Choosing a workout routine? Look for professional advice

Kim Hyung-kon, the father of satirical comedy in Korea, died suddenly last Saturday. The late Kim once weighed 120 kilograms (264 pounds), but dropped this to 90 kilograms three years ago after going on a crash diet.
“We are not sure what the exact cause of his death was, but there is a possibility of a myocardial infarction [heart attack] due to obesity, or ischemic heart disease, or arrhythmia because he died just a few minutes after he finished exercising at a gym,” said Song Hyoung-Gon, an emergency medical doctor at Samsung Medical Center. Incidents of crash dieting followed by sudden death after a workout are increasing.
Those who drop weight rapidly are most likely to suffer from the so-called “yo-yo” syndrome whereby without a strict exercise regimen and diet control the lost weight can be rapidly regained. This is because the body reacts as if it is in an extreme starvation situation if weight drops dramatically, and it goes into an “emergency mode” in order to build up food reserves. This exacerbates the battle between the body’s desire to eat and the mind’s desire to lose weight.
People who have lost weight by exercising tend to workout excessively and drive themselves relentlessly, even if they only gain a few pounds ― they suffer from “weight phobia.”
“Those who lose a lot of weight are suffering from weight phobia even though the degree is different depending on the individual,” said Kang Jae-heon, a family medical doctor at Seoul Paik Hospital. “They step on the scale a number of times a day, or talk to themselves, saying ‘I wish this [fat] would go away,’ as they touch their abdomen.” Such people are very conscious, almost obsessive, about their weight, he added.
Dr. Kang said that doing the wrong exercises can even be bad for a person’s health. The late Kim recommended on a TV show a few days before his death that doing a workout after taking a shower in hot water was an effective way to lose weight. He explained that the process speeds up the body’s metabolism and makes a person sweat more as the heat helps open up the skin’s pores. It was reported that Kim had a sauna before running on a treadmill ― he died shortly afterwards in a bathroom. If this is true, Kim did the worst thing to place additional stress on his heart.
A sauna helps a person sweat more but it also slows down blood circulation. If one rigorously exercises in this situation, the heart pumps faster to maintain an adequate blood supply to the muscles. Thus, if a coronary artery has lost its elasticity or is clogged at some point, a myocardial infarction can ensue, stopping the heart.
“Some middle-aged people who are overweight have a sauna or exercise wearing water retaining training suits in order to sweat more so that they can lose more weight,” Dr. Kang observed. “But that is very dangerous idea.”
Also, losing weight by exercise alone doesn’t always mean that you have become healthy. There are reports noting that formerly obese people still have a higher possibility of getting cardiovascular diseases even after losing weight, compared to people who have consistently maintained a normal weight.
“By losing weight, the possibility of getting cardiac disorders can drop, but already narrowed or damaged arteries don’t improve dramatically,” said Kwon Hyeon-cheol, a cardiologist at Samsung Medical Center.
Another expert said that people should reduce their level of exercise when they feel emotional or mental stress. Mental instability or stress triples the possibility of sudden death. Suffering from neuroses about dieting, or obsessing about exercise also produces stress that can exacerbate cardiovascular illnesses.
“There are some people who die suddenly from a heart attack after finishing a marathon,” said Yang Yun-joon, a family medical doctor at the Sports Medicine Center of Ilsan Paik Hospital. “There are no symptoms until two-thirds of the coronary arteries are clogged, so even those who do exercise regularly should get regular check ups especially if they smoke or have high blood pressure,” Dr. Yang recommended.

by Ko Jong-kwan