After gaining 20 kg in one year, Ms. Xuyen embarked on an aggressive weight loss regimen. Her diet consisted primarily of salads and vegetables with minimal meat, completely eliminating carbohydrates. She also incorporated twice-daily gym sessions, once in the early morning and again late at night. While she lost 6 kg in the first month, she felt exhausted. Her weight then began to rebound from the second month onwards.

Facing persistent low energy, insomnia, and irregular menstruation, Ms. Xuyen sought medical attention at Tam Anh General Hospital Ho Chi Minh City. She weighed 70 kg, with a body mass index (BMI) of 29 and visceral fat measuring 264 cm2 – more than 2,5 times the safe limit. This classified her as grade two obese. Doctor Vo Tran Nguyen Duy, from the Department of Endocrinology and Diabetes, noted her muscle mass was below 30%, significantly lower than the average 40-44% expected for her age.

Doctor Duy analyzes Ms. Xuyen's muscle and fat indices. Photo: Tam Anh General Hospital

Doctor Duy analyzes Ms. Xuyen's muscle and fat indices. Photo: Tam Anh General Hospital

"The patient's muscle loss resulted from prolonged improper dieting," Doctor Duy explained. He added that fasting for weight loss depletes the body's energy and protein stores. Protein is crucial for nourishing and protecting muscles during weight loss. Insufficient protein intake prevents the body from adequately recovering muscle, leading to atrophy.

Overtraining further exacerbates the problem, forcing the body into "survival mode." In this state, the body prioritizes fat storage and breaks down muscle for energy, leading to counterproductive results. Excessive exercise also heightens stress, further eroding muscle. Muscle loss reduces calorie burning, causing weight plateaus despite continued dieting or exercise. Poor sleep and high stress elevate cortisol, a hormone that can degrade muscle when sustained at high levels. Lack of sleep also lowers testosterone and growth hormone, impairing muscle regeneration.

Doctors and nutritionists then provided Ms. Xuyen with a balanced diet plan to support weight loss, combined with obesity medication. Instead of extreme restriction, she learned to consume adequate nutrients, including carbohydrates and protein for muscle maintenance, alongside 30-60 minutes of daily exercise.

After one month, she lost 5 kg without the previous fatigue. An InBody scan showed a slight muscle increase to 32% and a 25 cm2 fat reduction. After three months, she had lost 13 kg, with muscle mass reaching 40%. She continues treatment, aiming to lose another 7 kg.

Ms. Xuyen undergoes a blood fat index test. Photo: Tam Anh General Hospital

Ms. Xuyen undergoes a blood fat index test. Photo: Tam Anh General Hospital

Doctor Duy recommends that overweight and obese individuals reduce their total daily calorie intake by 10-20% (300-500 calories). This approach provides sufficient energy to protect muscle while effectively burning fat. To maintain muscle mass, individuals should consume about 1,6-2,2 g of protein per kg of body weight daily, prioritizing high-quality sources like chicken breast, fish, and eggs. Opt for slow-absorbing carbohydrates for sustained energy, avoiding refined sugars and fast food, which can lead to increased insulin and fat accumulation.

Duc Hanh

*Patient's name has been changed