A 112kg man suffers from metabolic syndrome and severe fatty liver! Lose weight from both inside and outside, and enjoy slimness in a healthy way

A 35-year-old man works in the technology industry. Due to long working hours and lack of exercise, he has become obese. The employee's recent physical examination results showed high fasting blood sugar and triglycerides, and abnormal liver index, so he went to the outpatient clinic of Wu Shangxian, the attending physician of the Endocrinology and Metabolism Department of Chi Mei Hospital. The examination found that his weight was 112 kilograms, his waist circumference was more than 100 centimeters, and his blood pressure was slightly high at 136/86 mmHg. He was diagnosed with metabolic syndrome, and the results of an abdominal ultrasound examination showed that he had severe fatty liver.

Man A has tried to lose weight many times but with little success. Dr. Wu recommended that he exercise regularly and adjust his diet, and use weight loss drugs approved by the Ministry of Health and Welfare to control appetite and reduce hunger. With the help of medication and a reshaped healthy lifestyle, Mr. A successfully lost five kilograms in three months, and his blood sugar and liver index abnormalities also improved. Currently, I am still continuing my weight loss plan and monitoring my blood sugar and fatty liver in the outpatient clinic.

Nearly 30% of children and adolescents are obese, and the obesity rate increases with age.

Wu Shangxian, chief physician of the Department of Endocrinology and Metabolism at Chi Mei Hospital, Chi Mei Medical Foundation, explained that obesity has become a major health problem for modern people, and its prevalence rate is increasing year by year in Taiwan. According to the National Nutrition and Health Status Survey from 2017 to 2020, the overweight and obesity rate among adults has reached 50.7%, and the rate among adults over 65 years old is as high as 61%. Nearly 30% of children and adolescents are also overweight and obese. This problem cannot be ignored.

The accumulation of visceral fat can easily lead to metabolic syndrome, causing mild abnormalities in blood pressure, blood sugar and blood lipids. If not actively controlled, subsequent complications such as diabetes, fatty liver and cardiovascular disease may occur. Research data also show that obesity is associated with increased rates of degenerative arthritis, gastroesophageal reflux disease, infertility, depression, sleep apnea and cancer. Therefore, active weight loss has the effect of prevention being better than treatment for people with sub-health who have not yet developed complications, and it also has the effect of improving blood sugar control and reducing cardiovascular risk for people who already have diabetes and cardiovascular disease.

Multiple methods to effectively deal with the challenge of obesity, a comprehensive weight loss strategy

Dr. Wu Shangxian emphasized that the basic principle of weight loss comes from a negative energy balance, that is, the energy consumed is greater than the energy consumed. A comprehensive weight loss plan should include diet control and exercise, which will be more effective than a single method. In terms of diet, you should reduce energy intake, reduce high-sugar and high-fat foods, increase the intake of vegetables, fruits and high-fiber whole grains to provide a sense of fullness, and try to avoid sugary drinks and refined sweets. You can refer to the Harvard Healthy Eating Plate to choose the food composition, with vegetables and fruits accounting for half of the plate, healthy protein (choose more fish and poultry, and limit red meat) and whole grains accounting for one-quarter each, and then pair it with healthy oils. In terms of exercise, it is recommended to achieve 150 minutes of moderate-intensity exercise per week. Both aerobic exercise and resistance exercise have significant health benefits.

Weight loss drugs can control appetite and reduce the risk of obesity

Dr. Wu Shangxian pointed out that the weight loss drug incretin preparation approved by the Ministry of Health and Welfare in recent years has become a savior for those who have difficulty controlling their appetite. Incretin is a hormone secreted by the intestines. In addition to increasing insulin secretion after meals to improve blood sugar control, it also slows down gastric emptying and stimulates the brain to produce a sense of fullness, helping to reduce food intake.

Dr. Wu Shangxian said that for obese patients who have already developed complications, they can be evaluated by an endocrinologist and use weight-loss drugs, combined with diet adjustments and exercise, which usually have good results. However, it is recommended that the drugs be used continuously for at least half a year. After stopping the drugs, they should try to maintain a healthy lifestyle after the adjustments to reduce the chance of gaining weight again. (Photo courtesy of Chi Mei Hospital)

The 2023 SELECT study pointed out that patients with obesity and cardiovascular disease can lose an average of 9.4% of their body weight in two years by using incretin preparations, and can also reduce the incidence of cardiovascular risk events by 20%. Therefore, patients with BMI ≥ 30 kg/m2 or BMI ≥ 27 kg/m2 and at least one comorbidity (such as hypertension, type 2 diabetes, or dyslipidemia) can consider using incretin preparations to increase the effect of weight loss. In addition, for patients with severe obesity, weight loss surgery is also a quick and effective method. The current indications approved by the National Health Insurance Administration are BMI ≧37.5 kg/m2, or BMI ≧32.5 kg/m2 and combined with high-risk complications (such as type 2 diabetes, hypertension, apnea syndrome, etc.).

Obesity is closely related to chronic diseases. Change your lifestyle to stay healthy and slim.

Dr. Wu Shangxian said that obesity is not only a problem of external beauty, but also an important factor affecting health. Obesity is associated with many chronic diseases, and the health benefits of actively changing lifestyle for obese patients are self-evident. For obese patients who have already developed complications, they can be evaluated by an endocrinologist and use weight-loss drugs, combined with diet adjustments and exercise, which usually have good results. However, it is recommended that the drugs be used continuously for at least six months. After stopping the drugs, they should try to maintain a healthy lifestyle after the adjustments to reduce the chance of regaining weight and protect their own health.