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 Luo Han Ying
Endocrinology
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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.

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Written by Tang Zhuo
Endocrinology
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Obesity weight loss methods

The treatment of obesity involves two main components. One is reducing calorie intake and the other is increasing calorie consumption, mainly emphasizing a comprehensive treatment based primarily on diet and exercise. Secondly, medications or surgical treatments can be utilized. In the case of secondary obesity, it is important to treat the underlying cause. So, what is behavioral therapy? It involves educating patients and their families about obesity and its risks, enabling them to cooperate with the treatment, adopt a healthy lifestyle, change dietary and exercise habits, and maintain these changes consciently in the long term as the foremost and most important measures in the treatment of obesity. Thirdly, controlling diet and increasing physical activity are crucial. Individuals with mild obesity can control their total food intake with a low-calorie, low-fat diet. For those with moderate to severe obesity, total calorie intake should be strictly controlled, with women limited to 1200-1500 kcal per day and men to 1500-1800 kcal per day. Following this standard, a weight loss of 1-2 pounds per week can be achieved. Furthermore, for severe obesity, medications can be used to reduce weight, which can then be maintained. If necessary, surgical procedures such as jejunoileal bypass or biliopancreatic diversion surgery can be considered.

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Written by Luo Juan
Endocrinology
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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.

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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 Luo Juan
Endocrinology
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Obesity is classified as a disease.

Obesity is a clinical syndrome characterized by a body mass index (BMI) exceeding normal levels. Generally, obesity with an unclear cause is called simple obesity, or primary obesity, while obesity with a known cause is called secondary obesity. In China, the standards for BMI are as follows: a normal BMI is below 24 kg/m². Being overweight is defined as having a BMI greater than 24 kg/m², mild obesity is greater than 26 kg/m², moderate obesity is greater than 28 kg/m², and severe obesity is greater than 30 kg/m². Therefore, obesity is a metabolic clinical syndrome.