Morbidly obese man loses 80 kilograms without surgery

Obesity is a modern disease of civilization. Mild obesity can be improved through diet and exercise control, while for severe obesity, clinicians often recommend weight loss surgeries such as gastric bypass, sleeve gastrectomy or gastric banding. But can morbid obesity only be solved with a scalpel? Chef Huang, who once had a BMI of 66.4, is a good example. With the combination of internal medicine treatment and lifestyle adjustment, he successfully lost 80 kilograms of fat in 16 months without having to undergo abdominal surgery, and regained his health and happy life.

Huang Zhiwei, who is a chef, suffered from morbid obesity due to his family history of obesity and high-fat diet. However, after 16 months of internal medicine treatment, his waist circumference has been greatly reduced. (Photography by Luo Huiwen)

Huang Zhiwei, 34 years old, is 173 cm tall. Two years ago, he weighed 198.8 kg and had a BMI of 66.4 (the normal BMI for adults is between 18.5 and 24), which is typical of severe "morbid obesity". He said he was so fat that he couldn't lie down to sleep. He had difficulty breathing when he lay down, so he could only live a painful life sitting up to sleep. Moreover, he always carries blood sugar and blood pressure medications with him. Even his knees cannot support his huge and heavy body, so he has to take painkillers to relieve pain and allow him to walk. I feel that life is really painful and I just want to solve it quickly with surgery.

"I'm so fat that I feel like I'm going to die!" This feeling made Huang Zhiwei want to have surgery to quickly solve the problem of obesity. However, after consulting a weight loss physician, he started by improving his lifestyle habits: calculating calories when eating every day, reducing the consumption of fats and meat, and reducing calorie intake from more than 4,000 calories to about 1,500 calories; quitting sugary drinks, changing from more than 10 cups of sugary black tea a day to only drinking boiled water; starting from no exercise, he developed a habit of exercising for an hour a day and playing paintball games whenever he had free time; and taking weight loss drugs that can suppress appetite, reduce absorption and promote metabolism. Finally, after 16 months, he lost 80 kilograms and his BMI value dropped to 39.7. Although it has not reached the normal standard, he no longer has to sleep sitting up, and has stopped taking blood pressure and blood sugar drugs for 4 years, getting rid of the entanglement of morbid obesity.

Morbidly obese people who want to have surgery should first undergo a six-month internal medicine weight loss program

Dr. Xiao Dunren, a hepatobiliary gastroenterologist specializing in obesity medicine, said that morbid obesity is defined as BMI ≥ 40, which is a major challenge for obesity specialists in weight loss clinics. He recommends that patients should receive six months of internal medicine treatment before surgery. If they cannot lose 10% of their original weight within six months, it is not too late to have surgery.

Huang Zhiwei underwent internal medicine treatment, and his big belly gradually disappeared by eating less, exercising more, and taking medication. (Source: Dr. Xiao Dunren)

Although the risk of surgery for severe obesity is less than 1%, even if the surgery is successful, the chance of regaining weight is still quite high if the lifestyle and eating patterns do not change. Therefore, clinicians will recommend that patients need long-term diet control and exercise therapy after surgery to improve weight control effectiveness.

Compared to medical treatment, isn't surgical weight loss more effective faster? Dr. Xiao Dunren explained that although the success rate of weight loss through medical treatment within 6 months is less than 10%, it is an important first step. During this period, you should actively establish good eating and exercise habits. Even if you do go for surgery later, you can still get health insurance benefits and a better weight loss maintenance rate.

Conditions for health insurance to cover bariatric surgery

Currently, the National Health Insurance Administration stipulates that the health insurance coverage for patients undergoing weight loss surgery must be that the patient has a BMI ≥ 40 or a BMI ≥ 35 and has high-risk complications, such as diabetes, hypertension, sleep apnea syndrome, etc.; and must also meet the following five conditions:

1. Controlled by exercise and diet for more than half a year.

2. Aged between 18 and 55.

3. No morbid obesity caused by other endocrine diseases.

4. No alcoholism, drug abuse or other mental illness.

5. The patient's mental state is sound and no abnormalities have been confirmed by consultation with a psychiatrist.

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