[Click! Health] "Systematic Treatment Needed" Rapid Increase in Obese Patients Receiving Hospital Treatment

The number of patients visiting hospitals due to obesity is increasing significantly. According to statistics from the Health Insurance Review and Assessment Service, the number of obese patients receiving hospital treatment increased more than twofold from 14,966 in 2017 to 30,170 in 2021. The proportion of hospitalized patients due to obesity also accounts for 5% of all patients.

Obesity stock photo. [Image source=Pixabay]

In the past, obesity was viewed simply as a symptom caused by lifestyle habits, but now the prevailing view is that it should be regarded as a disease and treated accordingly. Professor Lee Hye-jun of the Obesity Clinic in the Department of Family Medicine at Chung-Ang University Hospital emphasized, "One might wonder if it is necessary to visit a hospital just for dieting, but obesity is a metabolic syndrome disease that is the root cause of many illnesses and can cause several fatal complications, so systematic treatment through hospital care is necessary."

Diseases caused by obesity include not only diabetes, hypertension, and dyslipidemia but also coronary artery diseases (angina, myocardial infarction), heart failure, stroke, and other cardiovascular and cerebrovascular diseases that can lead to death. Gastrointestinal diseases, gout, osteoarthritis, various urogenital diseases, and even the risk of cancer increase. Professor Lee explained, "Recent studies have confirmed that obesity can increase the risk of cancer occurrence. A 25-year follow-up study showed that male cancer deaths due to obesity were about 14%, and female cancer deaths were 20%. According to a follow-up study based on data from the National Health Insurance Service, the risk of developing colorectal cancer, liver cancer, bile duct cancer, prostate cancer, kidney cancer, papillary thyroid cancer, small cell lung cancer, non-Hodgkin lymphoma, and melanoma increases as body mass index rises."

Obesity, which is the root cause of many diseases, requires systematic treatment by specialists at hospitals. Obesity treatment methods include lifestyle modification therapies such as diet and exercise, medication, and surgical treatment. To treat obesity, it is necessary to assess the degree of obesity and accompanying diseases and set individualized, customized goals. For hospital-based obesity treatment, body mass index and waist circumference are measured to evaluate the degree of obesity, and tests for various diseases causing obesity are conducted. Comorbidities such as hypertension, diabetes, and dyslipidemia are identified, and lifestyle factors such as diet, exercise, sleep, stress, and depressive symptoms are investigated to assess health risks before treatment. Professor Lee said, "When starting obesity treatment, weight loss goals are set in consultation based on the individual's health status, and diet therapy, exercise therapy, and behavioral therapy are implemented, with medication therapy combined as needed."

Professor Kim Jong-won of the Obesity Metabolic Surgery Clinic at Chung-Ang University Hospital is performing obesity surgery treatment.
[Photo by Chung-Ang University Hospital]

Surgical treatment can be considered for patients with a body mass index (BMI) of 35 kg/m² or higher, or those with a BMI of 30 kg/m² or higher who have obesity-related comorbidities and have failed to lose weight through non-surgical treatments. Surgical treatment for obesity is the only treatment method for weight loss and maintenance in patients with morbid obesity and is also effective in improving obesity-related comorbidities, including type 2 diabetes.

Professor Kim Jong-won of the Obesity Metabolic Surgery Clinic in the Department of Surgery at Chung-Ang University Hospital stated, "In Korea, surgery is covered by health insurance for patients with a BMI of 35 kg/m² or higher, or those with a BMI of 30 kg/m² or higher who have comorbidities such as hypertension or diabetes. Morbid obesity is recognized as a disease requiring treatment due to the high risk of death from various complications, and surgical treatment should be performed when weight loss through diet, exercise, or medication is difficult."

Obesity metabolic surgeries such as sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, and biliopancreatic diversion with duodenal switch are standard surgeries with proven efficacy and safety. Other surgeries include mini-gastric bypass, biliopancreatic diversion, sleeve gastrectomy with duodenal-ileal bypass, and gastric plication. Recently, adjustable gastric banding has been gradually decreasing, and currently, sleeve gastrectomy is the most commonly performed surgery in Korea. Professor Kim explained, "For patients diagnosed with morbid obesity, the response rate to treatment through diet and medication is less than 3%, so surgical treatment is the most reliable and only effective treatment method. Studies show that mortality decreases by 40% in morbidly obese patients who undergo surgery, with diabetes-related mortality reduced by 92%, cardiovascular disease mortality by 59%, and cancer mortality by 60% due to morbid obesity surgery."