Incheon Sejong Hospital Center Director Lee Sung-bae \"Avoid Extreme Diets\"

Lee Sung-bae, Director of the Obesity and Metabolic Surgery Center at Incheon Sejong Hospital, stated on the 9th that the "one meal a day" diet challenge is gaining popularity among patients with severe and morbid obesity. He warned that “extreme diets can negatively impact health, easily cause yo-yo effects, and even lead to weight gain.”

Extreme diets include the one-meal-a-day diet, intermittent fasting, and single-food diets.

Each food has different nutrients, and restricting the diet to one type of food or prolonging fasting means that the body cannot get the necessary carbohydrates, proteins, fats, vitamins, and minerals to function correctly. Over time, this can lead to malnutrition and various deficiencies. Additionally, lacking dietary fiber can disrupt bowel regulation as it is important for preventing constipation and maintaining healthy gut microbiota. Repeatedly consuming the same food also poses problems.

Director Lee explained, "Eating only the same food can lead to boredom with food, eating disorders, and an overall negative relationship with food. It can affect mental health and the enjoyment of eating, potentially leading to binge eating or overeating. During the initial adaptation phase, headaches and dizziness may occur due to a lack of energy supply to the brain, and there is a higher risk of developing food intolerances or allergies."

Experts cite poor eating habits as the fundamental cause of obesity. Consuming too much sugar, foods made from grain flour, and high-fat foods can lead to obesity. 

Obesity is an immunosuppressive state because fat cells secrete various inflammatory substances, causing chronic systemic inflammation, which leads to various metabolic diseases.

While obesity can be improved with diet, exercise, and lifestyle changes, these methods alone are often ineffective for severe obesity, which is considered a refractory disease. 

Director Lee stated, "Diet and non-surgical treatments are nearly ineffective for patients with severe obesity. The probability of a patient in their 30s or 40s losing weight on their own is only 1 in 1,000. Professional medical assistance is necessary." He emphasized the effectiveness of "metabolic surgery" for patients with severe obesity.

Metabolic surgery mainly includes "sleeve gastrectomy," which restricts intake, and "Roux-en-Y gastric bypass," which limits absorption. 

Sleeve gastrectomy reduces the stomach size to about 14% of its original volume, making it easier to feel full and changing appetite and taste due to hormonal changes. The surgery is laparoscopic, allowing for discharge typically two days after the procedure. After one year, the stomach volume increases to 30% of its original size, concluding the weight loss effect of the surgery.

Roux-en-Y gastric bypass involves creating a small pouch from the upper stomach and connecting it to the small intestine in a Y shape. This surgery moves the meeting point of food with pancreatic and bile juices to the lower small intestine, preserving pancreatic function and preventing blood sugar spikes. Known as diabetes surgery, it is recommended for patients who take insulin or more than three types of diabetes medications due to its high rate of complete remission of type 2 diabetes.

Both surgeries result in a 30-35% weight loss compared to pre-surgery. For obese patients with diabetes, metabolic surgery increases life expectancy by 9.3 years and reduces cancer incidence and cancer mortality by 50% and 30%, respectively. The yo-yo effect is rare, maintaining weight loss for over 15 years.

Director Lee of the Incheon Sejong Hospital's Obesity and Metabolic Surgery Center stated, "The purpose of metabolic surgery is to alleviate and preemptively block various metabolic diseases such as type 2 diabetes, hypertension, hyperlipidemia, non-alcoholic fatty liver disease, and asthma, thereby preventing fatal conditions like stroke and myocardial infarction. Metabolic surgery is the most effective obesity treatment available. It not only physically limits stomach volume but also induces hormonal changes that decrease appetite and alter taste."

He further advised, "Avoid ineffective and harmful extreme diets. Instead, manage and control your weight with the help of professional medical staff to prevent future diseases and improve your quality of life." Meanwhile, Incheon Sejong Hospital recently surpassed 500 cases of metabolic surgery. This milestone was achieved a year and six months after the specialized Center for Metabolic Surgery was launched in December 2022.