Analysis of Weight Loss Taboos and Extreme Methods: The Health Costs of Diarrhea-Based Weight Loss, Risks of Liposuction, and Indications for Gastric Reduction Surgery

Diarrhea is a common digestive symptom, commonly known as "loose stools," characterized by an abnormally increased frequency of bowel movements and loose stools. Some classify diarrhea into pathogenic diarrhea and drug-induced diarrhea. Drug-induced diarrhea refers to the elimination of large amounts of intestinal contents and water through diarrhea by taking weight-loss drugs, slimming teas, or fat-blocking pills, which prevent the body from absorbing nutrients and fats, thus achieving weight loss. While diarrhea can indeed lead to short-term weight loss, its side effects can be more harmful than obesity itself. Diarrhea causes the body to expel a large amount of water in a short period. When the body is severely dehydrated, the skin becomes dull and lifeless, cells shrink, and their activity decreases, seriously affecting health.

Furthermore, some slimming teas or pills contain ingredients like phenbutylamine and fluphenazine. These suppress appetite by acting on serotonin and the central nervous system, but they also significantly increase the burden on the heart. Long-term use can affect cardiac function and may even induce heart disease. Fat ingested into the digestive tract is a large molecule; the epithelial cells of the digestive tract cannot absorb triglycerides. They must be broken down into glycerol and fatty acids by pancreatic lipase before they can be absorbed. One slimming drug called Senic works by inhibiting pancreatic lipase activity; since triglycerides cannot be broken down, they cannot be absorbed into the bloodstream and are excreted from the body.

Loose stools containing fat can irritate the rectum, easily causing intolerable steatorrhea in children and adolescents. Long-term use of selenochemicals can lead to fat-soluble vitamin deficiencies due to impaired fat digestion and absorption. Using diarrhea for weight loss can result in nutrient deficiencies due to impaired nutrient absorption, affecting the growth and development of children and adolescents, and significantly impacting the health of adults. Therefore, the use of drugs and methods of inducing diarrhea for weight loss are strictly prohibited during exercise. Since body fat is mostly distributed in the abdomen, buttocks, and thighs, localized surgical liposuction methods have emerged.

Surgical liposuction involves removing excess fat through surgical procedures. It is generally divided into open surgery and liposuction. Liposuction refers to the removal of excess fat tissue using various types of liposuction tools while preserving the skin and superficial fat tissue. Its advantages are speed and, although invasive, the area involved is relatively small. Disadvantages include significant bleeding, serious complications and side effects, the need for general anesthesia, and the potential for anesthetic complications. Post-operatively, small fat fragments may dissolve into the bloodstream, leading to fat embolism and potentially causing brain injury. Localized liposuction can also cause skin depressions that are difficult to correct.

Liposuction only temporarily removes large pieces of fat tissue from the body. If unhealthy lifestyle habits such as overeating and lack of exercise are not changed, obesity may recur. Obesity is a systemic accumulation of fat; even after liposuction, a large amount of fat remains in the body, therefore its effect on alleviating fatty liver and dyslipidemia is not significant. Liposuction is generally not recommended for obese patients. It is only considered as a weight-loss method for a few obese patients who cannot lose weight through exercise. "Sleeve gastrectomy," also known as laparoscopic gastric reduction surgery, is one of the methods for treating morbid obesity.

The basic method involves laparoscopically removing the greater curvature of the stomach body and fundus using a linear cutting and closing device, creating a tubular shape from the remaining stomach and thus reducing its volume. This also removes most of the secretory cells within the stomach, leading to a decreased appetite post-surgery. Two factors contribute to hunger: a drop in blood sugar and a reduction in the volume of gastrointestinal contents. This "small stomach" surgery removes a large portion of the stomach, allowing for greater stomach expansion with less food, easily creating a feeling of fullness, stimulating the satiety center, and decreasing appetite. While this surgery is simpler and safer than other weight-loss surgeries, it alters the normal structure of organs, and the removed stomach cannot be restored, potentially leading to complications such as bleeding and leakage at the resection margins.

If unhealthy eating habits such as overeating are not changed, the capacity of a "small stomach" can still gradually expand. Therefore, stomach reduction surgery is generally not recommended. Weight loss can be achieved through dietary restrictions, changing unhealthy lifestyle habits, and increasing physical exercise. Surgery is only considered when other weight loss methods fail to significantly improve obesity, and the patient has obesity-related diseases such as hypertension or diabetes, poses a significant risk to exercise, and has a BMI > 32 kg/m².