In-depth analysis of extreme weight loss methods: the burden of marathon running and the truth about liposuction.
The marathon-style weight loss method utilizes exercise to increase energy expenditure, thereby reducing weight. Running is the most popular choice among those trying to lose weight. Studies show that running burns more calories per hour than swimming, skipping rope, or playing badminton. However, many people still have insufficient understanding or misconceptions about exercise for weight loss. The disproportionate effect of exercise on weight loss, or even weight gain, is a source of frustration for many dieters. The most typical example is the marathon-style, long-duration, high-intensity running method. I. Does running longer lead to more weight loss? Marathon runners often believe that the longer they run, the more energy they burn, and the more effective it is for weight loss. In fact, the effectiveness of running for weight loss is not necessarily proportional to the running duration, but rather depends heavily on whether energy intake is restricted and the type or form of exercise. Studies show that the weight loss effect of exercise can vary greatly among individuals, but overall, under conditions of no energy restriction, 150 minutes of moderate-intensity exercise per week or marathon-style running can result in no change in weight or even weight gain. Furthermore, the weight loss effect of running is also related to running speed, intensity, and regularity. The following are common reasons why exercise may not be very effective for weight loss:
The goal of running too fast for weight loss is to reduce body fat, and fat burning primarily occurs through aerobic exercise. Therefore, running too fast not only fails to burn fat but also accelerates glycogen depletion, leading to exercise-induced hypoglycemia and reduced athletic performance. Low-to-moderate intensity aerobic exercise at 45%–65% of maximum oxygen uptake (VO2 max) has the highest fat oxidation efficiency, while exercise exceeding 70% of VO2 max actually decreases fat oxidation efficiency.
Eating after exercise can lead to increased appetite and extreme thirst due to energy depletion, decreased blood sugar, and dehydration. Many people reward themselves with sports drinks or delicious food, but these drinks or foods often contain a lot of energy, easily replenishing or even exceeding the energy consumed during exercise.
A sedentary lifestyle outside of exercise is key to weight loss by ensuring energy expenditure exceeds energy intake, achieving a negative energy balance. If daily physical activity is minimal, relying solely on exercise to burn energy often fails to achieve the desired results.
Running is difficult to execute. It is a high-intensity and time-consuming exercise that is hard to maintain in the long run. Over time, it can easily lead to psychological burden, increase feelings of self-defeat and guilt, deviate from the original positive intention of weight loss, and even cause people to give up on themselves.
Running in a monotonous environment for extended periods on the same route leads to rapid muscle adaptation and psychological boredom, easily resulting in a weight loss plateau and making it difficult to sustain a running plan. Secondly, the dangers of marathon-style weight loss: Marathon running may not be effective for weight loss and can place significant physical strain on the body. Studies show that even professionally trained marathon runners experience severe joint damage, muscle tears, inflammation and redness on the inner thighs, and even acute kidney injury such as hematuria and proteinuria after running. Prolonged running also causes significant changes in body fluid composition. On the one hand, increased blood concentration burdens internal organs; on the other hand, significant loss of water and electrolytes through sweating leads to thirst, weakness, and even life-threatening shock. Improperly replenishing with excessive water at this time can easily cause hyponatremia and electrolyte imbalance, resulting in nausea, dizziness, and blurred vision in mild cases, and severe consequences such as cerebral edema, headache, and permanent damage to the nervous system in severe cases. Therefore, post-exercise hydration should be combined with electrolyte replenishment, ideally using sports drinks rich in electrolytes. Furthermore, prolonged, high-intensity exercise can lead to stress-induced damage to the immune system, making one more susceptible to colds, fever, and even increasing the risk of infection. The improper pre-run preparation, running techniques, and post-run recovery practices of non-professional athletes can further aggravate joint and cartilage damage, increasing the burden on the heart and lungs. This is especially true for people with respiratory and circulatory system diseases; for them, marathon running is undoubtedly adding insult to injury. Therefore, it is not recommended for ordinary people to choose marathon running for weight loss and fitness; they should proceed according to their own physical condition. Liposuction is a revolutionary approach to weight loss, offering the advantage of rapidly reducing subcutaneous fat. The earliest liposuction surgery can be traced back to 1890, when Demars and Marx first reported "abdominal wall skin and fat removal." In the 1920s, Charles Dujarier, a surgeon in Paris, France, first used small incision local fat scraping to reshape the body and remove body fat, ushering in a new era of small-incision liposuction surgery. Today, liposuction has become one of the most common cosmetic surgeries, with an estimated 1.453 million procedures performed worldwide annually. However, whether liposuction is a universally applicable weight loss method requires careful consideration. Experts advise that liposuction is not suitable for treating simple obesity. I. The Mystery of Liposuction Liposuction, also known as fat removal, is a procedure that quickly removes fat cells from certain subcutaneous areas of the body to achieve body contouring or as an adjunct treatment for diseases. The main methods of liposuction include: ① Tumescent liposuction; ② Resonance liposuction; ③ Ultrasonic liposuction; ④ Water-assisted liposuction. In addition, there are electronic liposuction, laser-assisted liposuction, radiofrequency-assisted liposuction, and endoscopic-assisted liposuction. The underlying principles of liposuction, regardless of the method, are essentially the same: first, fat cells are dissolved and broken down using a certain technique without affecting the neurovascular structure, while maintaining fluid balance. Then, specific suction equipment is used to remove the fat from the body, minimizing patient discomfort. Currently, with the continuous development of liposuction, its indications are rapidly expanding. It has become an important auxiliary technique to improve other cosmetic surgeries, including neck augmentation, breast reduction, abdominoplasty, arm augmentation, thigh lifting, and post-weight loss body contouring. However, liposuction is not a permanent solution. Compared to weight loss methods such as diet control and exercise, liposuction's biggest advantage is its speed, and it is the only way to truly reduce the number of fat cells in the body. Many people even believe that liposuction can reduce the number of fat cells, achieving "permanent" weight loss. However, liposuction is not a permanent solution. Studies have shown that while women undergoing abdominal liposuction may experience significant weight loss and BMI improvement within 12 months, this effect disappears within a few months (3-20 months) post-surgery. Surgical fat removal is likely to trigger a feedback loop of fat redistribution and compensatory fat growth, especially a compensatory increase in visceral fat. Furthermore, liposuction only removes excess fat and does not increase basal energy expenditure; many people who do not change their diet and lifestyle after surgery are more prone to weight regain. III. Risks of Liposuction While liposuction has become a relatively safe subcutaneous surgery due to advancements in science and technology, it still carries certain risks. According to foreign statistics, one person dies in every 47,415 surgeries, a rate of 0.0021%. Liposuction can lead to more than 20 complications. The most common complication is irregular shape, with an incidence rate of 2.7%. For those who are highly concerned about their appearance or have a fear of deformity, impulsively choosing liposuction could lead to lifelong regret. The five most serious complications-thromboembolism, fat embolism, pulmonary edema, lidocaine poisoning, and intra-abdominal organ lesions-can all lead to death. For example, the most common pulmonary thromboembolism has a mortality rate as high as 23%. Although some studies have reported that liposuction can improve the body's metabolism of sugars and lipids and increase insulin sensitivity to some extent by reducing a large number of fat cells, physical activity is far more effective and safer than liposuction. Once complications occur, the losses often outweigh the gains. IV. What to pay attention to with liposuction: For some severely obese patients (BMI > 30 kg/m²) who have developed lower limb osteoarthritis and other fat-related diseases, such as lipedema, lymphodystrophy syndrome, multiple symmetrical lipomas, and insulin-induced lipodystrophy, which seriously affect their quality of life, liposuction may be a better treatment option if it is difficult to improve through diet and physical activity alone. In this case, it is essential to consult an experienced professional plastic surgeon for a thorough evaluation. The following points should also be noted:
Small, multiple aspirations are recommended. Generally, no more than four sites should be aspirated at a time. Without hospitalization, no more than 800ml of fat should be aspirated at a time, while aspirations of more than 1000ml require hospitalization for observation.
Choose safe suction sites; classic areas include the chin, upper arm, abdominal belt, buttocks, and thighs.
Pay attention to postoperative care and rehabilitation, and use physical therapy such as elastic bandages and infrared rays.
Control your total dietary energy intake, supplement with protein, and maintain a balanced diet.
Regular exercise after surgery can help prevent the accumulation of visceral fat in the abdomen.
Liposuction is not recommended for individuals during their growth and development period, menstruation, or if they have diabetes or hypertension. In short, liposuction is not a suitable method for weight loss. Proper weight loss should be sought from doctors and nutritionists, relying on a balanced diet and appropriate exercise to achieve weight loss without harming one's health.
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