Extreme obesity, why diet is more difficult?

Many people see the success of a diet as a ‘problem of will’. However, it is a rather harsh story for people who are very obese and very obese. This is because it is not easy for them to reach their target weight only with a general diet. Severe obesity is a condition in which the body mass index (BMI), which is the weight (kg) divided by the height (m2) value, is 35 kg/m2 or more. If you become obese, you cannot lose weight with general diet methods such as exercise or diet.
365mc Cheonho Branch CEO Jo Min-young said, “There is no need to blame too much for the fact that highly obese people have tried dieting and failed to succeed.” As a result, there is more to being overweight than usual, and it requires treatment rather than general management,” he said. Director Cho explained, “Severely obese people have degenerated fat cells and are in a state where it is difficult to lose weight through general fitness or diet. He pointed out that, in the early stages of obesity, the size of fat cells can be reduced only with exercise and diet, but the degenerated fat cells of highly obese people are so large that they cannot return to normal, unlike those who are overweight. The nature of maintaining the enlarged cell size is also a factor that makes the diet of highly obese people difficult. At this time, if you go on a general healthy diet or exercise, fat cells feel threatened and secrete various hormones in the brain to increase the desire to eat. In the end, even if you try to lose weight, the vicious cycle of gaining back weight is repeated.
Highly obese people have a particularly difficult time controlling their diet. According to domestic and foreign studies, food can induce addiction like drugs in highly obese patients, which can encourage overeating and binge eating.
Director Cho said, “When a person is hungry, a neurotransmitter called leptin is secreted from fat cells in the body, which stimulates the appetite center in the brain hypothalamus. Obese people have an excessive amount of fat cells accumulated in their body, so this signal transduction system has a problem and they lose control over their food intake,” he said. “Just as all addictions develop tolerance, people with food poisoning will want more and more food, which can lead to weight gain and worsening of addiction symptoms,” he said. In one overseas study, it has been reported that when a person with severe obesity eats food, the brain reaches a state of extreme excitement, similar to that when taking a new drug, ecstasy.

Psychological problems such as low self-esteem due to severe obesity are also factors that make it difficult to lose weight. Severe obese patients are also aware of the fact that they have gained too much weight. Although they do not show it outwardly, most of them are deeply troubled by their own flesh. However, there are many cases where the motivation for dieting is broken because of negative thoughts such as ‘I can’t exercise’ or ‘I’ve gained weight since I was young, so I can’t imagine my skinny figure’. Director Cho said, “Especially if you have tried a diet in the past and have failed, your self-esteem and confidence are extremely low, and there is a high possibility that you will lose your will to diet.”
In fact, obesity has a significant adverse effect on mental health. A study from the University of Exeter’s College of Life and Environmental Sciences found that the higher the body mass index, the greater the risk of depression. In particular, it was found that people who had not previously been depressed are more likely to suffer from depression following gaining weight. Also, in a study at Aarhus University Hospital in Denmark, for every 10 kg increase in body fat above the standard standard, the risk of depression increased by 17%.
A weakened body due to excessive obesity can also hold the ankle of diet. Patients with severe obesity are more likely to have weakened joints due to excessive load on their knees or waist due to their heavy weight. Because of this, unlike others, even if you move a little, your joints and knees hurt, and eventually you will lose more exercise and gain more weight. Exercising too hard puts you at a much higher risk of injuries such as fractures. In the end, it is not easy to improve severe obesity with one’s own efforts such as exercise or diet, so professional help is needed.
First, through consultation and detailed diagnosis, the current health status, fat mass, and muscle mass should be comprehensively checked and, if necessary, medications should be prescribed to improve the problem. Above all, since it is difficult to control appetite by oneself, dietary nutrition counseling and drug treatment are inevitable. Director Cho said, “The diet can have the opposite effect if you excessively reduce the amount of food from the beginning, so it is important to have a sense of accomplishment by lowering your daily calorie intake little by little. One way to motivate you is to consider liposuction. “he advised. In fact, as a result of the 365mc survey, highly obese people with a BMI of 35 or higher who received liposuction obtained positive results for weight loss. As a result of a survey of 231 highly obese customers who visited the hospital in 2020, the hospital found that they lost an average of 11.3 kg following surgery. In particular, 118 patients, regarding half of the patients who underwent the procedure, were able to get out of the high obesity index and expect health-improving effects.
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