First, what is morbid obesity Overweight and obesity has become a worldwide epidemic. Obesity refers to a certain degree of significant overweight with a thick fat layer, a state caused by excessive accumulation of body fat, especially triglycerides. Simple obesity is a complex chronic metabolic disorder in which excess nutrition leads to the accumulation of body fat. When the energy provided by food and beverages consumed greatly exceeds the metabolism and basic physiological movements of the body, weight gain will occur, resulting in obesity. Obesity has become the most serious public health problem facing both developed and developing countries. Together with AIDS, drug addiction and alcoholism, it constitutes one of the four new socio-medical problems. Published in the Lancet journal of research results show that the total number of overweight and obese people in the world has grown from 857 million in 1980 to 2.1 billion at present, which is almost relative to 30% of the earth’s population. The current global 671 million obese people, the United States is at the top of the list, accounting for 13% of the world’s obese people; the second place is China, China now has 46 million adults “obese”, 300 million people “overweight”. According to the World Health Organization reported that each year due to complications arising from overweight took the lives of about 3.4 million people. Nowadays, can not control the mouth of the “meatless, three high (high oil, high salt, high sugar) diet”, can not take the legs of the “car instead of walking, computer scanner at work, go home couch potato” and other factors to make the fat more and more. Second, what are the hazards of morbid obesity and associated diseases Obesity is a metabolic disease, can cause a variety of complications. Excess adipose tissue in the body is an important risk factor for metabolic diseases. For this reason, the World Health Organization has identified obesity as the fifth major risk factor for health. The harm of obesity is serious, obesity patients due to body fat and bloated, mobility so that the daily life, employment and work are affected to varying degrees, and can even cause serious psychological and social problems, leading to psychological disorders and depression. In addition, obesity can also cause a series of complications that multiply with age, such as: sleep apnea syndrome (OSAHS), type 2 diabetes mellitus, hypertension and other cardiovascular diseases, hyperlipidemia, tumors, joint injuries, hyperuricemia, male sexual dysfunction, polycystic ovary syndrome, depression and so on. The risk of premature death from metabolic diseases increases as the body mass index rises. The World Health Organization has focused on the prevention and treatment of obesity as a serious chronic disease. Third, do I have obesity? Body mass index (BMI) is an important measure of ideal body weight, the formula is: BMI = weight (Kg)/height (m2). China’s guidelines for the surgical treatment of obesity (2007) refer to the Asia-Pacific region, the classification of adult BMI index: BMI in the range of 18.5-22.9 for healthy, in the range of 23.0-24.9 for overweight, in the range of 25.0-29.9 for = 1 * ROMAN I degree of obesity, in the range of 30-34.9 for = 2 * ROMAN II degree of obesity, greater than 35 for = 3 * ROMAN III obesity. For the obese people in the Asia-Pacific region, abdominal circumference is also one of the criteria for determining obesity, if the male abdominal circumference of more than 2250px, women more than 2125px, also known as obesity. Fourth, why do obese people sleep easily snoring? When it comes to obesity, we are more concerned about the appearance, weight and so on, and now, we are beginning to pay attention to the impact of visceral fat on health. The relationship between snoring and obesity is similar to this, obese body type is not only in the appearance of the body, its body of the soft palate and pharyngeal cavity side walls and back wall is also attached to a large amount of fat, these reasons lead to the narrowing of the upper respiratory tract. In addition, the hypertrophy of the tongue will likewise impede the throat channel, especially when sleeping in the supine position, the tongue falls back, more likely to cause sleep breathing disorders, snoring; therefore, the body composition of obese people make it easy to snore. Fifth, if I have the symptom of snoring, should I consult a doctor? Sleep breathing disorder is not only snoring during sleep, but also other manifestations. Here is an initial screening criterion for you: besides snoring, if you have one of the following symptoms: high blood pressure/obesity/small chin/poor daytime sleepiness, then you need to consult a doctor in time. Of these, poor daytime mental performance can be measured by the Epworth scale, and a score of more than 11 indicates poor daytime mental performance. It is even more noteworthy if men are aged 35-50 and women are post-menopausal. Can snoring be so serious that it is life threatening? It will. In the 7th International Conference on Sleep Apnea, a consensus was reached that if no attention is paid to the treatment of sleep apnea, then it will induce or aggravate many common and frequent diseases, such as high blood pressure, heart disease, diabetes, and so on. Current statistics show that 87% of patients with sleep apnea suffer from hypertension, 35% from coronary heart disease, and 72% from glucose metabolism disorders or diabetes. Recent studies have found that the chances of myocardial infarction and cerebral infarction occurring during sleep in patients with sleep apnea are three times higher than in the normal population. Meanwhile, effective targeted treatment of sleep disordered breathing can control more than 1/3 of hypertension, correct 25% of glucose metabolism disorders and reduce the incidence of cardiovascular disease by 20%, which indicates that these serious threats to the health of life and quality of life diseases and sleep disordered breathing have a close connection. Due to the complexity of OSAHS disease, involving oral craniomaxillofacial, oral orthodontics, respiratory medicine, neurology, surgical anesthesiology and our general surgery department, our hospital has been carrying out multidisciplinary collaboration in the treatment of obesity combined with severe OSAHS since 2004, and we have rescued critically ill patients with a BMI of 72.8 (body weight of 175 Kg, height of 155 m) and an AHI of more than 148, and the patients were admitted to the hospital! After the patient was admitted to the hospital, the patient was in respiratory failure, and from the time of admission to discharge, the patient always wore a ventilator to assist in breathing. After meticulous multidisciplinary collaboration and cooperation, the patient’s weight plummeted by 24Kg one month after discharge, and the AHI also decreased, and the patient gradually got rid of the ventilator, so that the patient was gradually able to take care of himself and return to the society. What is AHI? Apnea-hypopnea index (AHI) refers to the number of apnea plus hypopnea per hour of sleep. Apnea is defined as a complete cessation of nasal and oral respiratory airflow for more than 10 seconds during sleep; hypoventilation is defined as a decrease in respiratory airflow intensity (amplitude) of more than 50% from the basal level during sleep, accompanied by a decrease in oxygen saturation of more than or equal to 4% from the basal level. the normal value of the AHI is less than 5, and when it is greater than 70, there is a possibility of sudden death. VII. Who needs surgical treatment? In the past, surgeons only pay attention to the patient’s BMI, due to individual differences, age differences, regional characteristics, different types of obesity, the same BMI on the individual’s harm is also different, purely BMI as an indicator has been unable to adapt to today’s situation. At present, different regions have designated different BMI adaptation indexes according to the harm of obesity to human body from local characteristics. According to the Chinese guidelines for the surgical treatment of obesity (2014), surgical treatment can be considered in the following cases: 1. Confirmation of metabolic disorder syndromes related to simple fat excess, such as sleep apnea syndrome, type 2 diabetes mellitus, cardiovascular disease, fatty liver, lipid metabolism disorders, etc., and prediction of weight loss can be effectively treated; 2. BMI is an important clinical criterion for determining whether the surgery is suitable: BMI ≥ 32.5, active surgical treatment; BMI for 27.5 ~ < 32.5, combined osahs; 3, waist circumference: male ≥ 2250px, female ≥ 2125px; dyslipidemia; 4, high triacylglycerol (fasting TG ≥ 1.70 mmol / L), low high-density lipoprotein cholesterol (male fasting HDL-ch < 1.03 mmol / L, female), low HDL cholesterol (male fasting HDL-ch < 1.03 mmol / L, female). Fasting HDL-ch<1.29 mmol/L), hypertension (arterial systolic blood pressure ≥130 mmHg or arterial diastolic blood pressure ≥85 mmHg); 5, age 16-65 years old; 6, the patient understands the way of bariatric surgery, understands and accepts the risk of the potential complications of the surgery; understands the importance of the changes in the postoperative life style and diet for the postoperative recovery, and has the capacity to bear the changes, and can cooperate actively with the Postoperative follow-up. Who are not eligible for weight loss surgery? 1.Active substance abusers 2.Patients with mental illness 3.Critical personality disorder 4.Schizophrenia 5.Active severe depression 6.Binge eating disorder 7.Total refusal to change lifestyle and refusal to follow up treatment 8.Cancer, tuberculosis and HIV patients 9.Gastric ulcer patients 10.Surgery high-risk groups 11.Pregnant women 9.What are the types of weight-loss surgeries? There are three types of weight loss surgery: 1, restrictive surgery: to reduce food intake. Such as laparoscopic gastric sleeve resection. 2, restrictive and absorption-altering surgery: to reduce the amount of food intake, so that your absorption of ingested food is reduced. Such as gastric bypass surgery. 3.Absorption-altering surgery: Moderately altering the amount of food intake so that you only absorb a small portion of the food you take in. For example, biliopancreatic bypass. Currently, the most commonly used surgeries are laparoscopic gastric sleeve resection and gastric bypass surgery. Of course, you can consult with our professional team on the exact type of surgery you will have. What are the health effects of weight loss surgery? The latest foreign research results show that 5 years of follow-up, morbid obesity surgery patients mortality rate of 0.68%, while the mortality rate of patients who do not do surgery is as high as 6.17%. Therefore, the risk of untreated morbid obesity is much higher than the risk of surgery, and surgery can partially or completely improve obesity and related diseases. XI. What is the expected weight loss? After bariatric surgery, patients generally lose 50% to 60% of their excess weight in the long term: a recent 14-year long-term study showed that weight loss is sustainable. The amount of weight lost will vary between surgical procedures. Multidisciplinary support is also essential. However, how much weight you can expect to lose is limited by a number of factors: 1) your age 2) your weight before surgery 3) your general health 4) the type of surgery you undergo 5) your ability to exercise 6) your commitment to following dietary guidelines and other follow-up treatments and 7) your own motivation to lose weight, as well as the support of your family and friends Of these, your motivation to lose weight is the key to the whole process.