Obesity is a disease... Diet control-Exercise alone is difficult to manage complications
Obesity management and treatment
Obesity caused by various factors such as lifestyle-genetic-endocrine system changes In patients with severe obesity , weight loss effect and diabetes mellitus are small when trying metabolic surgery.
Due to the novel coronavirus infection (COVID-19), the actual number of obese people has increased as the time spent at home increases and the amount of activity decreases. According to the 'National Weight Management Status and Obesity Perception Survey in the Era of Corona 19' published by the Korean Society for Obesity, 4 out of 10 people (46.0%) have gained weight compared to before Corona. However, 8 out of 10 people did not recognize obesity as a disease, such as 'It can be solved by combining diet and exercise' (76%) and 'I do not take it particularly seriously' (9.0%). This was also found in the method of solving obesity, and it was confirmed that they were mainly choosing methods that they could try alone, such as exercise (71%), diet control (66%), and skipping meals (28%).
Obesity and endocrine disorders cause complications
Obesity is classified into primary obesity and secondary obesity according to the cause. Primary obesity is a state in which weight and body fat are increased due to an imbalance between energy intake and energy consumption, and is caused by various factors such as diet, lifestyle, age, race, socioeconomic factors, genetics, and neuroendocrine changes. Secondary obesity can be caused by genetic disorders, congenital disorders, neuroendocrine disorders, mental disorders, drugs, and the like.
Obesity is not an individual problem such as lack of will or negligence in self-management, but a disease that requires professional help like smoking or depression. In particular, highly obese patients with a body mass index (BMI) of 30 kg/m² or higher are more likely to be accompanied by metabolic diseases such as type 2 diabetes, hyperlipidemia, and hypertension.
Kim Won-jun, professor of endocrinology at the Obesity and Metabolic Surgery Center at Gangneung Asan Hospital, said, “It is easy to criticize individuals for thinking that obesity is a problem of lack of will, but in fact, it is a disease that can be caused by complications of endocrine diseases like diabetes, heredity, or neuroendocrine changes.” Severe obesity is closely related to diabetes and is highly likely to cause other complications, so the state is also applying health insurance for surgery.
Obesity metabolic surgery with great improvement in metabolic diseases
According to the guidelines of the Korean Society for Obesity, behavioral therapy, diet therapy, and exercise therapy through lifestyle improvement are primarily recommended as a treatment for obesity. For patients with a body mass index of 25 kg/m² or more, if weight loss is unsuccessful with these non-drug treatments, it is recommended to try drug treatment. Surgical treatment may be considered for patients with a body mass index of 35 kg/m² or more or 30 kg/m² or more and have obesity-related comorbidities. In this case, you may also be eligible for health insurance benefits.
Bariatric metabolic surgery is a treatment method that has a large weight loss effect and long lasting effect and has been proven to be effective in improving accompanying metabolic diseases. According to a follow-up analysis of obese patients in the United States for 8 years, the average weight of patients who underwent bariatric surgery was maintained after losing 20 kg, but the average weight of 232 obese patients who did not undergo surgery did not change. In addition, the incidence of hypertension, diabetes mellitus, and fatty abnormalities was also low 24 months after surgery.
Bariatric metabolic surgery, which is recommended for patients with severe obesity or obese patients with diabetes, is a method to induce weight loss by changing the structure of the gastrointestinal tract. It is divided into 'gastric sleeve resection', which cuts off the upper part of the stomach to reduce intake, and 'gastric bypass', which leaves a small stomach near the esophagus and connects it directly to the small intestine. Medical staff advise that even after bariatric metabolic surgery, lifestyle changes and management and treatment of comorbidities are necessary.
Kim Ji-hoon, professor of surgery at the Obesity and Metabolic Surgery Center at Gangneung Asan Hospital, said, “For obesity and metabolic surgery, both pre- and post-operative management are important. Close cooperation with professional medical staff, including the nutrition team, is necessary,” he said. Professor Kim said, "Because obesity requires continuous management after surgery, it is good to get help from a specialist at a hospital where cooperation is possible among local hospitals."