Obesity


Obesity is considered a type of disease.
Obesity is an endocrine and metabolic disease, also known as obesity disorder, mainly caused by excessive accumulation or abnormal distribution of body fat, leading to a chronic metabolic disease. It can result from various factors including genetic and environmental interactions, often characterized by excessive abdominal fat accumulation. Additionally, obesity is closely related to the occurrence of hypertension, coronary heart disease, type II diabetes, dyslipidemia, sleep apnea, cholecystitis, gallstones, osteoarthritis, and more. Therefore, obesity is classified as an endocrine and metabolic disease.


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.


What department does obesity hang?
First, I recommend visiting the Department of Endocrinology and Metabolic Science, because obesity itself is a metabolic disease, and now obesity is divided into simple obesity and secondary obesity. Simple obesity refers to weight gain caused solely by factors such as irregular eating habits, unscientific diet, and lack of exercise, without other underlying causes. There is also a type called secondary obesity, which is attributable to identifiable causes. For example, a common disorder in endocrinology known as Cushing's syndrome is caused by problems in the pituitary or adrenal glands, leading to an excessive secretion of cortisol in the blood. This results in the redistribution of fat and subsequent weight gain. Another example is hypothyroidism, which also causes weight gain. Therefore, it is essential to see an endocrinologist, who can determine based on clinical manifestations and actual conditions whether the obesity is simple or secondary, and then provide appropriate treatment.


What department should obesity be treated in?
Obesity should be considered based on the specific situation. If the patient has uniform obesity, meaning that the limbs and torso are equally fat, then they should visit the nutrition department for guidance on dietary control, diet adjustments, and increased exercise. However, if the patient's obesity appears different, for example, if they have a very thick back, a larger belly, a red face, and acne, then I suggest they consult the endocrinology department because it might be related to Cushing's syndrome, which involves centripetal obesity.


early symptoms of obesity
The early symptoms of obesity mainly include fatigue, poor appetite, somnolence, and a general lack of energy. The treatment for these symptoms fundamentally involves controlling obesity and reducing body weight. Weight control methods primarily include, firstly, dietary control by choosing low-calorie diets, such as a ketogenic low-carbohydrate diet to help reduce weight. The second method involves exercise; if one does not have conditions like diabetes, hypertension, or hyperlipidemia, they can gradually engage in both aerobic and anaerobic exercises within their capacity. The third option, if diet and exercise prove insufficient, is to consider medication. There are now a series of weight loss drugs approved by national safety and the Food and Drug Administration that can be used. Additionally, in cases of severe obesity, metabolic surgery can be considered to alleviate the symptoms of obesity. (Please use medication under the guidance of a professional physician and do not self-medicate.)


What should people with obesity not eat?
Patients with obesity generally also have elevated blood lipids, elevated blood uric acid, and slightly high blood sugar. Therefore, regarding diet, it is crucial to strictly adhere to a standard of low salt, low fat, and low purine. Avoid eating fried foods and animal offal, and do not consume carbohydrate-rich foods and sugary drinks. Additionally, for patients with high uric acid levels, it is advised not to consume excessive seafood and rich broths. It is recommended to avoid eating late-night meals, fried foods, and grilled items. The foods that should be avoided by patients with obesity are mainly determined based on the levels of blood sugar, blood lipids, blood pressure, and blood uric acid.


The causes of obesity
Obesity can be classified into primary and secondary obesity according to its causes. Primary obesity, also known as simple obesity, is the most common type among various forms of obesity. It is mainly caused by poor dietary habits such as overeating, especially excessive intake of fatty foods, and a sedentary lifestyle, rather than being secondary to other diseases. Secondary obesity, on the other hand, is often due to diseases of the hypothalamic-pituitary axis, hypercortisolism, hypofunction of the thyroid or gonads, insulinomas, and other diseases. Secondary obesity is mainly due to diseases, and it can show some symptoms of the underlying disease.


Causes of Obesity
In the medical field, obesity is categorized into two types: primary (simple) obesity and secondary obesity. Primary obesity occurs without any other physical diseases and is solely due to irregular lifestyle, unscientific eating habits, and lack of exercise, leading to weight gain. This type can be managed with lifestyle adjustments and proper dietary guidance to reduce weight. Secondary obesity, which is less common, often involves endocrine disorders such as Cushing's syndrome. This condition can arise from issues with the pituitary or adrenal glands, or other parts of the body such as tumors, leading to excessive secretion of cortisol. This in turn causes redistribution of body fat, leading to characteristic signs like moon face, buffalo hump, and accumulation of subcutaneous fat which are manifestations of obesity. Additionally, conditions like hypothyroidism can lead to myxedema, contributing to obesity, as well as drug-induced obesity. Examples include patients with nephrotic syndrome or lupus who experience weight gain from prolonged use of corticosteroids. Therefore, the causes are diverse and require differential diagnosis by a specialist based on the individual's condition.


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.


Can people with obesity do yoga?
Overall, individuals with obesity can still practice yoga, as obesity is a condition of nutritional excess and yoga is an aerobic exercise that can increase metabolic rate in the body, achieving a weight loss effect. However, there are many causes of obesity. Primarily, there is simple obesity, for which yoga can be helpful and can reduce body weight. If obesity is secondary, particularly induced by excessive use of steroids and conditions like Cushing's syndrome, yoga can be an appropriate form of exercise, but it is crucial to address the root cause. If the obesity is due to nodules on the adrenal gland, further surgical treatment might be necessary. Therefore, whether individuals with obesity can practice yoga also depends on their physical strength and other personal health conditions, including heart, liver, and kidney functions.