2024-03-30 02:55:08
[나만의 다이어트 찾기]Kwon Young-geun, Professor, Obesity Metabolism Center, Korea University Anam Hospital
Prescription drugs taken by obese patients… It doesn’t work if you want a slim body.
Advertising guaranteeing weight loss is a lot of exaggeration… To be successful, comorbidities such as diabetes must be improved
Surgical treatment, deep concerns – consulting a doctor is a must
Global pharmaceutical companies are releasing new obesity treatments one after another. An obesity treatment drug that has a greater weight loss effect than existing drugs is about to be launched in Korea. This is what many people who are planning a diet call the ‘dream diet pill.’ Thanks to this atmosphere, the obesity treatment market is growing. Domestic pharmaceutical companies are also accelerating the development of related drugs.
I have a question. Are these diet pills really effective? Will I really lose weight just with medication or injections? Will people who are not overweight or obese become slimmer if they take this medicine? Can severely obese patients return to normal weight if they use this drug?
Another question arises. Is there any other way to escape from obesity other than diet pills? They say surgery is done to suppress appetite, but is it effective? We asked Kwon Young-geun, a professor at the Obesity Metabolism Center at Korea University Anam Hospital, questions about drug and surgical treatment. Professor Kwon emphasized that awareness of diet pills should be established first.
● Before taking medicine, keep this in mind
Professor Kwon said, “Diet pills are not pills you can take whenever you feel like it. “We must not forget that it is a treatment for obesity,” he said. It is a prescription drug that obese patients must take with a doctor’s prescription. Of course, obesity medications should not be abused. If you take obesity medication to make yourself slim, not only is it ineffective, but it is also prone to side effects. Professor Kwon said, “Obesity medication is an auxiliary tool to help lose weight. “You have to give up the idea of just taking medicine and losing weight,” he said.
To be medically effective, it must be used when obese patients have a body mass index (BMI) of 25 or higher. It is recommended to use this if the patient has concomitant diseases such as diabetes, hyperlipidemia, or high blood pressure. In this case, accompanying diseases can also be improved.
BMI refers to weight (kg) divided by the square of height (m). According to domestic standards, 18.5 to 22.9 is normal, 23 to 24.9 is overweight, 25 is considered obese, and anything over 30 is considered severely obese. Severely obese patients may be less effective in losing weight with medication alone. Even if you lose weight, it is not easy to maintain it. For this reason, patients with severe obesity often receive surgical treatment in addition to medication.
Most obesity treatments have appeared recently. Therefore, medical data for more than 5 or 10 years is lacking. Of course, most drugs approved for long-term use have few side effects. But you can’t be at ease. Professor Kwon said, “A certain obesity treatment drug gained sensational popularity three years ago, but sales were discontinued after research showed that it increased the risk of cancer.”
● Let’s learn about the pros and cons of each drug.
Just by browsing the Internet for a few minutes, you will come across diet advertisements several times. In particular, advertisements promoting drugs that guarantee weight loss abound. You should not believe these advertisements at face value. The more an advertisement highlights the effectiveness of a drug, the more likely it is to be an exaggerated advertisement. Professor Kwon said, “There are four types of obesity treatment drugs approved for long-term use in Korea.” To classify them by ingredient name, they are △Orlistat △Phentermine/Topiramate △Naltrexone/Bupropion △Liraglutide.
These drugs induce weight loss by reducing food intake by preventing fat from being absorbed in the intestines or by suppressing appetite or the strong desire to eat at the sight of food. There are also medications that make you feel fuller so you eat less. Most medications are taken by mouth, but there are also injectable medications. Each drug has side effects. It is good to know which medicine is right for you.
These four obesity treatments are generally effective in reducing weight by 5 to 10% when used for one year. This means that if your weight is 80 kg, you can lose about 4 to 8 kg. Even if you increase the dose or take it for a longer period of time to try to lose more weight, you will not see any further effects. This is why obesity treatments are called supplementary measures.
Two new obesity treatments will soon be released in Korea. The ingredient names are semaglutide (product name WeGobee) and tirzepatide (product name Zebbound). Both drugs help you lose weight by acting as hormones involved in appetite control and glucose metabolism. In clinical trials, WeGobee was found to reduce weight by 15% and Zebbound by 20%.
Professor Kwon said, “The two drugs are known to be highly effective in simultaneously treating obesity and type 2 diabetes. “I think it could be a new option for patients who have not seen great results with existing treatments,” he said.
● Surgical method for treating severe obesity
If your BMI is over 30 and you are over 18 years of age, you will receive health insurance benefits when undergoing obesity surgery. However, if your BMI is 30 to 35, you must have at least one disease accompanying obesity such as high blood pressure, type 2 diabetes, hyperlipidemia, non-alcoholic fatty liver disease, sleep apnea, joint disease, asthma, and polycystic ovary syndrome to receive insurance benefits.
There are several types of surgical methods. In the past, a method was used to reduce intake by inserting a balloon into the stomach. This method has the disadvantage that when the balloon is removed after about 6 months, the weight returns to its original state. This means that the diet will fail after just 6 months. It is not practiced much these days. Likewise, the number of gastric band procedures, which restrict intake by tightening the upper part of the stomach with a band, has recently decreased as many reports have emerged that complications occur.
These days, sleeve gastrectomy is the most commonly attempted procedure. This is a method of cutting off 80% of the top vertically, as if cutting off a sleeve. Levels of ghrelin, the hunger hormone, decrease, reducing appetite and increasing satiety.
The next most common surgery is gastric bypass surgery. Cut off the rest, leaving only the top part. This way, food goes directly to the small intestine without going through the stomach, reducing food intake. It also affects appetite-regulating hormones, increasing the feeling of fullness.
What are the results of surgical treatment? Professor Kwon said, “The degree of weight loss varies from person to person, but on average, 25 to 30 percent of body weight is lost between 12 and 18 months.” This means that if your weight is 100 kg, it will be reduced to a maximum of 70 kg.
Could it be that the yo-yo phenomenon is severe? Professor Kwon said, “Patients whose weight returns to its original state and patients who lose less than 30% of their weight combined make up 10% (of all patients who underwent surgery).” The weight loss effect is definitely significant.
However, this diet is difficult to apply to overweight or obese patients. Professor Kwon said, “Unlike drugs, surgical treatment involves cutting out part of the stomach. “It cannot be returned to its original state,” he said, recommending that you think carefully and consult with a doctor before making a decision.
● Compliance with diet principles determines success
When do you judge whether a diet is successful? Professor Kwon said, “You can only say that you have succeeded when you do not stop at achieving your target weight and maintain that weight for a long period of time without the yo-yo effect.”
Professor Kwon once again emphasized that dieting can never be successful with medication alone. He said, “To succeed in dieting, you need to take a long view and change your lifestyle itself while combining diet and exercise.” Drug diets are only effective in the beginning, but when you stop taking the drug, almost everyone’s appetite comes back and weight gain occurs. Even if you have surgery, the yo-yo effect is the same if you do not improve your lifestyle.
Professor Kwon also emphasized that the approach should be ‘diet = obesity treatment.’ Therefore, only by not only losing weight but also improving comorbidities can the quality of life improve and the diet be considered successful.
There is no need to take obesity medication for cosmetic purposes. In this case, you must improve your lifestyle by combining diet and exercise to achieve final success in dieting. Professor Kwon added, “I hope you remember that if you do not follow these principles and only rely on drugs, your diet will 100% fail.”
Reporter Kim Sang-hoon [email protected]
2024-03-30 02:55:08