Obesity is a Disease, Weight Loss Is the Cure

Mrs. Kang, who delivered her first baby earlier this year, gained weight during her pregnancy and went from 60kg before pregnancy to 83kg in her last trimester. She thought her weight would go back to normal after delivery. However, even after two months, her weight did not go down any further than 75kg.

As a desperate attempt, she skipped more than one meal a day and shed five kilograms in two weeks. Nonetheless, her weight went right back to 75kg when she started to eat three meals a day again.

Kang said, “I had no idea how muscle and fat change while I was trying to control my weight by myself. I feel confident and assured now when a doctor guides me systematically and shows me how to lose weight.”

Recently, opinions have arose that obesity is a “chronic disease,” like high blood pressure and diabetes, and should be treated more aggressively by using drugs along with diet and exercise.

Seoul Paik Hospital of Inje University and Kangbuk Samsung Medical Center at Sungkyunkwan University provide obesity treatment programs for relatively low cost compared to some private hospitals or diet centers whose costs reach several million won per month on average.

Seoul Paik Hospital-

Seoul Paik Hospital provides “weight control” and “body shape management” programs.

The “weight control” program is a three-month program and once a week, the patient receives a checkup at the hospital to see if the treatment has progressed as planned. During the first visit, the patient is examined to see if she has any diseases including high blood pressure, how her eating habits are, and how much she uses her body.

Professor Kang Jae-hyun said, “We first find out what is causing the patient to be fat and decide which method to use among diet, exercise, and drugs. About 50 percent of patients are receiving drug treatments.”

If the patient has problem controlling appetite or eats too much oily food, drugs to control appetite and to inhibit fat absorption, respectively, are given. However, there may be some side effects such as dry mouth, fast heartbeats, and high blood pressure.

The success rate of this program is about 50 percent. This means that 60 percent of patients finish the three-month program and 90 percent of them succeed to lose the 10kg they set as a goal.

The cost is 300,000 won for the first month, including various blood tests, abdomen computed tomography (CT), body fat measurement, and consulting fees, 100,000 won for the second month, and 200,000 won for the third month. The third month cost includes another CT scan to check how much abdomen fat has been lost.

The “body shape management” program uses “Endermologie” equipment approved by the U.S. Food and Drug Administration (FDA) to reduce fat in particular areas of the body.

Kang said, “The equipment helps to dissolve fat in areas such as the abdomen using ultrasound. It does not reduce fat itself.” One can see an improvement after more than 10 treatments. The cost is 60,000 won per treatment and 200,000 won for four treatments.

Kangbuk Samsung Medical Center-

First-time patients should fill out a questionnaire asking about lifestyle, eating habits, and other traits. It is used to find out why the patient is fat and when he or she became fat.

Prof. Park Yong-woo said, “If a patient seems to have become fat due to some disease such as diabetes, we give a thorough physical exam. Patients with excessive abdomen fat have high risk to develop metabolic syndrome and other diseases.” The cost is 300,000 won at most.

If the patient has no particular disease, he receives diet, exercise, and drug treatments and visits the hospital once every other week to check progress. During this visit, he receives a body fat test and consultation from a doctor to discuss if the diet is working, if the drugs have any side effects, and if he is following the given exercise plan. The cost is approximately 50,000 won.

Park said, “We check the patient’s eating diary for bad habits such as eating little food but with too high calorie, or not enough protein consumption.” For example, they recommend bibimbab (rice mixed with vegetables) instead of fried rice and gourmet ground coffee instead of coffee with sugar and prima.

It is important to check through body fat measurement if the patient’s body fat and muscle change in a harmonious way. Park said, “If a patient skips his meal, has an irregular meal time, and doesn’t do enough exercise, he can gain body fat and lose muscle, although he may lose some weight overall.”

What kinds of drugs will be used depends on the patient’s willingness and the situation he or she is in. Appetite suppressors and thermogenic agents are popular. However, thermogenic agents that increase energy consumption can cause side effects such as fast heartbeat and insomnia.

Park said, “We guide patients to reach their desired weight in 12 weeks. Being overweight is a chronic disease, and it is necessary to change one’s lifestyle with a lifetime resolve to stay healthy.”

Na-Yeon Lee larosa@donga.com