Necdet Derici is a Turkish bariatric surgeon with many years of experience in the surgical treatment of obesity. He specializes in weight-loss procedures, including sleeve gastrectomy and other modern bariatric techniques. The doctor works extensively with international patients, providing detailed consultations on preoperative preparation, postoperative recovery, and long-term weight management. In the interview, he shares his professional perspective on safe and effective weight reduction and explains what results can be expected when obesity treatment is approached comprehensively.
The interview was conducted by Maria Chabdaeva, Director of the international organization Beauty by Experts Medical. Under her leadership, the company organizes medical travel for patients seeking plastic surgery with leading specialists around the world.
Good afternoon. Today we are interviewing Dr. Necdet. He is one of the leading specialists in the field of bariatric surgery.
The Surgeon’s Experience and the особенities of Sleeve Gastrectomy
- Please tell us about your experience. How many years have you been practicing? What education have you received?
I have been performing surgeries since 1995. For almost 29 years, I have carried out all types of procedures: sleeve gastrectomy, gastric bypass, revision surgeries, and metabolic (diabetes) surgery. So I truly have extensive experience.
- Overall, how many bariatric surgeries have you performed throughout your career?
It is difficult to calculate the exact number, but I have performed more than 10,000 surgical procedures, including obesity-related operations. Approximately half of them were for the treatment of obesity and diabetes.
- That is impressive. Let’s focus a bit on sleeve gastrectomy. What are the indications for this surgery?
An important parameter for performing this surgery is the body mass index (BMI). If patients have a BMI over 40, or a BMI over 35 accompanied by metabolic disorders, we can perform a sleeve gastrectomy.
- How is sleeve gastrectomy performed?
We usually use a laparoscopic method. That is why patients stay in the hospital for a very short time — one or two days — and the recovery period is less painful. They can typically return to work quite quickly, within a week. After the surgery, patients do not experience severe pain, and this is truly a very important point.
- What are the contraindications for this surgery?
We do not recommend sleeve gastrectomy for patients who are too young or too old. Additional contraindications include serious heart or lung problems, chronic diseases, and malignant tumors.
- What do you mean by too old or too young? What are the age limits?
If a patient is 12–13 years old, we do not operate. We usually perform the surgery after the age of 18. We also do not perform sleeve gastrectomy after the age of 65.
- Are there any heart conditions or infectious diseases that may be contraindications for surgery?
Of course, if there are heart conditions that make surgery dangerous, we do not perform the operation.
- Can we send you medical reports in advance to find out whether the patient has any contraindications?
Of course, we will review them. We thoroughly examine everything before surgery. If there are any contraindications, we inform the patients.
- Based on your experience, what results can patients expect after sleeve gastrectomy? How many kilograms do they usually lose?
Yes. Yesterday, I operated on a patient, and her mother told me, “You performed my surgery last year.” I honestly did not recognize her. People truly change — they can lose more than 40% of their total body weight.
- What does the amount of weight loss usually depend on?
For example, I operated on a patient who weighed 220 kg. One year later, her weight was 108 kg. The intensity of weight loss depends on the individual characteristics of a person’s body, but typically patients lose more than 40% of their total body weight.
- Do they lose weight gradually? Over what period of time?
As a rule, patients lose weight over a period of three years after surgery. Usually, the first six months are faster, then the process slows down slightly. This continues for about three years. After that, we advise patients to exercise regularly and follow a proper diet in order to avoid regaining weight.
- Weight can return, am I right?
All patients may gain some weight again, but they never return to their initial weight. Usually, up to 10% of body weight may come back. To prevent this, we stay in contact with patients and explain that they should exercise regularly and follow a proper diet.
Preparation for Surgery and Postoperative Follow-Up
- How should patients prepare for surgery? Should they try to lose weight on their own or not?
This is a very important question because patients often come to doctors and ask to be operated on immediately. This is truly dangerous. Before surgery, we prepare patients with a high-protein diet. During this period, they can lose approximately 4–5% of their total body weight. This makes the operation easier and safer. After the diet, the internal fat layer is significantly reduced, the liver volume becomes smaller, which greatly decreases the risk of surgical complications.
- How long should they follow the diet and how are they instructed regarding their nutritional plan?
It depends on the patient’s BMI. Preoperative preparation may take from three weeks to three months. If the BMI is around 40, the dietary plan is followed for 3 weeks; if the BMI exceeds 60–70, dietary preparation lasts 2–3 months.
- I see. So patients consult with a dietitian who prescribes an individual nutrition plan for them, correct?
The dietitian prepares patients before surgery and continuously monitors them after the surgical procedure. You know, this is work with “equipment” ☺, so we monitor our patients like equipment.
- And my next question: which specialists work with the patient to achieve the best results?
Patients are regularly monitored by the surgeon and the dietitian. However, before surgery they are usually examined by a cardiologist, an anesthesiologist, a psychiatrist, and a psychologist.
- And after the operation, how is follow-up organized?
Yes. We consult patients during the first week, the first month, the third month, and then every six months for life.
- As I understand, you and the dietitian supervise the patients?
Correct. Dietitians monitor patients on a regular basis. However, consultations with the surgeon are also important. We usually perform a follow-up endoscopic examination one year after sleeve gastrectomy.
- What restrictions are there after surgery?
After gastric bypass, patients follow a special diet. They can only consume light foods. For the first 10 days, we provide liquid nutrition, then for 3 months semi-liquid food, and after that the patient can gradually return to normal eating. These are general recommendations; more specific guidance is provided by the dietitian depending on the individual characteristics of the patient.
- How do patients feel after surgery? Do they feel hungry and unable to eat, or do they not feel hunger?
Yes, patients usually do not experience a feeling of hunger. In general, they feel well. However, after sleeve gastrectomy they may experience some discomfort. After gastric bypass, they usually feel better. They can eat light foods without significant problems.
- What about supplements? Do patients need to take additional vitamins such as vitamin B or others?
Of course, definitely. After surgery for obesity and diabetes, patients lose more than 40% of their initial body weight. They are able to consume only very small portions of food. Therefore, it is important to additionally take vitamins, minerals, and medications to protect the stomach. After surgery, we prescribe blood thinners for 10 days. Vitamins are always prescribed. We recommend that our patients undergo regular blood tests to timely detect decreased levels or deficiencies of iron, vitamin D, or other essential nutrients required by the body.
Gastric Bypass, Diabetic Surgery, and Possible Complications
- How is gastric bypass surgery performed?
It is performed similarly to sleeve gastrectomy — laparoscopically. Patients also stay in the hospital for two days. They can start eating the day after surgery. For the surgeon, it is a much more complex operation compared to sleeve gastrectomy, but for the patient there is practically no difference. In fact, it can even be more beneficial for them, as it allows easier eating in the years to come.
- Do they not need to follow a diet?
No, but they can.
After bypass surgery, patients cannot eat large amounts because the volume of their stomach is very small. However, we still recommend being cautious — following a healthy diet and not forgetting about physical activity. These recommendations are very important for all patients, regardless of the type of surgery they have undergone.
- How can we determine which patient is more suitable for sleeve gastrectomy, gastric bypass, or perhaps gastric banding?
Yes. In most cases, we recommend sleeve gastrectomy. Usually, this procedure is sufficient for weight loss. It is a simple, fast, and cost-effective method for treating obesity. However, if a patient has diabetes or metabolic problems, we usually advise gastric bypass. In cases of severe diabetes, I recommend biliopancreatic diversion.
- In general, does the choice of procedure depend on whether the patient has diabetes or other conditions?
Yes, exactly.
- I know that sleeve gastrectomy is one of the methods for treating diabetic patients. How does it work, and what benefits does the patient get from this operation?
Patients are usually very satisfied with this procedure, as it fundamentally changes their appearance. Sometimes they are hard to recognize when they return after six months and look genuinely happy. Often, one patient will bring another within a year.
- Does the operation help reduce blood sugar levels? Can patients take fewer medications afterward? Does it completely cure diabetes? What are the medical benefits for patients?
Sleeve gastrectomy, gastric bypass, and biliopancreatic diversion – all these procedures treat diabetes. However, for patients with this condition, we recommend gastric bypass and biliopancreatic diversion. For example, sleeve gastrectomy helps cure diabetes in 70% of cases, gastric bypass in 80–85%, and biliopancreatic diversion in 85–90%. Therefore, within diabetic surgery, we prefer gastric and biliopancreatic bypass. Sleeve gastrectomy is mainly performed for weight loss.
- Understood. How does the treatment plan for diabetic patients change after gastric bypass? Do they need fewer medications, or is their blood sugar better controlled? What is the outcome after surgery?
Diabetic patients often experience significant health improvements after bariatric surgery. Their blood sugar levels decrease substantially, which can lead to a reduction or even complete discontinuation of anti-diabetic medications.
- We know that after significant weight loss, excess skin can appear. When is surgery to remove excess skin indicated?
I usually advise patients to wait up to three years because the weight loss process is still ongoing during this period. Understandably, many people want to remove excess skin as soon as possible – within six months or a year. However, I still recommend waiting three years.
- Am I correct in understanding that after three years, the patient will still have a small stomach volume and can eat small portions, but will no longer lose weight?
After three years – no.
- Understood. Do scars remain after surgery?
Scars may remain in patients prone to keloid formation. In more than 95% of people, no scars remain.
- How large can the scars be?
Postoperative scars usually become almost invisible within six months.
- Okay. Could you tell us more about possible complications of the surgery?
The most common complications of bariatric surgery are bleeding, pulmonary embolism, thromboembolism, and infection. They occur in 3–6% of cases. Much depends on the surgeon’s experience. If the surgeon has performed a large number of such operations, the risk of complications is minimized.
- Is it possible for a patient to experience serious complications after returning home? For example, if everything went well in the Istanbul hospital, but the patient develops complications at home. Is this possible?
Late complications can occur. These may include intra-abdominal adhesions and ileus (intestinal obstruction). However, the likelihood of such complications is less than 1%. In such cases, the patient must contact the hospital where the surgery was performed.
- Are you prepared for such follow-ups?
We are always in contact with our patients.
- Could you please explain more about gastric banding? In what cases is this procedure indicated? It is a less invasive surgery, right?
Correct.
- What is the surgical technique?
To improve my skills in performing this procedure, I worked with Mr. de Lemons in Belgium and Mr. Tapas in France. Mr. Tapas even came to Turkey to help me refine my surgical technique. As I see it, gastric banding is still performed in Europe, but in Turkey we have abandoned this procedure. Between 2000 and 2010, I practiced it, but in reality, gastric banding is no longer considered a good option.
- Why?
First, the results are not very good. Second, complications may arise — infection of the band or migration of the band into the stomach wall. Unfortunately, such problems do occur. Therefore, we no longer perform this operation.
- If we compare gastric banding, gastric bypass, and sleeve gastrectomy, in which case does the patient require a longer and stricter diet?
Correct. Gastric bypass is generally more effective than sleeve gastrectomy. However, every surgery has both advantages and disadvantages that should be considered. Sleeve gastrectomy alone is usually sufficient for weight loss. But if the patient has diabetes or metabolic syndrome, we typically recommend gastric bypass.
- Can we say that gastric bypass is more effective in terms of weight loss, or does the patient lose almost the same amount of weight with gastric banding and sleeve gastrectomy?
For weight loss, all procedures are equally effective.
- So, if a patient simply wants to lose weight, is sleeve gastrectomy sufficient? And is the post-operative diet less strict than after gastric bypass?
After gastric bypass, there is a higher risk of vitamin and mineral deficiencies. Therefore, patients need to monitor their health more carefully.
- I believe this information is very useful for our patients. Thank you very much. It was very interesting to talk with you.
Thank you very much.
How to travel to Turkey for weight loss surgery with Necdet Derici?
To arrange a bariatric surgery trip with Necdet Derici, you need to contact the physician coordinators at Beauty by Experts Medical via the phone numbers listed on the website or submit a request on the clinic page. Specialists will promptly consult with you, help prepare medical documents and examination results for the surgeon, and organize a preliminary remote review of your case.
Beauty by Experts Medical recommends only verified clinics and top specialists personally selected by Director Maria Chabdaeva. All medical centers undergo strict quality control, have modern equipment, and receive numerous positive reviews from patients around the world.
Physician coordinators support the patient at every stage — from trip planning to returning home. They assist with booking flights and hotels, organize transfers, provide translation, and maintain continuous communication during the stay in Turkey. The comprehensive support from the Beauty by Experts Medical team and the extensive experience of Necdet Derici in bariatric surgery allow patients to safely undergo the operation and take an important step toward weight loss, better health, and improved quality of life.
