"Rebound of the Weight Set Point"... A Doctor Who Lost 38kg from 118kg Explains the Core of Obesity Treatment

A doctor who lost 38kg from a state of severe obesity shared the trial and error experienced during the weight loss process, the principles of obesity medication, and precautions. On the tvN "You Quiz on the Block" broadcast on the 2nd, a cardiothoracic surgeon appeared and revealed in detail the process of reducing weight after leaving behind a past weight of 118kg.

From the Denmark Diet to Low-Carb High-Fat: The Causes of Repeated Weight Loss and the Yo-yo Effect

The guest shared his experience of losing 16kg through the 'Denmark Diet,' which he started at the suggestion of his mother ahead of his wedding when he weighed 118kg. At that time, he lowered his weight to the mid-80kg range through a harsh diet that extremely restricted salt and carbohydrates, but as he began his internship, his weight rapidly rose back to over 100kg due to irregular eating habits and the consumption of carbonated drinks during night shifts.

Afterward, he tried various methods such as the Emperor Diet, intermittent fasting, and low-carb high-fat (LCHF). Regarding the Emperor Diet, the guest explained, "I focused only on the fact that I could eat as much meat as I wanted, so I ended up eating too much, making it ineffective," and added that with intermittent fasting, "I ended up overeating due to a compensatory psychological desire during the allowed eating hours, so I didn't see much effect either." He maintained a low-carb high-fat diet for about 8 months and lost some weight, but he also used the obesity medication Saxenda to overcome a plateau.

The guest explained the difficulty of weight maintenance faced by severely obese patients using the concept of the 'Weight Set Point.' He said, "It is a state where the endocrine metabolic system is fixed at a specific weight (e.g., 116kg)," and "If you try to move away from this set point, a strong rebound occurs in the body, which can cause symptoms such as hand tremors." In other words, even if weight is reduced, because of the body's tendency to return to its original weight, strict management that makes it difficult to continue one's livelihood is required to maintain it.

The Role of Obesity Medication and Mandatory Medication Rules

Regarding recently introduced obesity medications, the guest mentioned, "It seems these medications play a role in neutralizing the body's tendency to maintain the weight set point." He explained that when using the medication, he directly feels changes such as food descending more slowly.

However, he also warned about the side effects and contraindications to be careful of when using obesity medication. According to the guest, nausea, vomiting, diarrhea, constipation, and indigestion are common side effects. In particular, he cautioned that if the established stepwise dosage increase rules are violated to see effects quickly, situations may arise where one must be hospitalized for fluid therapy due to extreme vomiting or diarrhea.

He also specifically mentioned medical contraindications. He emphasized that those with a history of chronic pancreatitis, patients with medullary thyroid cancer, and women who are pregnant or planning to become pregnant must never take the medication.

"Weight Loss is an Opportunity for Exercise"... The True Purpose of the Medication

Regarding research results showing that weight can return to the original weight if the medication is stopped, the guest said, "It is already a fact proven by research results," implying that rather than relying solely on medication, changing lifestyle habits using the medication is important.

The guest defined weight loss through obesity medication or surgery as "a kind of opportunity." He advised that if weight is too high, exercise itself can be difficult and dangerous due to the physical burden, so the state of lowering weight through medication should be used as a stepping stone to start exercising in earnest. In other words, he emphasized that the results of weight loss achieved through medication should lead to improving the body constitution through exercise.