he goes to the doctor, for checkups, only once a year.

The great benefit, after the weight loss, was that the pancreatic function improved substantially, without the need for daily treatment with insulin. The metabolic problems caused by diabetes have improved quickly and considerably, only needing to support pancreatic function with oral medication. The blood pressure has returned to normal values, the kidney function has rebalanced, it is currently within the ideal physiological parameters, and the biological constants that show the state of the liver are within normal limits.

"Weight loss is the main mechanism that explains the remission of diabetes, by increasing the insulin sensitivity of the peripheral tissues. Recent studies, however, also indicate hormonal mechanisms that are improved by the surgical treatment, the normalization of blood sugar occurring in the first postoperative days, before weight loss. Moreover, if for a period of 5 years, the patient does not show signs of diabetes under the conditions in which he doesn’t follow any anti-diabetic treatment, we can tell that he is cured", explains Professor Dr. Catalin Copaescu.

The only Center of Excellence in Bariatric Surgery in Romania

The only Center of Excellence in Metabolic and Bariatric Surgery in Romania, with double international, European, and American accreditation, is located in Ponderas Academic Hospital. The Center has all the necessary resources for the complete treatment of obesity and its associated problems, and the team, with multiple specializations, is close to the patients at every stage of the bariatric program while ensuring all the required investigations before surgery, the surgical 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 paid to the direct communication between the patient and the doctor, their needs are always being taken into account, which is why the medical team includes a psychologist who offers counseling.

Patients benefit from guidance and support from the first contact with the doctor, while having a dedicated personnel close to them.

7 years later

Recently, it has been seven years since the bariatric surgery, and Cristian maintains his ideal weight and feels very well.

"I still eat very little. I got used to this style for a long time and it's already something normal for me. I don't have any health problems. The lumbar pains disappeared a few months after the surgery, I sleep well, I no longer have sleep apnea, and I no longer have stomach pains. The analyses are perfect, I don't have any kind of nutrient deficiency. I eat as varied food as possible, but I don't impose restrictions on myself, because I get full quickly and I don't have any discomfort due to the feeling of hunger", Cristian concludes his story.

The gastric bypass type surgery is a bariatric procedure that contributes to the improvement of metabolic diseases associated with obesity: diabetes, high blood pressure, hepatic steatosis, causing the loss of over 80% of excessive weight. It is equally important that, due to the changes applied to the digestive tract, adapted to the needs of each patient, they are preserved in the long term and they can represent the solution for obesity and diabetes.

Author: Silvana Patrascanu, Senior Medical Editor

Consultant: Professor Doctor Catalin Copaescu, Medical Director of Ponderas Academic Hospital