What causes obesity?

Written by Tang Zhuo
Endocrinology
Updated on March 15, 2025
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Obesity, also known as adiposis, is a chronic metabolic disease caused by excessive accumulation of fat in the body or abnormal distribution of fat. The causes of obesity are numerous and complex. The exact cause is not clear, but it is believed to include a variety of factors such as genetics and environment, which interact with each other. From the perspective of genetic factors, the probability of developing obesity significantly increases. The second factor, the environment, mainly includes diet and physical activity. Long periods of sitting or lack of sports, and insufficient physical activity can lead to reduced energy expenditure. Poor dietary habits, such as overeating, a preference for sweets or greasy foods, can easily lead to obesity. Thirdly, it can be due to some genetic abnormalities. Fourth, obesity in childhood is also more likely to progress to adult obesity, with more than 50% of individuals who are obese after the age of six developing obesity in adulthood.

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Written by Zhao Xin Lan
Endocrinology
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What department should I go to for obesity?

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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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.

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Written by Luo Juan
Endocrinology
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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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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 Luo Juan
Endocrinology
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symptoms of obesity

Regarding the symptoms of obesity, they vary with the type of disease. For example, in secondary cases, there are clinical manifestations of the primary disease. For instance, obesity caused by hypothyroidism may also present with fatigue, poor appetite, dry skin, etc. Some people have obesity due to insulinoma or recurrent hypoglycemia, leading to repeated eating. The clinical manifestations also include symptoms of hypoglycemia such as palpitations, trembling hands, sweating, and a sense of hunger. If it is a case of simple obesity, generally, men primarily show an apple-shaped obesity, with fat accumulated mainly above the waist. In contrast, women exhibit a pear-shaped obesity, with fat accumulation below the waist, such as in the lower abdomen, buttocks, and thighs. Of course, related to obesity, there are also manifestations of cardiovascular diseases, high blood pressure, diabetes, etc. Some people with obesity may also experience sleep apnea syndrome, venous thrombosis, and so on. Studies suggest that the incidence of malignant tumors is also higher in patients with obesity. Because patients with long-term obesity carry excess weight for a long period, they may experience lower back pain, joint pain, swelling, and are more prone to abrasion or combined fungal or purulent infections in the folds of the skin. Therefore, the clinical manifestations of obesity vary according to the cause of the disease.