detail
*It has been translated using AI
The view of obesity in Korean society is still trapped in the frame of ‘self-management failure’. In fact, according to a 2023 survey by the Korean Society of Obesity, 58% of 1,000 adult men and women aged 20 to 59 said they “look like they are lazy” about obese or overweight, and 56% said they “look like they lack willpower and self-control.” I even gain weight again after losing weightAs for the reason for the phenomenon, 39% cited “lack of individual will.”
Experts point out that this “weight stigma” is the biggest obstacle to shrinking patients and hindering professional treatment. In order to effectively treat and manage obesity, the perception that obesity is a chronic disease that is difficult to solve with individual efforts must first be established in society.
Oh Sang-woo, a family medicine professor at Dongguk University Ilsan Hospital and Jang Hyung-woo, a cardiovascular thoracic surgeon at Seoul National University Bundang Hospital, explained, “Obesity is not just a condition of heavy weight, but a ‘multiple chronic disease’ caused by multiple factors.” They warned of the risk of various complications associated with obesity and emphasized the need for long-term treatment and management to restore metabolic health beyond simple weight loss.
Professor Jang Hyung-woo, who has overcome high obesity by losing more than 30kg through obesity treatment, said, “My life was so dark that I thought ‘I won’t live long’ before I lost weight. As a thoracic surgeon, I treated cardiovascular patients, and I felt a great sense of urgency that the risk of obesity could someday come to me.” In particular, Professor Jang emphasized the close association between obesity and cardiovascular disease. Professor Jang explained, “If obesity worsens, inflammatory substances continue to be secreted from adipose tissue, leaving whole-body blood vessels in a chronic inflammatory state. In this process, as blood vessels harden and debris accumulates on the walls of blood vessels, cardiovascular diseases such as myocardial infarction and stroke can occur earlier than normal weight people.”
Experts point to obsessing over ‘weight numbers’ as the biggest mistake commonly made when starting obesity treatment. This is because the number of scales is only the sum of not only body fat, but also the weight of moisture, muscles, and skeletons. If we starve in a short period of time or lose weight by limiting our diet to an extreme degree, our body recognizes it as an emergency, causing us to lose moisture and muscles first instead of body fat.
If the muscle mass decreases rapidly like this, the basic metabolism decreases, and you will experience a ‘yoyo phenomenon’ in which you gain much more weight even if you eat the same as before. The number of scales may have temporarily decreased, but the metabolic environment inside the body is worse than before.
On the other hand, weight may not change easily when professional obesity treatment and proper exercise and diet are combined. This is because dense muscles fill the spot instead of body fat decreasing. Fat is about 18% larger in volume than muscles when it is at the same weight. Therefore, even if the weight value remains the same, if body fat percentage is lowered and muscle mass increases, the body is improving to a much healthier state, such as a decrease in waist circumference and normalization of blood sugar and triglyceride levels.
Taking to the scale from time to time every day and being happy with the numbers maximizes psychological stress. Professor Oh Sang-woo explained, “If stress increases the secretion of a hormone called cortisol, it induces fat cells to store more fat and makes it difficult to break down the stored fat easily.” In other words, the obsession with numbers itself causes hormonal disturbance, which is an obstacle to weight loss. Therefore, it is sufficient to measure the weight once a week under certain conditions, and rather than focusing on changes in waist circumference or lighter body conditions.
With the recent emergence of various drug treatment options along with obesity metabolic surgery, social interest in obesity treatment has increased. In response, Professor Oh said, “We need to look at obesity treatment from a long-term perspective,” and advised, “Since the medical intervention is stopped and the weight can gain again over time, lifestyle improvements such as diet and exercise must be made together in order to maintain the weight lost and restore overall health.”
Most importantly, the beginning of obesity treatment is to escape from the blame of ‘I gained weight because I didn’t do well’. Professor Oh said, “There is a lot of information about obesity, but there are not a few unverified information.” “It is most important to check whether the information I know is correct through a reliable expert and to continue to practice the right principles.” He also added that long-term weight management should be supported by support from family and surrounding people and professional help from medical staff. Professor Jang also recommended those who want to start treating obesity, saying, “It can be very difficult to overcome obesity on their own. I hope we can improve obesity in a safe and healthy way through consultations with obesity experts who can provide medical help.”
Obesity is not a problem that can be solved simply by making a strong mind, but a disease that requires professional treatment. Recently, various options and medical support environments for effective obesity treatment have been prepared. It’s time to take the blame for obese patients and understand the disease itself accurately. When obesity is recognized as a chronic disease and approached from the perspective of long-term treatment and metabolic health care, individual health recovery as well as social stigma can be eliminated.
[Seo Jung Yoon, reporter of Maekyung Health]
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