As winter approaches in earnest, the physical activity of people shrunken by the cold is decreasing. Although the amount of exercise is already low due to Corona 19, the metabolism is falling due to the cold, and the prevalence of obesity is increasing.
According to the recent announcement of the ‘National Health and Nutrition Examination Survey, 3rd year (2021) results’ announced by the Korea Centers for Disease Control and Prevention, the prevalence of obesity in 2019, just before the outbreak of Corona 19, was 41.8% for men and 25.0% for women, but Corona 19 was prevalent. In 2021, two years later, both men and women increased to 46% male and 26.9% female.
As obesity increases, the possibility of developing diabetes due to insulin resistance increases, and it can cause complications due to metabolic diseases such as myocardial infarction and stroke. Since severe obesity can be life-threatening, obesity must be recognized as a disease and treated.
▲Severe obesity causes life-threatening metabolic diseases and various diseases
Obesity occurs when activity is low compared to intake of nutrients, and refers to an excessive amount of adipose tissue. Excessive fat cells accumulated in the body secrete inflammatory substances and active oxygen, which interferes with metabolism and leads to a vicious cycle of accumulating fat and creating inflammation again.
In general, a body mass index (BMI) of 30 or more is called severe obesity. In the case of severe obesity, metabolic syndrome such as hypertension, hyperglycemia, and hyperlipidemia inevitably follows. Metabolic syndrome, also called ‘lifestyle-related disease’, increases the incidence of diabetes due to insulin resistance and causes cardiovascular and cerebrovascular diseases such as myocardial infarction and stroke.
In addition, severe obesity causes menstrual irregularities or infertility due to hormonal imbalance, and various diseases due to non-alcoholic fatty liver, sleep apnea, and chronic inflammation. In addition, the incidence of various cancers such as colorectal cancer and breast cancer increases, so it should be recognized as a serious life-threatening disease.
Severe obesity is a major cause of hormonal imbalance along with genetic and environmental factors, so it is difficult to improve it by controlling eating habits or exercising alone. In addition, since our body has homeostasis to maintain weight, the yo-yo phenomenon occurs after dieting, so there is a limit to losing weight by one’s own will.
▲ Obesity metabolism surgery is a key maker of daily recovery
Recently, obesity metabolism surgery is being performed as an effective method for treating severe obesity. Currently, there are sleeve gastrectomy, which cuts the stomach vertically to reduce its volume, and ‘Ruwai gastric bypass,’ which skips ingested food to the small intestine along with gastric resection.
The surgical method is decided after close consultation with the doctor according to the patient’s condition and whether there are complications such as diabetes. However, in the case of Lou-Yi gastric bypass, sleeve gastrectomy is often chosen in Korea, where the incidence of gastric cancer is high because postoperative endoscopy is difficult.
Sleeve gastrectomy is a method of restricting food intake by reducing the size of the stomach, reducing about 80% of its normal volume. It is characterized by maintaining normal function because it only reduces the volume without damaging the sphincter that moves above and below the stomach. After surgery, secretion of ‘ghrelin’, an appetite stimulating hormone, is also suppressed, which helps to reduce appetite.
The government has also recognized the dangers of obesity and has applied health insurance since 2019. Subjects are ▲ Body Mass Index (BMI) of 35 or more ▲ Body Mass Index (BMI) of 30 or more accompanied by complications (diabetes, sleep apnea, polycystic ovary syndrome, etc.) ▲ Body Mass Index (BMI) of 27.5 or more and second if you have type 2 diabetes.
In the case of severe obesity, bariatric surgery is the most effective long-term proven method, but it should be accompanied by a thorough diet and steady self-management after surgery.