Who bariatric surgery is actually for
This is the treatment where we decline the highest proportion of enquiries, deliberately. Criteria exist because the operation is permanent and the risks are real.
| BMI | Qualifies when |
|---|---|
| 40 and above | Generally eligible on BMI alone |
| 35–39.9 | With an obesity-related condition: type 2 diabetes, sleep apnoea, hypertension, severe joint disease |
| 30–34.9 | Only with poorly controlled type 2 diabetes, and even then case by case |
| Below 30 | Not eligible for surgery with us, whatever you have been told elsewhere |
Work out where you sit with the weight-loss surgery calculator, and see what a realistic target weight looks like with the ideal weight calculator. Both run entirely in your browser — the numbers never reach us.
Who we decline
- BMI below the threshold for the procedure. Operating outside criteria is how this field got its reputation.
- An uncontrolled eating disorder. Surgery makes bulimia and binge-eating disorder more dangerous, not less.
- Untreated substance dependence, including alcohol.
- No realistic plan for lifelong supplements and follow-up. Without those, a bypass causes deficiency disease.
- A decision driven by someone else rather than by you.
- An expectation that the operation fixes why you eat. It does not, and that gap is where late regain comes from.
Sleeve, bypass, or neither
The right answer depends on your reflux, your diabetes and your willingness to take supplements for life — not on price.
| Procedure | Excess weight lost at 12–18 months | Reversible | Best when |
|---|---|---|---|
| Gastric sleeve | 55–70% | No | No significant reflux; simpler operation preferred |
| Gastric bypass | 65–80% | Technically, rarely | Reflux, or type 2 diabetes you want in remission |
| Mini gastric bypass | 65–80% | More easily than a full bypass | Similar to bypass, technically simpler |
| Gastric balloon | 10–15% of total weight | Yes — removed at 6–12 months | A temporary measure, or a trial before committing |
| Gastric botox | 5–10% of total weight | Yes — wears off | Modest, temporary. Genuinely minor |
| Revision surgery | Variable, usually lower | No | A previous procedure that failed or caused reflux |
How to read "excess weight loss"
It is the percentage of weight above your ideal body weight that you lose — not of your total weight. Someone of 140 kg with an ideal weight of 70 kg has 70 kg of excess; losing 65% of that reaches 95 kg, not 70. Clinics quote the percentage because it is the bigger number. Ask for the expected figure in kilograms.
What also improves
- Type 2 diabetes goes into remission in roughly 60–80% of cases after bypass, often within weeks and before much weight has gone.
- Obstructive sleep apnoea improves substantially in most patients, frequently to the point of stopping CPAP.
- Hypertension improves or resolves in around half.
- Joint pain, mobility and fertility typically improve markedly.
- These are what a clinician cares about most, and none of them appear in a photograph.
The part that is lifelong
The operation takes ninety minutes. Everything that determines whether it works takes the rest of your life.
- Protein, every day, permanently. The single most modifiable factor in your result and the one most often neglected. Losing weight as muscle turns a good outcome into a poor one.
- Supplements for life after a bypass, and usually after a sleeve. Deficiency is the commonest avoidable long-term complication and it is entirely preventable.
- Annual blood tests — B12, iron, folate, vitamin D, calcium. Arrange these at home before you travel, not after a problem appears.
- Resistance exercise, which protects muscle mass as the weight comes off.
- Addressing why you ate. Surgery restricts the stomach and does nothing to stress, boredom, grief or habit. Where food was the coping mechanism, something has to replace it.
- Follow-up. Patients with structured follow-up keep meaningfully more weight off at five years. It is the strongest argument against treating surgery abroad as a transaction.
The plateau
Loss slows markedly at months six to nine, for nearly everyone, as metabolic rate adjusts to a smaller body. It is a physiological adjustment, not a failure — and the people who do worst long-term are often the ones who gave up during it.
Safety, stay length and the corner that gets cut
Bariatric surgery is major abdominal surgery on patients who are, by definition, higher risk. The stay length is not a package option.
- A JCI-accredited hospital with intensive care on site, not a day clinic. Non-negotiable for this procedure.
- A consultant anaesthetist present throughout, with experience of bariatric airway management.
- A leak test during the operation, and imaging before discharge.
- Seven to ten nights in Turkey minimum. Leaks typically present on days three to seven, which is precisely the window a short package sends you home in.
- Anticoagulation and early mobilisation. This group is at elevated risk of clots, and flying too early compounds it.
- A dietitian before and after, with the staged diet written down in your own language.
| When | What happens | Typical loss |
|---|---|---|
| Weeks 1–4 | Liquid then pureed diet; rapid loss, much of it fluid | 5–10 kg |
| Months 2–3 | Soft then normal textures. Fastest sustained period | 10–18 kg total |
| Months 4–6 | Steady loss, energy returning, exercise realistic | 20–30 kg total |
| Months 6–9 | The plateau. Normal, not failure | 25–35 kg total |
| Months 9–18 | Slower loss toward the lowest point | 30–45 kg total |
| Months 18–24 | Stabilises; some regain is expected | Settles 10–20% above the low point |
Weight-loss surgery in Turkey: frequently asked questions
40 and above generally qualifies on BMI alone; 35–39.9 with an obesity-related condition such as type 2 diabetes or sleep apnoea. Below 30 we decline, whatever you have been told elsewhere.
Bypass produces more loss and is better for reflux and type 2 diabetes, at the cost of lifelong supplements and a more complex operation. Sleeve is simpler but can worsen reflux. The right answer depends on your case, not the price difference.
55–70% of excess weight after a sleeve, 65–80% after a bypass, at 12–18 months. Ask for the figure in kilograms — clinics quote the percentage because it is the larger number.
Most people regain 10–20% of what they lost between years two and five, settling well below their starting weight. The strongest predictor of where you end up is whether anyone was still supporting you at year three.
Almost certainly not. The plateau at months six to nine happens to nearly everyone as metabolic rate adjusts. Giving up during it is what causes genuinely poor long-term results.
Seven to ten nights minimum. Leaks typically present on days three to seven, which is exactly the window a short package would send you home in. This is a clinical figure, not a package option.
After a bypass, yes, and usually after a sleeve too. Deficiency is the commonest avoidable long-term complication and it is entirely preventable with a daily routine and annual bloods.
Above about 40 kg of loss, significant excess skin is the norm. Age, how long you carried the weight and skin quality matter more than how fast you lose it. Contouring comes at least 18 months later.
No. It restricts the stomach and does nothing to stress, boredom, grief or habit. Where food was the coping mechanism something has to replace it, and that is where most late regain comes from.
Possibly. Bariatric surgery is funded on medical grounds in several health systems where BMI and comorbidity criteria are met and a supervised programme has been completed. Ask your GP before paying anyone, including us.
As a temporary measure or a trial, sometimes. It produces 10–15% of total weight loss and is removed at 6–12 months, with most people regaining afterwards unless the habits changed. It is not a substitute for surgery where surgery is indicated.
BMI below threshold, uncontrolled eating disorder, untreated substance dependence, no plan for lifelong supplements and follow-up, or a decision that is not clearly the patient’s own. It is the procedure where we say no most often, on purpose.
