Text/Zhao Bin
May 11 is World Obesity Day. Today, the global rate of overweight and obesity is growing rapidly and has become a serious threat to human health.
There are a variety of weight loss products and weight loss institutions on the market, how should people in need lose weight scientifically? How to deal with the rebound after weight loss?
Zhang Peng, chief physician of the bariatric and metabolic surgery department of Beijing Friendship Hospital affiliated to Capital Medical University and director of the Beijing Bariatric and Metabolic Surgery Quality Control Center, reminded in an exclusive interview with China News Service that some so-called weight loss drugs spread on the Internet are very risky, and copying other people's plans may not only have a bad effect, but also damage the body.
Don't take "fortune" seriously
What is obesity in the medical sense? Zhang Peng said that at present, the internationally used standard for measuring the health of the human body is the BMI (Body Mass Index) index, which is calculated as: BMI = weight (kg) ÷ height (m) ².
In general, the normal range of healthy weight is a BMI between 18.5 and 24, with a BMI below 18.5 for emaciation, 24-28 for overweight, and more than 28 for obesity. Among obesity, 28-32.5 is mildly obese, 32.5-37.5 is moderate, more than 37.5 is severe obesity, and more than 50 is very severe obesity. However, for special groups such as professional athletes, this value is not absolute, and it is necessary to make a comprehensive judgment based on multiple indicators such as fat content.
However, there are also people who do not feel unwell even though their BMI value has exceeded the standard. This situation cannot be taken lightly.
Zhang Peng believes that obesity is often complicated by a variety of diseases, such as diabetes, hyperlipidemia, hypertension, high uric acid, fatty liver, sleep apnea syndrome, female polycystic ovary syndrome, etc. At the same time, excess weight also has an impact on the overall health, such as wear and tear of the lower limb joints, stress urinary incontinence, gastroesophageal reflux, cardiopulmonary hypofunction, cardiovascular and cerebrovascular diseases, etc., and obesity is even associated with at least 13 types of tumors. From the moment of overweight, the damage to the body has already begun, but the obvious discomfort symptoms appear sooner or later.
Talking about the reasons for obesity, Zhang Peng said that obesity can be divided into two types from a medical point of view:
The first is primary obesity, which is mainly caused by poor diet and lifestyle, and the vast majority of obese patients belong to this category; The second is secondary obesity caused by other diseases, which is rarely caused by endocrine diseases, long-term use of certain drugs, or congenital genetic mutations.
Only by correctly understanding obesity and clarifying its root causes can we scientifically deal with it and reduce the harm caused by obesity to health.
The wrong way to lose weight is harmful to health
According to the content released in 2023 by the international academic journal "Diabetes, Obesity and Metabolism (IF: 5.8)", according to the BMI (body mass index) classification standard of overweight and obesity, 34.8% of the 15.8 million adult subjects in mainland China are overweight and 14.1% are obese. Obesity has become one of the important diseases that endanger the health of Chinese people.
Zhang Peng said that for the treatment of overweight and obesity, a stratification strategy is adopted, if it is only overweight, and does not reach the level of obesity, most people can reduce their weight or even return to normal by changing their bad habits and increasing exercise. However, if it reaches the level of obesity, that is, exceeds the standard weight by more than 10 kilograms, it is a disease, and it is necessary to go to the hospital for medical treatment, be evaluated by a professional bariatric doctor, and carry out scientific and safe weight loss treatment according to the evaluation results. According to the concept of modern medical weight loss treatment, it can be divided into three types of treatment:
The first is nutritional therapy. Under the guidance and supervision of a doctor, develop a low-calorie diet plan to ensure adequate protein, unsaturated fatty acids, vitamins, trace elements, water and dietary fiber. According to the individual's physical health, under the guidance of specialists, rationally use personalized "16+8" time-restricted diet, "5+2 fasting", "Mediterranean diet", "ketogenic diet" and other means. Because everyone's situation is different, copying the online circulation plan or someone else's plan may not only have a poor weight loss effect, but also may cause a series of problems such as malnutrition and endocrine disorders, which will damage your health.
The second is drug treatment. The core of it is effective and safe, and the key is to standardize the use of drugs officially approved by the State Food and Drug Administration. At present, the drugs officially approved by the State Food and Drug Administration for weight loss include orlistat, liraglutide 3.0mg and benaglutide, and some weight loss drugs are in the clinical trial stage and have not yet been officially approved. These drugs must be used rationally under the guidance of a weight loss specialist, and some so-called "fat bombs" and "thyroxine" drugs that are intended to lose weight by increasing consumption are very risky and must not be tried blindly.
The third is surgical treatment. Surgery is generally recommended for patients with moderate to severe obesity, especially those who have other diseases due to obesity. At present, the most common surgical methods in the world are sleeve gastric resection and gastric bypass. At present, this type of surgery is minimally invasive, and only 3 to 5 small holes with a diameter of 0.5-1 cm can be made in the abdomen, so it is also called "keyhole surgery". At the same time, we should warn everyone not to blindly pursue less "holes", but to pay more attention to the precise operation of intra-abdominal surgery. Such a small hole does not leave a significant surgical scar for most people.
Weight loss myths don't just rebound
Rebound after weight loss is a problem for countless "weight loss people".
Zhang Peng said that the rebound of weight circulation is very bad for the body. Every time you lose weight, you will lose a certain amount of muscle, and when you regain weight, you will mainly regain fat, so your body fat percentage will increase after rebounding, which will cause more damage to your body. In particular, repeated weight loss and repeated rebound are more likely to lead to fatty liver and insulin resistance.
Therefore, weight loss must strive for a success, and maintain it for a long time, in principle, do not indulge after the weight loss is successful, at least for two years to strictly monitor the weight, once the weight gain trend is found, take immediate measures to adjust, otherwise the rebound will get out of control.
There are many misunderstandings about weight loss, in addition to rebounding. For example, if the weight loss method is improper, the body will quickly enter the protection mechanism similar to the power saving mode of the mobile phone, and the various weight loss methods will be ineffective.
Zhang Peng reminded that foods and health products that claim to have weight-loss effects should be treated very cautiously, and in principle, they should also be used under the guidance of weight-loss specialists. In particular, some products containing laxatives can bring irreversible damage to the body and even endanger life when taken for a long time. At the same time, it is important to avoid receiving weight-loss guidance in informal institutions, such as those that claim to charge by weight loss, and the risk is difficult to assess.
Talking about the trick of losing weight and avoiding pitfalls, Zhang Peng said that the best way is to seek medical treatment in the professional metabolic bariatric department of a regular medical institution and lose weight scientifically under the guidance of a doctor. Taking the Department of Metabolism and Bariatric of Beijing Friendship Hospital as an example, a multidisciplinary joint (MDT) outpatient clinic composed of doctors from endocrinology, nutrition, surgery, otolaryngology and other departments has been opened.
However, many places, especially county-level hospitals, do not have metabolic weight loss departments, so what should I do?
Zhang Peng said that more and more hospitals are now opening multidisciplinary outpatient clinics or bariatric specialist clinics for bariatric treatment, specializing in medical bariatric diagnosis and treatment. If you go to a hospital that does not have such an outpatient clinic, you can also choose endocrinology and metabolism, nutrition and other departments.
Source: The country is a through train
Editor: Gao Yanjiao
Editor-in-charge: Wei Xi