[KoK! Health] Leaving 'Severe Obesity' Untreated Threatens Life... Proper Treatment Essential

Diabetes and Cardiovascular Disease Complications
Consider Bariatric Surgery for Severe Obesity
Health Insurance Coverage Based on Criteria Since 2019

[Asia Economy Reporter Lee Gwan-ju] As winter fully sets in, physical activity tends to decrease. With the reduced exercise due to COVID-19 and the added cold weather, metabolism declines and obesity prevalence is on the rise. In particular, severe 'morbid obesity' can be life-threatening, so appropriate treatment is necessary.

Obesity stock photo. [Image source=Pixabay]

According to the '8th National Health and Nutrition Examination Survey, 3rd Year (2021)' by the Korea Disease Control and Prevention Agency on the 15th, the obesity prevalence before the COVID-19 outbreak in 2019 was 41.8% for men and 25.0% for women, which increased to 46% for men and 26.9% for women in 2021.

Obesity refers to a state where fat tissue is excessive due to lower physical activity compared to nutrient intake. Excess fat cells in the body secrete inflammatory substances and reactive oxygen species, which interfere with metabolism, causing a vicious cycle of further fat accumulation and inflammation.

Generally, a body mass index (BMI) of 30 or higher is considered morbid obesity. Morbid obesity inevitably leads to metabolic syndrome, including hypertension, hyperglycemia, and hyperlipidemia. Metabolic syndrome, also called 'lifestyle disease,' increases the risk of diabetes due to insulin resistance and can cause cardiovascular and cerebrovascular diseases such as myocardial infarction and stroke.

Additionally, it causes menstrual irregularities and infertility due to hormonal imbalance, non-alcoholic fatty liver disease, sleep apnea, and various diseases caused by chronic inflammation. It also increases the incidence of various cancers such as colorectal cancer and breast cancer. Kim Yong-jin, head of the Obesity and Diabetes Surgery Center at H Plus Yangji Hospital, emphasized, "As obesity increases, the possibility of diabetes due to insulin resistance rises, and complications from metabolic diseases such as myocardial infarction and stroke can occur. Morbid obesity can even threaten life, so obesity should be recognized as a disease and treated."

Morbid obesity is caused mainly by genetic, environmental factors, and hormonal imbalance, making it difficult to improve through diet control or exercise alone. Also, the body has homeostasis to maintain weight, so yo-yo effects occur after dieting, limiting weight loss by willpower alone.

Recently, metabolic surgery has been performed as an effective method to treat morbid obesity. The surgeries widely performed worldwide include 'sleeve gastrectomy,' which vertically reduces the stomach volume, and 'Roux-en-Y gastric bypass,' which bypasses the stomach and small intestine. In Korea, where the incidence of stomach cancer is high and endoscopic examination after surgery is difficult, sleeve gastrectomy is often chosen.

Sleeve gastrectomy reduces the stomach size to limit food intake by about 80% of the normal volume. It reduces volume without damaging the sphincters at the top and bottom of the stomach, maintaining normal function. After surgery, secretion of the appetite-stimulating hormone 'ghrelin' is also suppressed, helping to reduce appetite.

The government has recognized the risks of obesity and has applied health insurance coverage since 2019. Eligible candidates include ▲BMI of 35 or higher ▲BMI of 30 or higher with complications (diabetes, sleep apnea, polycystic ovary syndrome, etc.) ▲BMI of 27.5 or higher with type 2 diabetes. Center head Kim explained, "For morbid obesity, metabolic surgery is the most effective method verified long-term, but thorough dietary therapy and consistent self-management must accompany the surgery."