비만관리센터 治療 成果에 對한 硏究

金東煥,李京燮 대한한의학회 부인과학회 2001 大韓韓方婦人科學會誌 Vol.14 No.1

Obesity is a condtion that fatty tissue is accumulated in the body excessively. It can make people dwindle mentally and socially, and increase diseases of adult people for example hypertension, arteriosclerosis, DM and so on. these days, obese people are increasing because the standard of living improved and the eating habits changed like western nations. As people have more understandings of obesity, people who want to be managed by the obesity management center's treatments are increasing. We selected the fifty patients who had taken the whole treatments procedure of Kangnam Kyung Hee Korean hospital's obesity management center, and appointed them as the materials. At first, we examined the patients' age, onset, other symptom, other disease, family history, lactation, experienced obesity treatments by using the questionnaire. Treatment for obesity consists of Lipodren, ear-acupuncture, aquamassage, strengthening exercise of waist and abdomen(B-200), radiation of infra-red, dietary treatment, and modification of behavior. And the whole procedure is put in operation twelve times. The comparison of before with after treatments is done by measuring of the change of the degree of obesity, BMI, percent body fat, and fat distribution. Inbody 2.1(Biospace co., Korea) is used as the measuring device, and the paired t-test is used to prove the statistical significance. The mean age of the patients is 30.6. 21 patients(42%) got obese when they were in high school. 15 patients(30%) complained of constipation. 8 patients had digestive diseases, 5 patients heart diseases. 18 patients(36%) had family history of obesity. Speaking of the method of lactation, 12 patients(24%) ate powdered milk, 10 patients(20%) ate both powdered milk and mother's milk in their infancy. So, 44% of all patients ate artificial diet. 35 patients(70%) experienced other treatments for obesity. Among them 20 patients experienced dietary treatment, 14 patients starvation cure, and 13 patients exercise. Before and after treatment, the degree of obesity decreased from 134.44±18.28(%) to 128.12±17.34(%). BMI decreased from 27.854±3.749(㎎/m2) to 26.542±3.509(㎎/m2). Percent body fat decreaesed from 37.142±4.499(%) to 35.238±4.688(%). Fat distribution decreased from 0.9212±0.0625 to 0.8998±0.0576. Body weight decreased from 71.858 11.685(㎏) to 68.486(㎏). We investigated the change of obesity indexes before and after the treatment and got the statistical significant results.(p<0.05) Through this study, we could find out the epidemiologic feature of obese patients and be convinced that our treatments for obesity had a statistical significance.

비만 관련 전문가들이 비만 치료시 느끼는 문제점에 대한 견해 조사

한정순(JungSoon Han),강재헌(JaeHeon Kang),김경아(KyungA Kim),김철환(CheolHwan Kim) 고려대학교 보건과학연구소 2005 보건과학논집 Vol.31 No.2

Bac㎏round : Obesity is correlated with chronic degenerative disease such as cardiovascular disease, hypertension, hyperlipidemia and diabetes etc. Although obese person should try to reduce their weight, they seem to have lack in recognition of obesity and of patience for weight control. Methods : Therefore, This study is about opinions of obesity treatment professionals including doctors, dietician, and sports prescription etc on proper obesity standards, causes for obesity, necessity of weight management, diseases resulting from obesity and methods to treat obesity, earned through research on problems in Korean obesity conducted to them. Results : 1. Professionals regarded waist circumstance as the most proper standard to determine obesity of Korean. 2. Professionals regarded deficient of exercise, rather than life style or intake of dietary fat food, as the biggest cause for obesity of Korean. 3. Professionals regarded necessity of weight management of Korean is to stay healthy. 4. Professionals regarded Diabetes as a disease that can be resulted from obesity of Korean. 5. Professionals said that their obesity patients preferred drug treatment most. 6. Professionals regarded lack of patients" willingness as the biggest reason of failure of obesity treatment. 7. Professionals regarded 69.4 ㎏, 176.3 ㎝(male) and 52.8 ㎏, 162.2 ㎝(female) as the most desirable weight and height.

우리나라 비만치료의 현황: 2020 대한비만학회 비만진료지침을 중심으로

이은정 대한의사협회 2022 대한의사협회지 Vol.65 No.7

Background: Obesity is a complex disease, and its prevalence is gradually increasing globally. The increasing prevalence of obesity is shown to significantly affect the development of obesity-related comorbidities. This paper describes the recent updates on obesity treatment in Korea based on the 2020 Korean Society for the Study of Obesity guidelines for obesity management. Current Concepts: Accurate evaluation of obesity is important before treatment initiation. Obesity in Korean adults is defined as body mass index ≥25 kg/m2, and abdominal obesity is defined as waist circumference ≥90 cm ≥ for men and ≥85 cm for women. It is recommended that energy intake be reduced and that the degree of energy ≥ restriction be individualized based on patient characteristics and medical conditions. Guidelines recommend assessment of the exercise participation and health status before prescribing exercise therapy; aerobic exercise for at least 150 min/week or 3.5 times/week is advised to facilitate weight loss. Although nutrition and behavior therapy and increased physical activity constitute the mainstay of obesity treatment, pharmacotherapy is recommended concomitant with comprehensive lifestyle modification. Bariatric surgery should be actively considered in patients with severe obesity and in those with obesity-related comorbidities. Discussion and Conclusion: Obesity and the associated comorbidities result in an increased socioeconomic and medical burden. Multifactorial intervention using a team approach is warranted for optimal management of obesity. This guideline will benefit primary care physicians for safe and effective decision-making regarding obesity management and treatment.

외래 비만 클리닉에서 행해지는 비만 치료의 목적 및 타당성에 관한 평가

양정혜,이명구,임성진,이보름,권익혁,방준석,이종길,임성실,Yang, Jeong-Hye,Lee, Myung-Koo,Lim, Sung-Jin,Lee, Bo-Reum,Kwon, Ik-Hyun,Bang, Joon-Seok,Lee, Chong-Kil,Lim, Sung-Cil 대한약학회 2009 약학회지 Vol.53 No.1

Metabolic syndrome is increasing nowadays and one of causes is obesity. Therefore prevention and treatment of obesity is very important to decrease of Metabolic syndrome. However currently many pharmacotherapy for obesity are popular in Korea and it may be dangerous. The aim of this study is to evaluate the purpose and relevance of obese treatment in two areas (capital & local) of Korea and suggest to guide for the right directions of pharmacotherapy in obesity treatment. We selected and surveyed 90 patients (88 females, 2 males, age of $23{\sim}60$) at random who received a prescription after consulting with a doctor at several clinics of Cheongju-area and Seoul-area, from May thru June, 2007. And we evaluated their prescriptions. In results, only 26.7% were obese (13.3%, 23<BMI<25) or overweight (13.3%: BMI>25), most 73.3% patients were normal (65.6%, 18.5<BMI<23) or underweight (7.8%, BMI<18.5, p<0.01) by body mass index (BMI: Kg/$m^2$). The purpose of treatment was for appearance (38.9%), health (41.1%) or both (18.9%, p<0.01). 94% patients had the past history of obese treatment. Prescriptions were consisted of CNS stimulant, anticonvulsants, antidepressant, laxatives, diuretics, or antianxietics. Obese treatment is very important for health to prevent disease such as Metabolic Syndrome. However it should not be abused. In conclusion, some patients of obese treatment is not relevant to obesity and pharmacist role is important to guide them for the right directions in obesity treatment.

Clinical impacts of hazardous alcohol use and obesity on the outcome of entecavir therapy in treatment-naïve patients with chronic hepatitis B infection

Won Gil Chung,Hong Joo Kim,Young Gil Choe,Hyo Sun Seok,Chang Wook Chon,Yong Kyun Cho,Byung Ik Kim,Young Yool Koh 대한간학회 2012 Clinical and Molecular Hepatology(대한간학회지) Vol.18 No.2

Background/Aims: The aim of this study was to analyze the clinical impacts of obesity and hazardous alcohol use on the outcome of entecavir (ETV) therapy in chronic hepatitis B (CHB) patients. Methods: The medical records of 88 treatment-naïve patients who were diagnosed with CHB and received ETV between March 2007 and September 2009 were analyzed retrospectively. Body mass index (BMI) values and Alcohol Use Disorders Identifi cation Test (AUDIT) scores were obtained at 6 months after the initiation of ETV (0.5 mg daily) treatment. Results: A BMI of 25 kg/m2 or more was recognized as an indicator of obesity, and a total AUDIT score of 8 or more was recognized as an indicator of hazardous alcohol use. Of the cohort, 24 patients (27.3%) were obese and 17 (19.3%) were hazardous alcohol users. The rate of seroconversion, alanine aminotransferase (ALT) normalization, and hepatitis B virus (HBV)-DNA negativity (<300 copies/mL) at 3, 6, and 12 months of treatment did not differ significantly between the normal-BMI and high-BMI groups. Moreover, the rate of seroconversion and HBV-DNA negativity at 3, 6, and 12 months of treatment did not diff er signifi cantly between the nonhazardous and hazardous alcohol users. However, the frequency of ALT normalization at 12 months was signifi cantly lower among hazardous alcohol users (91.5% vs. 70.6%; P =0.033). Conclusions: Obesity and hazardous alcohol drinking have no significant impact on the outcome of ETV treatment. However, the ALT normalization rate at 12 months after initiation of ETV treatment was signifi cantly lower among the hazardous alcohol users. (Clin Mol Hepatol 2012;18:195-202) Background/Aims: The aim of this study was to analyze the clinical impacts of obesity and hazardous alcohol use on the outcome of entecavir (ETV) therapy in chronic hepatitis B (CHB) patients. Methods: The medical records of 88 treatment-naïve patients who were diagnosed with CHB and received ETV between March 2007 and September 2009 were analyzed retrospectively. Body mass index (BMI) values and Alcohol Use Disorders Identifi cation Test (AUDIT) scores were obtained at 6 months after the initiation of ETV (0.5 mg daily) treatment. Results: A BMI of 25 kg/m2 or more was recognized as an indicator of obesity, and a total AUDIT score of 8 or more was recognized as an indicator of hazardous alcohol use. Of the cohort, 24 patients (27.3%) were obese and 17 (19.3%) were hazardous alcohol users. The rate of seroconversion, alanine aminotransferase (ALT) normalization, and hepatitis B virus (HBV)-DNA negativity (<300 copies/mL) at 3, 6, and 12 months of treatment did not differ significantly between the normal-BMI and high-BMI groups. Moreover, the rate of seroconversion and HBV-DNA negativity at 3, 6, and 12 months of treatment did not diff er signifi cantly between the nonhazardous and hazardous alcohol users. However, the frequency of ALT normalization at 12 months was signifi cantly lower among hazardous alcohol users (91.5% vs. 70.6%; P =0.033). Conclusions: Obesity and hazardous alcohol drinking have no significant impact on the outcome of ETV treatment. However, the ALT normalization rate at 12 months after initiation of ETV treatment was signifi cantly lower among the hazardous alcohol users. (Clin Mol Hepatol 2012;18:195-202)

원저 : 한방비만프로그램을 통한 체중과 부위별 복부둘레의 경과 관찰 및 상관성 연구

허수정 ( Su Jeong Heo ),이재은 ( Jae Eun Ie ),김현진 ( Hyun Jin Kim ),조현주 ( Hyun Ju Cho ),명성민 ( Sung Min Myoung ) 한방비만학회 2009 한방비만학회지 Vol.9 No.2

The purpose of this study was to investigate the progress of weight and waist circumference(WC) through oriental obesity treatment and clarify the correlation between weight loss and WC change. Methods The subjects were treated from January 2007 to September 2009 in J Oriental Medical Center. Herbal medicine, electro acupuncture, oriental obesity physiotherapy were performed for a month. We checked the change of weight and WC at every treatment. We classified the WC into upper, middle, lower parts specifically and measured them individually. Measurements were analyzed by using one-way repeated measures ANOVA and we also investigated correlation between weight loss and WC change. Results (1) During the first and second treatment sessions, the weight loss was the highest, 0.96±0.86 kg(1.46±1.32 %) and during the 5th and 6th treatment sessions, the lowest 0.37±0.61 kg. The final weight loss was 3.71±1.47 kg(5.51±2.12 %). (2) After 8 treatment sessions, the reductions of upper, middle and lower WC were 3.59±2.26 %, 5.93±2.75 %, 5.51±3.22 %, respectively. As the patients received more treatment, there was a progressive decline in the variation of weight and middle WC. However, the decline rate of upper and middle WC fluctuated during the treatments, forming a W-shaped curve. (3) Analysis of the correlation between the weight loss and WC change shows that the reduction of middle WC was most closely associated with the weight loss. Conclusions This study indicated that the rate of weight loss and WC reduction showed stagnation during the 5th and 6th treatment sessions, and the reduction of middle WC was most closely associated with the weight loss. Since the progress of weight and WC change is an important field of research on obesity, further systemic studies would be needed for the foundation of a clinical guideline.

Obesity and hypertension in children and adolescents

Jeong Sooin,Kim Sung Hye 대한고혈압학회 2024 Clinical Hypertension Vol.30 No.-

As childhood obesity rates increase worldwide, the prevalence of obesity-related hypertension is also on the rise. Obesity has been identified as a significant risk factor for hypertension in this age group. National Health Surveys and meta-analyses show increasing trends in obesity and pediatric hypertension in obese children. The diagnosis of hypertension in children involves percentiles relative to age, sex, and height, unlike in adults, where absolute values are considered. Elevated blood pressure (BP) in childhood is consistently associated with cardiovascular disease in adulthood, emphasizing the need for early detection and intervention. The pathogenesis of hypertension in obesity involves multiple factors, including increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system (RAAS), and renal compression due to fat accumulation. Obesity disrupts normal RAAS suppression and contributes to impaired pressure natriuresis and sodium retention, which are critical factors in the development of hypertension. Risk factors for hypertension in obesity include degree, duration, and distribution of obesity, patient age, hormonal changes during puberty, high-sodium diet, sedentary lifestyle, and socioeconomic status. Treatment involves lifestyle changes, with weight loss being crucial to lowering BP. Medications such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may be considered first, and surgical approaches may be an option for severe obesity, requiring tailored antihypertensive medications that consider individual pathophysiology to avoid exacerbating insulin resistance and dyslipidemia. As childhood obesity rates increase worldwide, the prevalence of obesity-related hypertension is also on the rise. Obesity has been identified as a significant risk factor for hypertension in this age group. National Health Surveys and meta-analyses show increasing trends in obesity and pediatric hypertension in obese children. The diagnosis of hypertension in children involves percentiles relative to age, sex, and height, unlike in adults, where absolute values are considered. Elevated blood pressure (BP) in childhood is consistently associated with cardiovascular disease in adulthood, emphasizing the need for early detection and intervention. The pathogenesis of hypertension in obesity involves multiple factors, including increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system (RAAS), and renal compression due to fat accumulation. Obesity disrupts normal RAAS suppression and contributes to impaired pressure natriuresis and sodium retention, which are critical factors in the development of hypertension. Risk factors for hypertension in obesity include degree, duration, and distribution of obesity, patient age, hormonal changes during puberty, high-sodium diet, sedentary lifestyle, and socioeconomic status. Treatment involves lifestyle changes, with weight loss being crucial to lowering BP. Medications such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may be considered first, and surgical approaches may be an option for severe obesity, requiring tailored antihypertensive medications that consider individual pathophysiology to avoid exacerbating insulin resistance and dyslipidemia.

한의 치료로 호전된 소아비만 환자 9례에 대한 임상증례군 보고

최은영,이현희,이혜림 대한한방소아과학회 2023 대한한방소아과학회지 Vol.37 No.3

Objectives This study was written to report Korean medicine treatment for obese children. Methods This study included obese children who visited the Department of Korean Pediatrics at the Daejeon Korean Medicine Hospital of Daejeon University from September 18, 2020 to March 30, 2023. Height and weight at the first visit and on the day of the last herbal medicine termination were measured, and changes before and after treatment were observed. Liver function tests were performed before and after the treatment. Results Of the nine obese children who received Korean medicine treatment, five were male (55.6%) and four, female (44.4%). In term of age, there were five 8-year-olds (55.6%), two 6-year-olds, and two 10-year-olds (22.2%); the patients’ mean age was 8.00 ± 1.414 years. The treatment period was more than three months, and the average treatment period was 177.11 ± 106.013 days. After treatment with Korean medicine, the patients’ heights increased, and the body mass index (BMI) percentile and obesity decreased. Liver levels were maintained within the normal range without abnormal liver function after herbal medicine treatment, and no adverse reactions were observed during Korean medicine treatment. As a result of the pattern identification analysis, gastrointestinal damp-heat type and yin deficiency with internal heat were reported at a high frequency. Conclusions Korean medical treatment can reduce the degree of obesity without hindering the growth of childhood obesity.

한방병원에서 시행 한 소아 비만 관리 프로그램 10예에 대한 평가

정선희,이승연,Jeong, Sun-Hee,Lee, Seung-Yeon 대한한방소아과학회 2004 대한한방소아과학회지 Vol.18 No.2

Objective : There have been many programs to treat childhood obesity, since childhood obesity has shown up as a social problem. The purpose of this study was to find out considerable matters to manage Childhood Obesity Treatment Program (COTP). Methods : This study was made with reference to clinical progress notes of children with obesity, visiting the oriental medicine center, to take COTP from July 30th, 2003 to August 25th, 2004. COTP was consist of abdominal aroma massage, abdominal low frequency acupuncture therapy, auricular acupuncture therapy and behavior modification. Results : 1. Seven children who taken COTP started fat from young age and three started from about ten-year-old ages. 2. Six children have fat fathers, a child has fat parents and three children have no fat family member. 3. The obesity levels of Obesity Index(OI), Body Mass Index(BMI) and Rohler Index(RI) were different, used for evaluating the result of treatment, though they are used for a child. The result of OI reflected more sensitive from changes of weight than those of BMI and RI. 4. We got the better results with numbers of treatment and exercise. Conclusions : More correct standard are needed to estimate degree childhood obesity. And it is necessary to carry out obesity treatment program with behavior modification, for children with obesity. to be healthy adults.

소아비만의 치료에 대한 국내 임상연구 동향

김경리,한재경,김윤희,Kim, Kyoung Ri,Han, Jae Kyoung,Kim, Yun Hee 대한한방소아과학회 2016 대한한방소아과학회지 Vol.30 No.3

Objectives The purpose of this study is to investigate Korean clinical studies on treatment of childhood obesity and to propose for better treatment options for childhood obesity. Methods Based on RISS, KISS, OASIS, KMbase with the keyword 'childhood obesity', 'child obesity', 'obese child', 'overweight child', total of 21 randomized controlled trials (RCTs), 11 single clinical studies, 3 chart reviews and 3 case reports have been found, and were analyzed. Results and Conclusion 1. Some study subjects were classified based on their sex - only men or women in a group or sometimes both. Another way of classify the study subjects were based on their age - preschooler, primary school students, middle school students, and high school students. The diagnostic criteria of the subjects were BMI (body mass index), Body fat percentage, Obesity index, Weight and unknown criteria. 2. The treatments used in 38 studies were exercise alone, education alone, both exercise and education or herbal therapy. The 7 studies that used herbal therapy as part of their study intervention had a study group with herbal intervention only and the other 2 study group with herbal treatment in addition to exercise and education. 3. 9 studies included herb medicines, electroacupuncture, auricular acupuncture, cupping, aroma massage, infrared light, and abdomen pad. Herb medications used in 5 studies included Chegameuiin-tang 2 kinds, Sobieum, Biman-tnag, and I-razin. 4. The methods of assessment used in 38 studies were classified by 7 categories and anthropometry parameters which is the basic methods are used in all studies 5. Almost studies (29 studies in all 38 studies) were using anthropometric parameters results on significantly effectiveness of childhood obesity. 6. More studies are needed to prove true effectives from various treatments, especially herbal therapy for childhood obesity.