Diet Without Yo-Yo Effect: The Science of Diet and Medication

Professor Jang Hyung-woo explained that when adipose tissue accumulates excessively, inflammatory substances released from it attack blood vessels and tissues throughout the body, accelerating vascular aging. He pointed out that obese people experience much faster vascular aging compared to non-obese individuals, emphasizing that obesity is not just a matter of appearance but a serious health problem.

Professor Jang Hyung-woo expressed regret over the hygiene issues severely obese patients face when using public transportation and the resulting social prejudice. He explained that due to excessive sweating and difficulty cooling down, body odor is inevitable. He emphasized that for severely obese patients facing these difficulties, surgical treatments such as gastrectomy or gastric bypass may be necessary.

Professor Jang Hyung-woo stated that even with weight loss, already damaged musculoskeletal disorders, especially knee joint damage, do not recover. He gave examples of feeling discomfort in the knees and hearing a 'pop' sound when overexerting after losing weight, pointing out the limitations of high-weight exercises like deadlifts and squats.

Professor Jang Hyung-woo revealed that he had tried various diet methods, including the Danish diet, low-carb high-fat diet, Emperor diet, and intermittent fasting. He mentioned that only the Danish diet and the low-carb high-fat diet showed significant weight changes. He specifically noted that with the low-carb high-fat diet, he lost 9kg before hitting a plateau, and with the Danish diet, he experienced a severe yo-yo effect, pointing out the limitations of conventional diet methods.

Professor Jang Hyung-woo emphasized that general dietary regimens are extremely difficult for severely obese patients who need to lose more than 20kg. He explained that such weight loss requires superhuman patience, accompanied by physical pain that surpasses human limits. He analogized it to needing 'strongman' level effort that cannot be achieved by willpower alone, highlighting the difficulties faced by severely obese patients.

Professor Jang Hyung-woo recommended that those aiming for weight loss within 10kg adhere to low-carb high-fat principles in their daily diet. He advised reducing sweet food intake and aiding weight loss through a diet that maintains satiety, such as eating boiled eggs with olive oil.

Professor Jang Hyung-woo cited the ease of digestion, constipation relief, and the pleasure and satisfaction felt upon consumption as reasons why carbohydrate restriction is difficult. He explained that the unique satisfaction carbohydrates provide makes it realistically challenging to maintain a strict low-carb high-fat diet.

Professor Jang Hyung-woo viewed protein shakes as useful if they help maintain satiety and reduce carbohydrate intake. However, he pointed out their limitations, stating that it is difficult to maintain a diet solely with protein shakes, as one quickly gets bored, making continuous consumption challenging.

When asked about personality changes during obesity drug treatment, Professor Jang Hyung-woo asserted that while lethargy can occur, getting angry or irritable is very rare. He added that this is a common experience among many patients.

Professor Jang Hyung-woo stated that after 38 weeks of obesity medication, when half of the patients were given a placebo, their weight immediately began to increase. He explained that this proves the definite effect of the drug and shows that when the medication is stopped, there is a tendency for weight to return to its original state as previous eating habits resume.

Professor Jang Hyung-woo revealed that due to research ethics, they could not ignore patient weight gain, so they administered 'rescue Mounjaro' to patients whose weight had returned by more than 50% at the 84-week mark. He explained that this measure was based on the statistical fact that in most cases, weight returns to its original state if medication is stopped, and it was aimed at preventing the yo-yo effect upon drug discontinuation.

Professor Jang Hyung-woo emphasized that losing weight is much more difficult than quitting smoking. He explained that about 3% of those determined to quit smoking succeed, while the success rate for weight loss is significantly lower depending on the degree of obesity. He pointed out that people with a BMI between 30 and 35 have only a 0.5-0.6% chance of being at a normal weight after 9 years, and for severely obese patients with a BMI of 40 or higher, the success rate is only 0.0-something percent, underscoring the extreme difficulty of obesity treatment.

Professor Jang Hyung-woo pointed out that despite obesity being classified as a disease, insurance coverage for obesity treatments is currently not applied in South Korea. In contrast, he explained that advanced countries like the United States and Japan have already started or widely cover obesity treatment with insurance, suggesting the need for policy changes in Korea.

Professor Jang Hyung-woo honestly confessed that foods that aid in dieting are not tasty, and it is difficult to give up greasy, high-calorie foods for life. He stated that he himself has no intention of resisting greasy foods and believes that the injection treatment he chose can be maintained for life.

Professor Jang Hyung-woo criticized 'cheat days' as ultimately just a means to alleviate guilt for breaking rules. He said that if you want to eat, just eat, and that the meaning is diluted as many people have cheat days multiple times a week.

Professor Jang Hyung-woo pointed out that harsh diets ultimately lead to 'binge eating,' returning to original eating habits. He explained that binge eating is not simply eating a lot, but rather eating everything as one used to. He added that before surgery or drug treatment, dietary control was extremely difficult with willpower alone.

Professor Jang Hyung-woo strongly argued that blaming willpower for severely obese patients is unscientific criticism. He defined obesity as 'obesity disease,' a disease requiring treatment, and explained that it is a biological disease that makes it impossible to control appetite. Therefore, he emphasized that obese patients should be helped to restore their life expectancy through treatment.

Professor Jang Hyung-woo described the first digit of his weight becoming '7' since middle school as a 'miracle.' He expressed deep relief and gratitude that science allowed him to escape the risk of obesity-related complications (such as diabetes). He added that weight loss restored his self-esteem and improved his mental health.