Surgical treatment of obesity

Written by Yang Li
Endocrinology
Updated on September 06, 2024
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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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Written by Li Lang Bo
Endocrinology
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Which department does obesity belong to?

Obesity is defined by calculating the Body Mass Index (BMI), where one's weight in kilograms is divided by their height in meters squared to obtain a numeric value. If the BMI is 28 or higher, it is defined as obesity. There are two types of obesity based on BMI excess: simple obesity and secondary obesity. Simple obesity occurs without any other internal medical conditions, purely due to weight gain. Secondary obesity may be due to other psychosomatic diseases that lead to an increase in BMI. Therefore, it is recommended to consult the endocrinology department for physical examinations and laboratory tests to determine whether the obesity is simple or secondary. Hence, a consultation in the endocrinology department is advised.

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Written by Li Lang Bo
Endocrinology
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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.

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Written by Tang Zhuo
Endocrinology
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The Harms of Obesity

Mild to moderate primary obesity might not present with noticeable symptoms. However, individuals with severe obesity may experience heat intolerance, reduced physical activity capability, mild shortness of breath during activities, and snoring during sleep. The likelihood of developing coronary heart disease and hypertension is significantly higher in obese individuals compared to those who are not obese. Obesity leads to reduced lung capacity and decreased pulmonary compliance, which can cause various pulmonary functional abnormalities. For instance, obese hypoventilation syndrome, clinically characterized by sleepiness, obesity, and alveolar hypoventilation, often accompanies obstructive sleep apnea. Severe cases of obesity may lead to pulmonary heart syndrome. Obese individuals often experience metabolic disorders of lipids and carbohydrates; lipid metabolism disorders can lead to hypertriglyceridemia and hypercholesterolemia, while carbohydrate metabolism disorders are marked by glucose intolerance and diabetes. Moreover, obese individuals are more prone to arthritis, gout, and osteoporosis. Sexual dysfunction is common in obese individuals, with some obese men developing gynecomastia; obese girls tend to have an earlier onset of menstruation, while adult women with obesity often experience menstrual disorders, and in severe cases, amenorrhea. The incidence of polycystic ovary syndrome is also significantly higher in obese women compared to non-obese women.

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Written by Zhao Xin Lan
Endocrinology
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Can people with obesity exercise?

Obesity is a metabolic disease caused by excessive accumulation of fat in the body or abnormal distribution, commonly referred to as obesity, with body weight exceeding the standard. Obesity can be due to excessive intake and insufficient exercise; thus, not only can obese individuals exercise, but they also need to persist in it. However, during exercise, it is important to consider special circumstances. The amount and method of exercise vary from person to person, and it is necessary to develop individualized exercise plans and choose exercises or programs that are easy to maintain while progressively advancing. However, when designing exercise treatment plans, it is crucial to consider the impact of complications, especially for patients with cardiovascular, respiratory, or musculoskeletal comorbidities, and choose suitable forms of exercise. Generally, it is recommended to exercise three to five days per week, with 30 to 45 minutes of appropriate activity each day. Patients with these complications should avoid intense exercises and can start with mild activities such as brisk walking, swimming, and strolling, or consult with rehabilitation specialists to develop appropriate individualized exercise plans.

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Written by Tang Zhuo
Endocrinology
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Obesity can cause which diseases

Firstly, obesity, also known as adiposity, is a chronic metabolic disease caused by excessive accumulation or abnormal distribution of body fat. Diseases closely related to obesity include cardiovascular diseases, hypertension, diabetes, etc. Complications of obesity also include sleep apnea syndrome, venous thrombosis, and others. Moreover, the occurrence of malignant tumors increases with obesity, as prolonged obesity can lead to skin folds that are prone to abrasions and subsequent fungal or purulent infections.