KNUCH

Bariatric & Metabolic Clinic

The Bariatric & Metabolic Clinic consists of a multidisciplinary team including specialized surgeons, coordinators, nutritions and specialists at family medicine, endocrine internal medicine, and plastic surgeons. We effectively manages patients with obesity and comorbid metabolic diseases under systemized cooperation between professionals in various fields. In addition, through multidisciplinary treatment, the most appropriate treatment method for each patient's condition is presented, patients requiring surgical treatment are selected, and a stable pre- and post-operative management treatment can be provided. Obesity is one of the most common diseases in modern society, and the prevalence of the obesity population has steadily increased in Korea, reaching 32.4% in 2015. Obesity not only lowers the quality of life, but it is also accompanied by various diseases such as diabetes, heart and cerebrovascular disease, hyperlipidemia, and sleep apnea, which shortens lifespan in the long run, so active treatment and management are needed.

What is Obesity?

When it comes to obesity, people often think of it simply as 'fat' or 'overweight'. In particular, nowadays, 34.4% of Korean women think they are obese and 13.1% think they are normal weight while being obese due to prejudice against their ideal body shape. What is the exact standard of obesity?

Obesity is a state in which excessive body fat is accumulated, resulting in metabolic disorders. The most standardized obesity definition index is a body mass index. The body mass index is calculated by dividing the body weight by the square of the height (m), and Koreans are normal weight when the body mass index falls within the range of 18.5 to 22.9 kg/m2. Taking an adult who is 160 cm tall, about 47 to 59 kg is an appropriate range of healthy weight. Obesity is defined as a time when the body mass index is 25 kg/m2 or more and hyperobesity is defined as 30 kg/m2 or more. That is, an adult who is 160 cm tall is obese if it is 64 kg or more, and if it is 76.8 kg or more, it is included in the standard of hyperobesity.

Obesity is considered a recent disease because it is associated with several fatal diseases. Not only does it cause ischemic heart disease, stroke, diabetes, hypertension, dyslipidemia, and musculoskeletal diseases, but it is also an critical cause of colorectal cancer, breast cancer, lung cancer, and prostate cancer. It negatively affects an individual's health and daily life physically, mentally, psychologically, and socially. The treatment of obesity is very important because weight loss reduces complications caused by various obesity-related diseases and has a positive effect on the individual's mental and social as well.

Evaluation

Before treating obesity, it is necessary to determine the type and condition of obesity and whether there are complications. When visiting an obesity clinic, we check whether or not you are obese and whether there are complications, and treatment plan is customized according to age and comorbidities, and perform a physical examination (blood pressure, height, weight, body mass index, waist circumference), a body fat test (Inbody), a blood test (blood glucose, cholesterol, liver function, uric acid, thyroid function test, etc.), an electrocardiogram, and an imaging test (abdominal ultrasound or CT). Through these evaluation, differentiated obesity treatment can be started according to the each conditions.

Treatment

- Behavior therapy, Diet control, Exercise therapy

Exercise and diet are the most basic of obesity treatment. If this does not work, medication is used in combination, and surgical treatment is considered if patient is very highly obese or is concerned about severe complications. The most important thing is that even if patient has already taken medication or surgical treatment, exercise and diet therapy must be strictly. Patient cannot lose weight with easy way, and must suspect that there will be no significant side effects when you see advertising that you can lose weight "even if you eat as much as you want" or "without exercising."

Medication therapy

Drugs that treat obesity can be divided into two types. First, it is an appetite suppressant that acts on the central nervous system and lowers the appetite. In the past, amphetamine-based drugs have been mainly used, and recently released drugs have proven safety and are raising new expectations for obesity treatment. Each drug has indications and precautions, and the degree of weight loss is also different, so make sure to consult a doctor before taking it. Second, lipase inhibitor is the most representative drug that increase excretion. It is a drug that excretes a part of the fat ingested in feces so that it is not absorbed. Although it has the advantage of being safe, it may have discomfort such as fecal incontinence or fat stool. Drug selection should be individualized for each patient, and each drug