What department should I go to for obesity?

Written by Zhao Xin Lan
Endocrinology
Updated on September 25, 2024
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Obesity is a chronic metabolic disease that belongs to the field of endocrinology, so the first choice for early-stage obesity is to see an endocrinologist. Some hospitals also have specialized weight management departments, which are also an option for consultation. When obesity is accompanied by other serious comorbid conditions, such as coronary heart disease or heart failure, in addition to seeing an endocrinologist, it is also necessary to visit the cardiology department. If there is concomitant osteoarthritis, a visit to the orthopedics department is needed. Women suffering from menstrual irregularities or infertility should consult with a gynecologist. In summary, obesity is a disease that can cause multiple metabolic abnormalities and damage multiple systems, requiring early prevention and treatment.

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Causes of Obesity

Obesity, also known as adiposis, is a chronic metabolic disease caused by excessive accumulation or abnormal distribution of fat in the body. It results from the interaction of multiple factors including genetic and environmental factors that cause fat accumulation. Primary obesity, also known as simple obesity, is the most common type and is mainly caused by poor dietary habits, such as excessive food intake, particularly excessive fats, and a sedentary lifestyle. There is also secondary obesity, which is generally caused by diseases of the endocrine system. Hormonal treatments for allergic diseases and rheumatic diseases can also lead to secondary obesity.

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What medicine is taken for obesity?

Regarding obesity, first and foremost, one should not eat arbitrarily, meaning one should not randomly choose the so-called weight loss drugs available on the market. For obesity, we identify two types: primary obesity and secondary obesity. Primary obesity occurs without any specific reason, merely due to an irregular lifestyle, unhealthy diet, lack of exercise, etc., leading to weight gain. Secondary obesity has identifiable medical causes; for example, weight gain caused by taking large amounts of exogenous hormones; or hypothyroidism leading to myxedema, which causes weight gain; or issues with the pituitary or adrenal glands leading to excessive secretion of cortisol in the blood, causing a redistribution of fat that results in Cushing's syndrome, among others. For these types of secondary obesity, it is important to identify the underlying causes and treat them accordingly. For primary obesity, it is not advisable to recommend weight loss drugs commonly found on the market. The first recommendation is to control the diet scientifically, combined with a certain intensity of aerobic exercise to reduce weight. Caution is advised with those weight loss drugs sold by online marketers; one should not consume them carelessly.

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Surgical treatment of obesity

Surgical treatment for obesity is applicable under certain conditions. This requires the obesity to reach a specific level, defined by indicators such as a BMI of over 35, and in the absence of severe diabetes or complications associated with diabetes. Considering surgical interventions for weight loss, these primarily involve bariatric surgeries like gastric bypass or gastroenterostomy which reduce food intake and absorption, thereby decreasing calorie absorption to achieve weight loss. While the effects of surgical weight loss are generally quite good, it can lead to some long-term postoperative complications, so careful consideration is required.

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How is obesity treated?

Regarding the treatment of obesity, the cause of obesity must first be identified. For patients with simple obesity, the primary approach involves lifestyle interventions, including exercise and diet. The diet should involve a calculation of caloric intake based on activity levels, generally focusing on a low-calorie or very low-calorie intake. Additionally, it is recommended to engage in suitable aerobic exercises. Currently, there are products available such as fat enzyme inhibitors that reduce weight by inhibiting the absorption of fats in the intestines. Also, in the United States, GLP-1 agonists are available for the treatment of simple obesity. If obesity is caused by certain medical conditions, such as an endocrine disorder known as Cushing's syndrome, which can also lead to obesity, treatment should first address the primary disease, which would also resolve the obesity.

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What tests are needed for obesity?

Obesity is divided into simple obesity and secondary obesity. Simple obesity refers simply to being overweight without any other primary diseases. Secondary obesity requires examination of certain conditions, such as hypothyroidism, which can lead to obesity, thus necessitating thyroid function tests; or Cushing's syndrome, which involves increased body weight due to excessive corticosteroid hormones produced by various causes, necessitating an examination of the cortisol rhythm and sometimes a dexamethasone suppression test, magnetic resonance imaging (MRI) of the pituitary, and CT scan of the adrenal glands; also conditions such as depression or psychiatric illnesses that can lead to weight gain, requiring corresponding psychiatric scales, among others. In addition to these tests, it is also necessary to consider the patient's clinical symptoms and then conduct targeted examinations based on these symptoms.