Diagnosis and differential diagnosis of obesity, its serious harm to the human body, and key prevention and control measures.

V. Diagnosis and Differential Diagnosis of Obesity

Simple obesity is diagnosed by doctors based on abnormal changes in weight and observed during patient examination, but secondary obesity should be ruled out.

Simple obesity, if accompanied by hypertension, purple striae on the skin, amenorrhea, and elevated urinary 17-hydroxycorticosteroids, can be easily confused with Cushing's syndrome.

Therefore, an adrenal B-mode ultrasound or CT scan should be performed, along with a low-dose (2 mg/day) dexamethasone suppression test. Simple obesity can be suppressed, while Cushing's syndrome cannot, which can be used for differentiation.

Individuals with simple obesity and a low basal metabolic rate must undergo thyroid function tests to rule out hypothyroidism.

Obese individuals with hypothalamic syndrome should undergo endocrine function tests and cranial CT scans to rule out lesions such as vacuolated sella turcica or pituitary adenoma.

Simple obesity should sometimes be differentiated from water retention obesity, which develops rapidly and can lead to a significant increase in weight in a short period of time. This is mainly due to water retention and is often accompanied by symptoms of increased body fluid, such as headache, irritability, and depression.

In water retention obesity, weight is closely related to body position; weight increases when standing and decreases when lying down.

From morning to evening, the average weight gain is 1.5 kg, which is significantly more than the average gain of 0.4 kg for a normal person.

Frequent urination at night can lead to significant weight loss after a night's sleep.

The standing/lying position water test can show that the patient has water retention when standing.

VI. What are the harmful effects of obesity on the human body?

As mentioned above, obesity is often associated with hypertension, coronary heart disease, gallstones, diabetes, gout, and fatty liver.

Obese individuals also have a higher mortality rate from cancer than the general population. For example, the mortality rates for colon and prostate cancer are significantly higher in obese men, while the mortality rates for cervical, gallbladder, ovarian, and breast cancer are significantly higher in obese women.

When obese individuals require surgery for a certain disease, their diaphragm is elevated due to obesity, which restricts movement and reduces lung ventilation. If general anesthesia is performed, they may experience difficulty breathing or even suffocation. Therefore, the risks of anesthesia for obese individuals are greater than for the average person.

In addition, obesity increases the difficulty of surgical procedures. For example, during abdominal surgery, the thicker abdominal fat layer makes the operation more difficult, and the longer the operation time, the greater the chance of infection. Postoperative wound healing is also slower, and incisional hernias or wound dehiscence are more likely to occur.

Obese individuals have weaker resistance to disease and are more prone to postoperative complications such as lung infection, venous thrombosis, and pulmonary embolism.

Obese people move slower and have a poor ability to respond to external stimuli. Once they suffer from various external injuries, car accidents, or other accidents, they are more likely to suffer fractures and serious limb injuries.

Therefore, obesity is not a blessing. Long-term obesity can lead to the various complications and harms mentioned above, shortening the lifespan and increasing the mortality rate of obese people.

Some researchers have observed that the mortality rate of obese individuals is three times higher than that of people of normal weight.

Obese people are almost twice as likely to die from heart failure after the age of 40 or 50 compared to people of normal weight.

Domestic surveys of centenarians show that none of them are obese.

Therefore, controlling weight and preventing obesity is an important measure for prolonging life.

VII. How to prevent and treat simple obesity

Some studies have shown that the vast majority of children who are overweight before the age of 10 are still overweight as adults.

According to statistics from Western countries: among those who are overweight at age 10-13, 88% of females and 86% of males are overweight by age 31; while among those who have normal weight at age 10-13, only 18% of females and 42% of males are overweight by age 31.

Therefore, obesity prevention should begin in childhood, or more precisely, from birth.

Providing children with adequate nutrition is necessary, but it should be done appropriately rather than excessively, and infants should be encouraged to engage in appropriate physical activities in a timely manner.

There are two key points to preventing obesity in adulthood:

(a) Practice moderation in diet and maintain a balanced diet. Avoid overeating and excessive calorie intake.

(ii) Maintain regular exercise. As people enter middle and old age (50-60 years old), physical activity gradually decreases. If they do not change their eating habits and continue to eat the same amount as when they were young and middle-aged, it will inevitably lead to excessive nutrition and reduced calorie consumption. This will cause excess calories to be converted into fat and stored in various tissues and subcutaneous tissues, resulting in obesity.

As people age, even if they eat normally, they are more prone to weight gain due to reduced energy expenditure.

Therefore, a reasonable diet and appropriate physical exercise are important measures to prevent obesity.

The most effective way to correct obesity is through a combination of diet control and physical exercise, rather than relying on medication. Only when diet control fails can medication and acupuncture be used as adjunctive treatments.