Medical Ethics:

  1. 1. Autonomy - the patient has the right to choose or refuse treatment.

2 - Good treatment - the profession must treat the patient with full attention

  1. 3. No harm.
  2. 4. Justice - attention to the distribution of scarce health sources and to deciding who deserves to be treated (equity and equality).
  3. 5. Dignity - The patient (and therapist) has the right to dignity.
  4. 6. Honesty and

Types of hormones and their relationship to hunger and weight gain:

  • • Cortisone: is the hormone responsible for dealing with anxiety and stress, and works to increase blood glucose. It increases the desire to eat, especially fats and sugars as well as carbohydrates, has been found that all contribute to the abdominal fat, which is associated with diabetes and blood vessels. The best way to get rid of the increased secretion of cortisone hormone is to reduce the intake of fats and sugars, as it turns out that this hormone increases its activity with sleep deprivation, make sure to get enough sleep.
  • • Leptin and ghrelin: The hormone leptin task is to send signals to the brain in case of satiety and fullness and therefore orders him to stop eating. Guerlain is a hunger hormone and its function is anti-leptin. Its task is to tell the brain that it is time for the body to eat. This is the task of each hormone individually but unfortunately an overlap occurs very often leading to a kind of confusion. We don't eat only when we are hungry. Often we eat for other reasons such as feeling happy or wanting to eat sugar. With the repetition of such methods, the hormones of hunger and satiety are excreted for reasons other than hunger and satiety, causing a state of hormonal imbalance. All this, not to mention the compulsive diet regimens that increase the disorders of hormones within our bodies. We must identify for ourselves signs of satiety that we stop eating immediately after these signs appear.
  • • Estrogen and progesterone: After ovulation occurs in women increases the hormone progesterone within the body of the woman, a hormone that is the body of the woman and equipped for pregnancy. The more this hormone in the body the more women accept to eat more calories. Women also need lifelong female estrogen, especially during menstrual periods and menstrual periods. It was found that the lack of these hormones during the days of the menstrual cycle also pushes women to devour food frequently. All of this leads to increased fat storage inside the body.

Steps to help lose weight without diet:

Drink a glass of water 5-10 minutes before eating.

اذا- If you eat bread and carbohydrates preferably brown bread, rice, and brown noodles.

Breakfast is very important and must contain: protein - fruit - oats in order to help increase the burn during the day.

Replace juices and Pepsi with a glass of water and if you want a taste of water add a lemon.

Allow yourself to eat the meal you love, but it is rich in calories once a week.

Stay away from eating outside the house and instead cook inside the house.

Avoid fried foods and use coconut oil.

- If you won't chew something constantly, take sugar-free gum.

Sports such as walking and running should be part of your daily life.

Don't follow your weight on the scales instead. Follow the difference in your clothes or take a picture of yourself before and after. Remember that keeping the ideal weight is a lifestyle and sport.

Obesity surgery is necessary or recreational?

Only the patient can answer this question

If you suffer from diseases associated with obesity such as pressure, diabetes, heart disease, respiratory and movement problems or if there is a first-class history of these diseases, what are you waiting for?

What are the cases in which obesity surgery is not recommended?

Pregnancy or during the first 3 months after birth or the first months of lactation.

Active gastrointestinal tumors

How do you know if you are obese or not?

BMI is the weight on the square length in meters

More than 30 you are obese

There are many indicators by which you can find out if you are obese and each method, the easiest of these methods is the so-called BROCA Formula which is a simple method that is measured by calculating the length in centimeters -100 = normal weight ideal weight = normal weight -10% "Example: 180 cm-100 = 80 kg -8 = 72" is used to find out how much weight to lose.

What are the best bariatric surgeries?

Gastric sleeve or turn the path? What is the difference between them?

Dr. Ahmed Shabana will explain all the available and appropriate surgeries and the characteristics and conditions of each surgery to get the full success and then the participant in the decision and choose the appropriate surgery according to many criteria, including

Weight, height, age, way of life, marital status, eating, obesity history, consistency, culture, adherence to doctor's instructions and follow-up.

Gastric sleeve: 80% of the stomach is cut, this part to reduce it and to reduce the secretion of 80% of the hunger hormone ghrelin, so hunger is 20% and eating 20%, and the part being eradicated is the part exposed to expansion, the movement of food in the stomach faster and benefit from it all Because it is not affected by digestion and absorption and the rate of descent is excellent without the need for vitamins longevity, only the first 3-6 months and stomach widens after 5 years by a small allow to increase food from 20% to 30%.

Mini transformation: A small pocket is separated from the stomach and connected to the small intestine after 200 cm, so eat less and do not occur digestion and good absorption and this is the basis of the idea of ​​conversion, and when the food arrives to the new stomach filled quickly and reaches the intestines without digestion and come out without absorption and therefore we need supplements and vitamins Longevity So for malnutrition, sweets can be eaten in greater quantity with this process Operation But the patient is more susceptible to damping syndrome, the descent rate is excellent and the new stomach and intestines are more likely to expand in conversion.

What is the appropriate age for the quantization process?

Surgery can be performed for any age from the age of 10 years to the age of 75 years and it mainly helps in the treatment of diseases of pressure and diabetes caused by obesity.

Gastric sleeve features

Quantization of stomach reduction

  • • Less hunger and faster satiety.
  • • Safe, successful and simple operation with 99.9% success rate
  • • Gagging gives you a healthy balanced eating that is enough for the body.
  • • Quantification is a safe and radical solution to obesity and its risks.

Quantization (sound physiological process) does not affect digestive function in terms of digestion and absorption

  • • Does not cause any change in the internal anatomy of the body
  • • So we don't have to take vitamins longevity first 6 months only
  • • Increases the secretion of GLP1, which stimulates the secretion of insulin and therefore improves the burn and treats diabetes
  • • Gagging takes you from an obese person to a normal person.

Gagging has no negative or negative side effects in the future

  • • Gagging increases fertility in men and women for childbearing
  • • Gagging does not affect sexual ability but improves it for the better
  • • Losing weight increases your confidence.

Gagging has proven to be a great success in treating obesity and getting rid of excess weight by 90 to 100%.

Conditions for successful gastric sleeve

Quantum stomach is not deprived of eating, but there are some things that should be avoided only to reach the ideal weight and stay and continue it:

  • Stay away from gas.
  • Stay away from fast food.
  • Very minimized sweets.
  • Very minimized pastry.
  • Very low fried.
  • Not drinking while eating.
  • Stop eating immediately when you feel full.
  • walk daily for half an hour.

Simple exercises and swimming for an hour 3 times a week.

I want to quantize and I am addicted to sweets

A very large proportion of patients who love sweets after quantization occurs a change in their receptors taste and begins to tend to normal food and stop eating sweets.

But minimally invasive surgery remains the best option for dessert addicts.

But total or mini-path transformation requires complete patient adherence to vitamins and longevity analyzes.

I want to quantize and I suffer from reflux

First, determine the percentage, degree and cause of reflux. If the surgeon can repair the cause of reflux, it is possible in some cases to quantify

Features of bowel pathway transformation

 Suitable for dessert addicts, because of the occurrence of damping in the early years, which makes a person hates sweets and fat

It is advised to stop eating high calories until there is no weight gain

Esophageal reflux disease;

Defects divert the bowel

The patient will have to take vitamins for longevity


Frequent diarrhea

If a person thinks they can eat any high-calorie food, they may gain weight

How to prepare for obesity?

 An obese patient should undergo a pre-operative diet

In order to reduce the size of the liver and internal fat, which gives a better chance for the surgeon to perform surgery and reduce the time of operation and improve the condition of the heart and chest, which increases the safety of the operation and anesthesia

 So you get better and less pain after surgery and recovery

It also reduces some of the inflammation in the napkin around the stomach

Treatment of gastrointestinal and gastrointestinal infections

 Prepare the digestive system for the process up to 100% healing rate

Psychologically rehabilitate the post-operative system

- When preparing for any weight loss surgery you'll be able to make a lifetime commitment to more healthy changes in your diet and lifestyle.

- You must tell the doctor of all types of medicines, vitamins and supplements you take may require stopping before the operation.

- Perform medical examinations required by the surgeon.

- Follow a healthy style in the weeks leading up to the process to help you lose weight faster.

- Make sure you have the drinks and soups you need when you leave the hospital.

- Make sure you get the medicines you need after the operation and liquid if necessary under the supervision of a doctor.

Is a certain diet (diet) after the procedure?

The idea of ​​the process is to reduce the size of the stomach, ie, reduce the amount of food intake to it and thus get off the weight occurs automatically, but you eat all varieties.

The only contraindications are sweets, soda and sweets.

Those who resort to a certain diet after the quantization process can say that he did not realize the culture of quantization is to eat all the food items, but a small amount due to the small size of the new stomach, which follows a diet after the operation exposes his body to enter multiple periods of stability in contrast to what happens with Who understands the importance of eating all foods in small quantities and the limits of eating sweets.

What is Stapling Surgery?

Stapling the stomach or V.B.G. Is one of the old obesity surgery canceled and was done by placing a pin on the top of the stomach to separate the upper part of the stomach and then put another network this pin and the goal of narrowing the course of food from the esophagus to the stomach and the person quickly feel fullness and vomiting and proved a catastrophic failure of what happens to the expansion of the top of the network and severe narrowing in The network relies on high-speed fluids.

Some doctors tried to carry out the so-called butterfly process, which is the development of stapling and is not universally recognized and cause damage to the stomach tissue and many disease problems.

- The impact of obesity surgery on chronic diseases:

  • • Pressure, breathing problems, operations and heart? Heart disease and obesity surgeries?

Yes you can undergo bariatric surgery, but you have to go through Have a number of medical tests to better assess your health

Bariatric surgeries have proven to improve many health problems associated with heart disease, including:

Some believe that the deterioration of their health as a result of their diseases of blood pressure and heart make them unsuitable for the operation, and the truth is the exact opposite, these diseases are one of the reasons to undergo the process. See your doctor before surgery for a good preparation before surgery.

  • • Enlarged liver problem prevent the operation?

Most obese people have enlarged liver as a result of increased fat and do not constitute any obstacles to surgery.

  • • Diabetes and obesity surgery?

Does type 2 diabetes make the process more dangerous?

Bariatric surgery is the best treatment for type II diabetes

But with little weight is presented to the doctor to evaluate and determine the type of surgery with minor changes in the technique of surgery and dietary requirements and tests required before and good preparation for the patient to ensure the safety of the patient - This surgery is considered this technique for the treatment of sugar and not for slimming.

As for the first type, the process helps the patient to reduce insulin doses only

Hypertension - High cholesterol - Hypertrophy of the heart muscle.

During the tests, you should tell your surgeon the details of your entire condition.

  • • Dysfunction of thyroid and obesity surgery?

Does a defect in the thyroid gland prevent the operation of the process?

Thyroid rates should be adjusted before any surgical intervention

Thyroid hormone deficiency leads to weight gain, sedimentation of subcutaneous fat and reduced burning rate, but does not prevent gastric sleeve for weight loss. Hormonal therapy and analysis should be taken every two months to control gland function and the results of the process are very satisfactory in weight loss with thyroid patients.

Obesity surgeries improve the metabolic and metabolic processes in the body, which improves the performance of the drug for the thyroid gland. It should be noted that the problem of the thyroid gland has two types Type I increase in secretion is the loss of weight and is not one of the problems that we may face in clinics bariatric surgery.

 In the second case, a lack of secretion of thyroid hormone, which is the cause of existing obesity because the lack of secretion leads to a decrease in the burning of food and thus the accumulation of fat and obesity, and in the second case can not stop the hormone compensatory because obesity resulting from the lack of hormone is not the cause - and Refraining from taking hormone replacement therapy is very dangerous for the patient so it is not advised to stop the drug completely gland.

Does obesity surgery affect sexual desire and sexual process between men and women?

The sexual status of men improves in terms of ability, erection, fertility and desire in women

Pregnancy, childbirth, lactation and obesity surgery:

When can women undergo obesity after childbirth?

In the case of breastfeeding it is preferable to wait before surgery for 6 to 8 months, because the natural milk decreases, but at this age the child begins to eat outside food, which does not affect it -

In the case of artificial or abnormal breastfeeding, surgery can be performed after cesarean section (3 months).

Contraceptives and hormonal pulp

Does not affect the descent of the weight

Ovulation, menstrual cycle, pregnancy and obesity surgery:

Does the process have an effect on ovulation and the menstrual cycle?

Some women suffer from cysts of the ovaries that lead to irregular menstrual cycle

Lack of weight leads to the regularity of the menstrual cycle and works to address hormonal problems that lead to irregular menstrual cycle and ovulation and obesity lead to problems of ovulation and the menstrual cycle so after surgery takes some time to reorganize the hormones and return to normal.

After the operation: Usually occurs after obesity surgery disturbance in the menstrual cycle in terms of the number of times or quantity, whether decreasing or increasing, which is a natural thing is worrying lasts a period of 3 to 6 months and then very regular after that, and accompanied in the few days before or during the menstrual cycle increase In the weight of one kilo to 2 kilograms and after the weight down again.

Smoking and Obesity Surgery:

It is advised to stay away from smoking because obese patients often suffer from chronic diseases such as high blood lipids, diabetes or sleep and breathing problems, so smoking is a key factor in the worsening of these cases but can be practiced these wrong habits after two weeks for For smoking cigarettes and a month for smoking shisha.

Smoking should be discontinued 5 days before the operation, and the Respirometer should be used 3 days before the operation and brought in the hospital 3 days after the operation.

Anesthesia used in bariatric surgery:

Anesthesia type:

Determining the type of anesthesia depends mainly on the decision of the anesthesiologist may be total, half or topical

 This is according to the patient's health condition, but the problems of anesthesia are increased mainly according to the duration of the patient's anesthesia and that one of the most important advantages of laparoscopic quantization surgery is that the patient's duration of anesthesia does not exceed 25 minutes.

What are the tools used in gagging or routing?

Each patient is used:

1 stapler - 1 scissors for separating fat and blood vessels - 5: 6 pins and staples and staplers used are two common types Johnson & Johnson (US), Covidien (US) and each of them has modern technology called

 powered stapler and GST (J&J)

Signia And tristapler 2.0 (covidien)

It is the best and the latest thing except that it is twice the price, and the two companies of the most efficient companies and research and studies on bariatric surgery is done using one of them.

Pins used and bariatric surgeries:

 Fate pins used:

These Aldbabis are made of friendly material for the human body, titanium, which has been used for decades in surgical operations and has no interactions or adverse effects on the body.

After the healing occurs dock the stomach tissue and is considered within the stomach as it does not interfere with the MRI procedure

Do these pins affect the stomach or cause any infection or bacteria in the stomach?

The material made of staples is an inert material that does not react in any way with the body. In addition, we ensure that no bacteria or foreign body can cause infection over time.

Can staples be removed after surgery?

We do not need to remove the pins, which are made of an inert material that does not interact with the body and its presence inside the body there is no harm as the stomach fuses around the pins and its presence after that without damage or benefit.

** Post-Obesity Surgery **

** Possible symptoms after bariatric surgery **

Movement, sports and follow-up action:

When can I move and follow my children after the operation?

After two hours of awakening you can move very naturally but with a commitment to walking light at home and abide by the instructions from the first day to help your children safely.

When can exercise normally?

Movement after two hours and during the first month and a half of walking, and after a month and a half allows the exercise of all kinds of sports.

When can I drive?

After 10 days of operation

When can a marital relationship be practiced?

After two weeks


 It is advised to stop completely and if it is necessary after two weeks of operation

back to work:

Returning to work after the quantization process depends on the quality of work, and varies according to the individual's ability to endure, which varies from person to person, but in general a person can practice his office and light work within two to three days of the operation with ease, as for the field and cumbersome work It is not recommended two weeks before the procedure.

Postoperative pain:

Expected Pains:

There are very minor pains within two days after surgery, especially if the procedure is performed using a microscope technique because the size of the pain is related to the size of the wound resulting from the operation.

- There is a possibility of dizziness or dizziness in the first week of surgery because the body does not get used to the small amounts of food that enter the body after surgery and this only in the first week until the body gets used to the new metabolism.

Back pain after the operation:

Descending weight reduces the pressure that was on the spine and the spine begins to take a second form after getting rid of the pressure that was present and this change causes this pain.

The erosion of joints and vertebrae as a result of weight gain causes osteophytes and the impact of these appendages appears after reducing the surrounding fat and surrounding muscles and ligaments.

Therefore, you should follow the analysis of vitamin D and calcium in the blood.

Some patients may experience shoulder or left arm pain immediately after the operation:

Pain from another part of the body is either from the stomach itself or from the residual gases inside the abdominal cavity. This pain is short-term and goes away on its own. Vomiting:

Gastric sleeve surgery is not one of the surgeries that cause vomiting due to the presence of vomiting. It can lead to vomiting - even without overeating surgery is greater than the stomach's ability to absorb leads to vomiting

What are the causes and ways to avoid them?

1- Eating fast

After quantization, the human brain is still unaware of the quantization requirements, and continues on the same habits prior to the process, which is the speed of eating and eating quickly and in large quantities, which is not suitable for the size of the stomach and the mouth of the small new stomach leading to vomiting.

The solution :

Eating slowly and carefully eating the meal in order to give the stomach a chance that it receives food in a small amount befitting it and can be absorbed smoothly allows you to avoid vomiting and you allow your stomach it works without fatigue.

2 - not good chewing

It is important for the patient to realize after surgery that if the food is not chewed well, it will reach the esophagus in the form of large pieces opposite it and cause vomiting or up the stomach in the form of large values ​​relative to the size of the new small stomach, which leads to nausea and stomach pain.

The solution :

Chewing food well, especially in the beginning of the process because it helps the size of the new stomach to digest and receive a healthy eating properly without pressure and pain.

3 - eating and drinking together

Drinking water with food to help swallowing as the patient did before the operation is one of the most important causes of vomiting due to the limited size of the stomach and mouth of the small stomach after the new quantization, and also this habit may cause pressure and works to expand.

The solution:

Drinking water before or after eating only to help the stomach to focus on eating and the basic meal.If you skipped the period of 6 months after the operation felt hungry at night prefer drinking before eating because the feeling of satiety and fullness, which helps to reduce the amount of eating that you eat at night.

4 - shock the stomach once eating

This condition is not essential, but it can occur when you stop for a long time without eating and then are eating and shocked stomach eating suddenly eat protein, for example, may cause vomiting or pain in the stomach, which is rare, but may occur, a situation that varies from person to person.

The solution:

Make snacks between basic meals, such as vegetables and fruits, which pave your stomach for food.You can also drink warm drinks such as anise and green tea, which is useful in accepting the stomach for food.

5 - qualities of eating

Different eating qualities and different sensitivity of the stomach wall from person to person may be an important factor in vomiting or not, especially at the beginning of the process.

The solution :

From the beginning of the second month after the procedure, all food items are tested and considered to see which may increase the sensitivity of the stomach wall and is avoided and return after a period, and which does not affect them and it is possible to support the observations of the items in the ticket paper.

  1. 6. The patient may have a cold

Solution: Commitment to medicines


What is GERD?

A condition that results from a weak physiological valve between the esophagus and the stomach, which leads to the reflux of stomach acid into the esophagus, usually if the new stomach is too tight and lead to inflammation of the esophagus and throat and cough at night and vomiting yellow substance is the gastric juice.

What are its causes?

The reason for reflux is that patients eat their food quickly or large bites or drink water immediately after food or lie down after food and drink .. This is part of our wrong behavior before eating, and, we are supposed to reprogram the brain on the right ways to eat and that avoided this problem .. .

Ways to avoid and treat it?

  • • Please eat small bits equal to one sixth or a quarter of the size of the old bite.
  • • Chew well and grind teeth.
  • • Do not lie down after food, drink or sleep for hours after petals.
  • • Depending on the system of 4 or 5 meals during the day and abstain from one meal system.
  • • Avoid smoke or shisha ... and coffee ... and psychological tension.
  • • It is advised to take Nexium .. mg twice a day and Zantak 40 mg twice a day and Javiscon 300 when severe acidity.

Constipation after obesity surgery


After obesity surgery it is expected that there will be some changes in routine digestion as well as a change in bowel movement

Low water intake is one of the factors that contribute to constipation after obesity surgery


  • • Drink a glass of orange juice without filtering in the morning

Drink 2 to 3 liters of fluids per day

  • • Eating fruits .. especially (apricot .. Peach .. Berries .. Dried fruits .. Watermelon)
  • • Eat plenty of lettuce and cucumber without peel
  • • Eat green salad daily
  • • Eat a cup of low-fat yogurt daily with 2 hanging chia seeds are considered a remedy for constipation because it is rich in soluble fiber
  • • Walk daily for an hour to regulate bowel movement

In the case of the application of all natural remedies and there is no improvement we resort to the use of treatment for constipation

  • • Herbal_Mentholax (for chronic constipation, accidental, gas repellent and anti-cramps)

 There are no contraindications to its use - use 2 capsules if necessary

  • • Picolax_points - use 10 - 15 drops daily

Dizziness and dizziness after obesity surgery:


Low blood pressure due to lack of fluids and low blood sugar


Drink plenty of fluids

  • • Increase protein in eating ... Bean .. Eggs .. Legumes .. Tuna .. Chicken and the like protein and then power and components and then water and reduce the starches
  • • When moving from sleep mode or sitting is slow; because the body in the case of lack of Swaile and protein does not deal quickly with the change of pressure with movement, so we care not to move from position to a position suddenly until drinking enough fluid.

Headache after obesity surgery:


One of the main causes of headaches and lack of concentration after surgery is the lack of nutrition and lack of fluid and this is evident in the transformation surgery because of the impact on the absorption of food, but with quantization chances of this symptom is very small, but if it occurs in the first week only after surgery As a result of the body is not accustomed to lack of food


Some supplements and drinking water and the beginning of the body's new metabolism ends supply completely.

What is the treatment of cold and congestion after bariatric surgery?

 Treatment in case of cold and sore throat

  • • Augmentin antibiotic syrup or injection
  • • Tavanic 500 antibiotic (if older than 18 years)
  • • Panadol Cold Ink Flow once every ويتم hour and the disc is broken into two pieces
  • • With Claritin tablet every 12 hours
  • • Drink a large amount of warm fluids
  • • The orange juice

Hair loss after bariatric surgery

Temporary and not permanent viewer

the reasons:

  • • Not eating enough proteins
  • • Do not eat fresh vegetables and fruits containing sufficient vitamins
  • • Insufficient fluid intake
  • • Iron and zinc deficiency
  • • Vitamin B and d deficiency
  • • *Psychological state

Methods of treatment of hair loss after obesity surgery

  • • Eat a healthy balanced diet with a sufficient amount of protein 70 gm daily
  • • Eat fish continuously several times during the week because the fish is rich in omega-3, which helps to reduce the rate of hair loss
  • • Adjust the level of iron in the blood
  • • Adjust your blood zinc level
  • • Cut the ends of the hair regularly helps to get rid of damaged hair
  • • Prevent the use of hair dyes for a year
  • • Follow up with a psychiatrist
  • • Biotin 10000 or preorinoperfective plus or hair and nails with shampoo and serum kaminomoto or Shea butter
  • • Visit a leather consultant
  • • There are also a range of oils important for hair growth and reduce hair loss

Jadayel oil is available in pharmacies

  • • Can also make a range of oils

Castor oil - watercress oil - coconut oil - jojoba oil

Oils are mixed with each other and used daily on the scalp

  • • Hair vitamins which do not cause weight gain and do not open appetite, take the full dose

It is the best vitamins


Priorin N

Hair vit



  • • Blood test


Iron stores

vit D level & zinc level

  • • If you have anemia you need to take iron treatment 3-6 months ”

See your doctor

Bariatric Surgery

Obesity surgeries do not cure the already existing contraindications - the patient is usually advised to carry out sports starting from the second month of surgery, especially swimming and fitness exercises with drinking fluid amounts of not less than 3 liters per day and if the patient is committed to there will be a problem of contagion only what was present before If the sagging occurs, the solution will be the coordination and sculpting of the textures and begin consideration after reaching the ideal weight almost a year after surgery

How to avoid congestion after weight loss:

It is possible to avoid sagging by drinking too much water and adhering to protein at the beginning of the meal because it works to increase the burn with the elasticity of the skin and provide it with natural vitamin and after the month of commitment to sports and the most powerful sports to tighten the body safely swimming, zumba and walking.

What is cellulite?

Cellulite is a disorder of the subcutaneous connective tissue that causes scarring or orange peel, which affects the external appearance of the body.

Steps to prevent and alleviate cellulite:

  • • Maintaining exercise on a daily basis, to include all areas of the external musculature of the body, and make sure to sweat in the meantime.
  • • Avoid obesity, as it is one of the most important factors forming cellulite.
  • • Treatment of hormonal disorders in the body, through the detection of medical tests periodically.
  • • Eat a healthy diet, and avoid bad eating habits, such as eating fat and starches in large quantities, as well as stimulants such as: tea, strength, and soft drinks, as they contribute to the increased likelihood of the formation of cellulite.
  • • Avoid exposure to stress, it is reflected negatively on the health and freshness of the body.

Avoid tight clothing that presses the skin layer, especially The lower limb area.

  • • Use cosmetics such as special creams to prevent and reduce cellulite formation.
  • • The use of some devices specially manufactured for this purpose that help stimulate blood circulation and thus reduce cellulite.
  • • Mesotherapy sessions, which proved the results of its effectiveness to reduce cellulite without resorting to cosmetic surgery.

What are topical and strength control surgeries?

Normal Liposuction, Laser Lipo Smart and High Definition VASER

 We must distinguish between general and local obesity because it is wrong to deal with general obesity by localized solutions and therefore do not give the expected result and lose confidence in surgical interventions, although the error is not in the intervention but in the choice; because all these solutions were invented and used to treat problems of local obesity The body is at the ideal weight stage.

Damming syndrome

What is Daming Syndrome?

  • • It is a process that occurs as a result of the speed of food moving from the stomach to the intestines and that is much higher in the course of diversion than in quantization.
  • • What are the types?
  • • Type I
  • • Occurs after 15 to 30 minutes of eating and symptoms of a tendency to vomit or vomiting diarrhea cramps abdominal sense of fullness rapid heartbeat blurred sense of heat the body ...
  • • The second type
  • • It occurs after eating a high sugars meal and occurs after about 1 to 3 hours and symptoms of severe sweat rapid heartbeat lack of concentration with a sense of hunger and disturbance and a sense of fatigue and dizziness, which may reach fainting and studies confirm that the occurrence of the first type much higher than the second And there are few patients may suffer from the occurrence of both types
  • • What are the causes?
  • • The first type occurs as a result of the expansion of the intestine with food with the movement of fluid from the blood to the intestines and the release of some hormones from the intestine that reduce blood pressure.
  • • The second type occurs as a result of the arrival of a quantity of sugars to the intestine quickly lead to increased secretion of insulin, which leads to hypoglycemia.
  • • How to diagnose and symptoms?

Dizziness, fatigue, sweating, accelerated pulse, nausea

  • • Diagnosis of the condition is easy from the history of the symptoms and symptoms can be confirmed diagnosis by the work of the blood glucose curve or the work of the examination of the speed of emptying the stomach food using food radioactive substance is tracked movement.
  • • How can they be treated?
  • • First change the food system
  • • 1 - Depending on the number of more meals in smaller quantities (6 meals instead of 3)

Chewing food very well

3 - There is a break between any drink and food at least half an hour

  • • 4 - stay away from foods high sugars note, for example, that the milk is a low percentage of sugar and eating a large cup of milk may lead to symptoms occur note that sugar-free alternatives do not lead to the occurrence of Damping

5 - eat high-fiber food (pectin) to reduce the absorption of carbohydrates from the intestines such as plums, apples and plums

6 - Stay away from high-acid foods such as tomatoes, lemons and oranges

  • • 7 - relying on cooking methods of cooking little or no fat such as grilling instead of frying
  • • Lying on the bed after eating reduces the speed of food going down the intestines
  • • Secondly use some medications (please do not use any of them without consulting your doctor)

Glucopay is a drug used for diabetics that has been found to reduce damaging symptoms.

  • • 2-Sandostatin subcutaneous injection.

Change of mental state and depression after the operation:

Some complainants complain of mood swings and psychosis after the operation, and does not know what the reason despite the descent of weight .... The first days of the operation are very normal sense of remorse and this is a result of preventing eating the first period after the operation - but this feeling does not exceed ten days to a month only.

Depression after obesity:

(Occurs in degrees not everyone): Most people do not imagine that depression occurs after surgery to lose weight, but most important life changes may be followed by depression such as: travel to a new country or a new job or the birth of a child .. The reasons are many. Most of the cases are very happy to complete the operation successfully and the start of the observed weight loss, but this may be accompanied by changes in mood and moments of depression ..

What are its causes?

 1 / Excessive attention from family and friends may be accompanied by a sense of weakness and compassion for the patient himself as well as vice versa the lack of interest expected from friends and family.

 2 / severe shortage due to the burning of large amounts of fat and may cause the secretion of too much estrogen and this leads to sharp changes in mood.

 3 / Expect great changes in life after the change of weight, as if the patient imagines that all the disturbance in his life is caused by obesity and once you get rid of it will turn his life magically to the best and this of course does not happen drastically.

4 / The rapid change in weight in some cases makes the patient surprised himself and does not recognize them and accompanied by a change in mood.

 5 / Also one of the most important causes of depression is the lack of a loyal friend who used to share and comfort them in their problems, joys and unity (food).

How to avoid and treat it?

One of the most important tips to overcome depression and mood swings: Exercise because it secretes the hormone endorphins that cause happiness and improve mood.

Gallbladder and obesity surgery:


The proportion of patients who undergo obesity operations to the formation of gallstones in the gallbladder as it is known that gallstones can be formed after any rapid weight loss, whether by diet or by conducting obesity.

Gallstones after gastric bypass surgery consist of a greater proportion of patients undergoing quantification and some of these patients need to undergo cholecystectomy with obesity surgery.

Treatment and prevention:

  • • To prevent the occurrence of please drink large amounts of fluids and try not to stay for a long time without eating
  • • It is possible to take treatments to prevent gallstones

Ursofalk Tablets (500 mg) - twice daily

Does the stomach expand after quantization?

A question posed by many speakers. To answer this question, we must explain the subject with three clear points

  1. 1. Meandering on the inner gastric membrane

The gagged and non-gastric stomach has the ability to stretch. Thanks to the meandering on the inner stomach membrane. Meandering is medically called Gastric Rugae

These meanders do not cause gastric dilatation after gagging. But if the patient is fasting for long periods shrink aliasing causing contraction of the size of the stomach, and after eating these aliasing causes an expansion of the stomach. I go back and remind you that this is a natural expansion that occurs in the gagged and ungodly stomach

  1. 2. There is often no expansion after the operation

Most cases of quantization remove 80% to 85% of the stomach. A small part of the stomach remains 20% to 15% and after the first 6 to 12 months it reaches 25% to 30%, and with time it reaches 40% and does not expand any further under any circumstances, it is very rare to expand and expand in Place the operation or the size of the stomach becomes larger. But the patient's fear of beginning the process of pain and vomiting goes away over time; gradually the patient learns how to handle meals, suggesting that the stomach has expanded

  1. 3. Rare cases

The stomach may actually expand after gagging, either because of drinking effervescent and gaseous fluids or intentionally eating too much

A medical mistake from the surgeon was that the head of the stomach was not completely removed. In such cases the endoscope is returned to the patient to ensure that the head of the stomach is stretched due to non-removal

How can the patient evaluate the success of the operation?

Herein lies the skill of the surgeon

  1. 1. Hunger is less

Eat less but saturated

  1. 3. Vomiting does not occur
  2. 4. No wasting, dizziness or prolapse

4.There is no fatigue and fluids or water

  1. 5. Lose excess weight quietly

Aesthetic form

  1. 7. No mineral or vitamin deficiency occurs
  2. 8. There are no wounds

Is it possible to have a pregnancy after the operation?

Obesity is one of the causes of delayed childbearing due to its significant impact on the process of ovulation in women, so getting rid of obesity is one of the main treatments for delayed childbearing and obesity also have an impact on the health of the fetus in pregnancy with obesity, so it is preferred to conceive after successful surgery to reduce weight to The ideal weight is 6 months to 12 months after surgery.

Pregnant women who are pregnant at the ideal weight to be pregnant and her baby healthier, compared with those who are suffering from obesity, so it is preferable to conceive after 6 months of the operation.


My weight during pregnancy

The first three months

# No increase or increase is expected with a maximum of 1-2 kg.

 # The first months of pregnancy are accompanied by symptoms such as fatigue, loss of appetite and better

 1.Dividing meals into 4 or 5 snacks.

  1. 2. Eating digestible and low-fat foods such as live toast, fruits and vegetables, low-fat meat and fish.
  2. 3. Drink enough fluids, especially water and natural juices.
  3. 4. Eat plenty of foods rich in folic acid such as dark leafy vegetables, spinach and legumes such as beans, lentils, nuts, orange juice and broccoli.
  4. 5. Drink 2-3 cups of milk or equivalent dairy products per day.
  5. 6. Prevent eating and fasting for long hours is not desirable in the first months.

From the fourth to the ninth month

The symptoms of anorexia disappear and the placenta begins to function as an important plant for supplying the baby with food. Here you should pay attention to the weight ... It is best to follow a healthy diet to avoid any excess threatening the life of the mother or child.

How do I regain my weight after birth?

Average weight gain in pregnancy from 8 to 12 kg

There are specific points to know


How much weight after birth? There is a slight increase: such that the weight is 60 and becomes 72 kg (20%). And a medium increase: such as the weight of 60 and become 78 kilograms (30%). And a significant increase, such as weight 60 before pregnancy and becomes 84 (40%) or more


How long did it take to regain my weight? The slight increase takes 3-6 months. The average increase, takes 6-9 months. The large increase takes 9 months, a year or more


We do not allow harsh diet, except in four cases:

Pregnancy sugar - Preeclampsia (high blood pressure) - Depression - Special and very important events


Diet at 11 points:

No sugars

Pans and fat are forbidden

It is forbidden to pray to the glut

Limited quantities are allowed

High carbohydrates in fiber

Nuts, nuts and beans

 The Sudanese


Open quantities are allowed



Soups soup

Herbal Tea



Sports: The best sport is walking. For women after normal childbirth it is possible to exercise walking two weeks after birth. Sports of all kinds should be postponed after caesarean section until after 40. But we encourage walking inside the house


If you apply all of the above and you still find it difficult to lose weight. Check your sleep schedule. You should get 4-5 hours of continuous sleep. To reduce cortisol and raise burning. Don't be shy about asking for help from family and relatives.

Diet and vitamins after surgery:

Eating Rate:

In the first year, the dietary intake is 600-800 calories per day and the body needs 1,800 calories.

With the descent of weight, the rate of burning decreases from 1800 to 1200-1400 per day and the concomitant widening of the stomach and the rate of burning increases to 1000-1200 until there is a balance in the amount of food and lost and does not fall under the ideal weight or malnutrition.


The quantization process is distinguished from diverting it does not affect the absorption of nutrients in the body and the lack of some vitamins, salts and proteins is a temporary condition as a result of poor nutrition in the first months after quantization.

The quantization process has many techniques and depends on the experience and professionalism of the surgeon if the surgery is performed properly will maintain the function of the stomach normal without compromising the ability to digestion and absorption process, so we do not need to take vitamins longevity and are taking dietary supplement in the first months after surgery to The patient will get used to eating and gradually integrated food.

  1. 1. Most people in the Middle East suffer from a general lack of vitamin D - due to the lack of sun exposure at sunrise and sunset dates, therefore, the patient is forced to take a vitamin D injection once and then complete the treatment with tablets for 3 months Vitamin D3 (concentration 5000) once a day

2 - Vitamin B This vitamin is absorbed from the last part of the small intestine, but it occurs digestion in the stomach if not protected by a substance secreted from the stomach called intrinsic factor and this substance is reduced in some cases after gastric sleeve procedure and therefore is taken by injection Or sprayer for 3 to 6 months

3 - Biotin for hair is taking a type of hair vitamins (Biotin 10000 or Perfectil Plus or Priorin

4 - If the patient suffers from iron deficiency and anemia before surgery and if the patient does not take into account the healthy healthy nutrition integrated it is possible to take iron through the tablets - with follow-up after 6 months once in gastric sleeve and follow-up every 6 months in the course of the following tests Zinc, phosphorus, calcium and magnesium with the knowledge that these elements decrease in pathway conversion.

Descending weight:

Rates of descent:

Lose weight after surgery is gradually due to the defensive plans of the body to resist starvation and the point of stability of the weight through which it reduces the rate of burning and increase the rates of hunger and continue for a month and then resume the descent of the weight and that is better for the body to regain its balance, so do not worry about the descent of weight During the promotion of the body through sports.

Weight loss rates depend on the patient's commitment to a healthy diet after surgery and is not recommended to lose weight more than certain proportions and preferable staging to be in the first month about 20% of excess weight - within 6 months 50% of excess weight - a year from 60% to 90 %.

There is no fixed period in any weight loss process, but there is a patient who can benefit most from the process if he can change his lifestyle and eating habits with sports.

Experience has shown that only those who reach the ideal healthy are able to change their way of life and add sports to their weekly schedule.

There are many factors that determine weight loss after bariatric surgery:

Quality of Eating:

Reliance on high-calorie food (such as chips, biscuits, sweets, baked pate, donuts, chocolate croissant, white sugar, pepsi and many fats)

Second, eating unbalanced health

Third constipation and retention Swail and menstrual cycle

The lack of certain vitamins such as B and D and the lack of certain minerals such as iron and calcium

  1. V. Gastric dilatation

Sixth: Do not take responsibility for your weight, health and weak will

Weight Fastness:

- Once periods of stability occur, people usually get frustrated, and imagine that the process is no longer working or that there is a problem and therefore always emphasize that follow-up after the process is very important; so that we can solve such problems easily.

What are the causes of weight stability?

  • • Unhealthy eating
  • • High calorie foods
  • • The reaction of the body to the presence of a point of stability of the weight in which it reduces the rates of burning
  • • Expansion of the stomach and increase the proportion of eating

Vitamin B12 deficiency and d

  • • Willingness and lack of responsibility towards your weight


  • • Anemia
  • • Irregular meals.
  • • Organizing meal schedules is very important for increased burn
  • • Neglect of vegetables in the meal
  • • Lack of movement or physical activity
  • • Continuation of varieties of eating for a long period is necessary to change our eating system and type each period in order to break the stability of weight
  • • Lack of water, drink, very necessary 2 liters a day. Because water helps to detox and increase fat burning.

- Weight stability is of two types:

  • • Type I:

Sometimes weight loss seems to be consistent while you continue to change the size of your clothes; this is because the body fat is re-coordinated in certain places that have more fat than others, in which case your criteria are clothing size or your body measurement with tape

  • • Type II:

The weight and clothing size is fixed and this means that you are either not in compliance with the instructions or that the body enters into normal periods in which the loss of weight to rebuild itself in other respects a rest period, this period may last up to 6 weeks do not worry in these periods.

- Solution: In general, if there are periods of stability, please see the following:

  • • Types of high-calorie eating even if in small quantities.
  • • Eating all day and not on fixed dates (3 meals + 2 snacks).
  • • The time between meals is 3 to 4 hours and not less than 2 hours.
  • • Sports and activity in general, but if you are committed to sports, please change the type of exercise to do another group of muscles work, and get a quick boost of weight loss.

Drink water at least 2 liters, or 6-8 glasses a day, not juice, because water accelerates all fat burning processes.

  • • Taking vitamins is very important for fast and healthy weight loss.

- Once the missing link is fixed, weight loss usually begins quickly.

- If you adhere to all the instructions accurately and yet notice that your weight is beginning to prove, the magic solution is to eat something high calories in a meal above the normal level, and this deceives the body and stir fat burning processes quickly, but you should not repeat because this will help Weight on stability.

When do we worry about weight stability?

خفاض Low metabolic rate

البروتينLack of protein

🔸 Follow the same diet for a long time

فاف Drought

🔸 Lack of sleep and stress

 The balance is fixed but the shape changes?

It is a stage called the plateau stage in which the muscle mass that weighs more than fat is increased.In this stage, the descent of the weight is more pronounced in mirrors, sizes of confusion and body shape than on the balance.Therefore, we advise the patient after despair because it is a temporary stage and then reach the ideal weight and shape.

How is weight stability broken?

  • • Choose the right healthy eating.
  • • Make more effort as a sport.
  • • Good follow-up with the doctor.
  • • The work of analyzes of vitamins and blood picture taking compensatory treatment after follow-up.
  • • Follow-up increase at the first 2-3 kg resort to the fluid system for 3-5 days to break the stability and trigger the burning rates.

If stability is due to wrong eating habits or because the body is stopped to maintain itself here we begin the system of breaking stability:

 It is a system in which we shock the body at more calories than usual. It consists of:

  • • 2 days open more calories than usual and then
  • • 3 days of fruit, such as apple, watermelon, bananas, cantaloupe, oranges, peaches, all fruits except mango, grapes, figs and dates, in addition to yogurt light and vegetable soup
  • • Exercise in gym or walk daily.

Diet 45 days after surgery:

In principle 3 to 5 meals should be eaten but the variety should be varied to avoid stability;

Examples of breakfast meals:

Eggs With Cheese, Cucumber, Lettuce, Tomato, Grated Carrot, Rocca With Brown Or Baladi Toast.

Or beans with boiled potatoes with cumin, salt, black pepper and live in addition to the side vegetables.

Or fruit problem.

Or egg mashed potatoes.

Or there are no problems with tablet graft with the most important thing a variety of vegetables with live.

Examples of lunch:

Fried chicken or meat or any type of protein P oil is better to avoid and eat it in a more healthy way by placing in the oven and to avoid fatigue, especially the first period should contain a meal tomorrow protein and vegetables and starches.

At satiety it is possible to stop and complete lunch after a while.

Examples of dinner:

- Boiled eggs for example - fruit by yogurt - Kobaya fresh orange juice to avoid constipation

When ordering fast food, a lighter variety is selected

- It is important not to neglect drinking water 2 liters or more.

- Chewing food is very good.

- Do not drink before eating half an hour and after eating half an hour.

- Daily walking is very important after the operation.

- For sweets once a week after the third month.

- All kinds of fruits are allowed but in limited quantities and not wasteful.

Introduction to Food Psychology:

 Why do you like eating?

Why did you find your happiness in it?

** For the presence of sugar **

Sugar is present in all varieties even if you do not eat sweets, but sugar is present in many other starches, such as living most types.

To understand why sugar is classified as the number one enemy of humanity, the components of sugar must be understood first:

Sugar before it enters the blood from the digestive system is divided into two simple sugars (glucose and fructose)

Glucose is found in every living cell on Earth and can be synthesized in the body if not eaten.

Fructose is a different kind; it cannot be synthesized in the body and is eaten only in food. There is no physiological need for it and it is burned in the liver but in certain quantities.

This is not a big problem if the person is moving a lot or the nature of his work muscular movement, for example:

If you play sports and you finish the exercise and eat a fruit, your energy stores are empty so the liver will use the fruit sugar you eat to fill the energy stores of one fruit, but the increase in fructose liver can not deal with it and It raises insulin resistance in the body and is stored in the form of fat over time and this is one of the main causes of obesity, especially childhood obesity and diabetes type II ..

This means that (many tablespoons of sugar - sweets - chips and cookies and cola - and pastries - Basboush - Cinnamon - rice - Donuts - living white Baladi - Venu brown - tooth - croissant - pate - and most of what is sold in the supermarket) almost contains fructose. The large amount of sugar consumed by sugar addicts can cause fat on the liver and enlargement of the liver and can also cause the same diseases as alcohol addicts.

But why do we feel dizziness, headache and mood disorder once you refrain from eating sugar, but feel better mood once you eat a sweet or fast food or burger or pizza and others ?!

Because that food is processed in laboratories and has a very large amount of fructose, and fructose secretes dopamine, which is one of the hormones of comfort and happiness and intensely as if you are in an addictive state.

The less dopamine secretion you have, the more you eat it, especially the sweets and chocolates, ice cream, popcorn, caramel, carbohydrates, chocolates and others.

Finally you are a sugar addict formally and scientific and must be addressed because over the days you need more amounts of sugar!

Until you are surprised that you have become diabetic.

The solution is to take off

Like an addict, you will experience symptoms of withdrawal, depression, and impaired mood.

Bulimia Nervosa:

Is a mental disorder that affects women more than men - 8: 2.

The patient suffers from fear of being overweight

Vomiting (using finger, spoons, or pens)

2⃣Excessive use of laxatives

Exercise too much

Intensive use of diuretics

Causes of constant fatigue include:

  • • Lack of sleep
  • • Not eating enough food
  • • Anemia
  • • Depression
  • • Hypothyroidism
  • • Caffeine addiction
  • • Vitamin D deficiency

Chronic abdominal gas causes include:

  • • Chronic constipation
  • • IBS
  • • Milk allergy
  • • Celiac disease
  • • Obesity
  • • Smoking

Early symptoms of protein deficiency?

  • • Weight loss
  • • Tired
  • • Anxiety
  • • Low disease resistance
  • • In children cause slow growth
  • • And many more see your doctor

Causes of heat from the feet:

  • • Effect of sugar nerve p
  • • Vitamin B12 deficiency
  • • Inflammation of the foot lining
  • • The disc back presses the nerves
  • • Obesity
  • • Gout

Varicose veins

Symptoms of diabetes:

  • • Extreme thirst and hunger
  • • Blurry vision
  • • Numbness and numbness of the limbs
  • • Slow wound fusion
  • • Unexplained weight loss
  • • Feeling tired
  • • frequent urination

 Clear gastrointestinal symptoms in the small intestine:

- Stomach germ secretes harmful bacteria that eliminate most of the vitamins and minerals, so the small intestine absorbs bacteria and transports them from the digestive system to the blood system, which leads to:

  • • Vitamin D deficiency.
  • • Vitamin B12 deficiency.
  • • Calcium deficiency.
  • • Iron deficiency.

Some important points for those who underwent obesity surgery:

 Fast walking and water exercises are moderate-intensity aerobic exercises that urge sufficient effort, which is shown to increase the speed of the heart and cause sweating.

 The descent of weight depends on eating and quantity and sports auxiliary factor, but its importance in tightening the body and sculpture.

Lack of water in the body is the main cause of fatigue, lethargy, fatigue, joint pain, muscle and headache.

Excessive painkillers are one of the most common causes of gastritis.

 Avoid frequent stiff diets in order to lose weight because this deprives the bones of protein, leading to fragility.

 Waking up early contributes to keeping your weight moderate; it helps you sleep early and prevents you from eating late at night.

Reflux esophagus is one of the most common causes of chronic cough (which is absent even from some doctors) even in the absence of any symptoms such as a burning stomach and others see your doctor.

 one cup of yogurt provides the body with 30% of his daily need for calcium and 20% of vitamin D and is an ideal meal for weight loss

People with high cholesterol are advised to eat fiber-rich vegetables, such as beans because they lower cholesterol.

 Eat dinner at least 3 hours before bedtime to be digested and avoid weight gain.

Excessive thinness for no apparent reason indicates endocrine problems, the most important of which are hyperactivity Hyperthyroidism.