What is obesity? Today, nearly one-third of the world’s population is overweight or obese. In China, obesity is exploding. Currently about 43.6%, or 600 million Chinese, are overweight or obese. Obesity has become a major problem around the world, so what is the standard for obesity? How far are you from obesity? Zhang Zhongtao, General Surgery Department, Beijing Friendship Hospital In clinical practice, obesity is diagnosed by body mass index (BMI), which is defined as weight divided by height squared (kg/m2). What are the dangers of obesity? The number of additional deaths due to obesity in the United States ranges from 111,999 to 365,000 per year. Obesity reduces life expectancy by an average of 6-7 years, with severe obesity (BMI > 40 kg/m2) reducing life expectancy by 20 years for men and 5 years for women. Obesity can lead to a range of complications or related diseases that can affect our life expectancy or lead to a reduced quality of life. Health problems associated with obesity include: Metabolic complications: diabetes, insulin resistance, gout, etc. Cardiovascular diseases: hypertension, coronary heart disease, stroke, congestive heart failure, venous thrombosis Respiratory diseases: asthma, sleep apnea, etc. Tumors: esophageal cancer, intestinal cancer, liver cancer, gallbladder cancer, pancreatic cancer, kidney cancer, leukemia, endometrial cancer, cervical cancer, ovarian cancer, post-menopausal breast cancer, etc. Prostate cancer and other osteoarthritis Digestive system diseases: non-alcoholic fatty liver, gastroesophageal reflux disease and other urinary incontinence Reproductive system diseases: menstrual disorders, infertility, polycystic ovary syndrome, gestational diabetes, miscarriage and other anxiety and depression Diabetes often coexists with obesity Diabetes usually coexists with obesity. The proportion of Chinese adults with diabetes is 11.6%, or about 113.9 million people; and 41.5% of fat people have diabetes. Among people with diabetes, surveys show that 65% are overweight or obese, which is about 74.4 million people in China. Type 2 diabetes is a common endocrine metabolic disease, mainly a metabolic disorder caused by insufficient secretion or impaired action of insulin in the body, and obesity is now considered a major risk factor for diabetes. Among all types of diabetes, type 2 diabetes accounts for about 90% of patients. Diabetes has become one of the chronic diseases that seriously threaten human health. Diabetes can cause complications such as coronary heart disease, nephropathy, retinopathy and neuropathy, and these complications can cause death and disability to patients. How does diabetic obesity need to be treated? The traditional treatment for diabetes includes diet control, exercise, oral hypoglycemic drugs and insulin injections, etc. Type 2 diabetes is a progressive disease, and as the disease progresses, blood glucose tends to rise gradually, so the intensity of treatment to control high blood glucose should also be strengthened: lifestyle intervention (diet control, exercise) is the basic treatment; if lifestyle alone does not bring blood glucose control up to the standard, your doctor will recommend that you start medication (diabetic obesity). If lifestyle alone does not bring blood glucose control up to the standard, the doctor will recommend you to start medication (metformin, etc.); if blood glucose still does not reach the standard with metformin treatment alone, the doctor will recommend you to add insulin pro-secretory agents or alpha-glucosidase inhibitors; if two oral hypoglycemic drugs are not effective, insulin treatment needs to be added. These treatments can hardly cure diabetes fundamentally and keep patients’ blood sugar stable in the long term, nor can they fundamentally stop the occurrence and development of various complications of diabetes. Strict dietary control and repeated blood sugar fluctuations cause continuous mental stress to patients and affect their quality of life. Patients with diabetes urgently need a treatment that provides good control of diabetes and its complications. In recent years, more and more obese patients have undergone bariatric surgery with good weight loss results. However, bariatric and diabetic surgery is not only effective in reducing the patient’s weight, but also in improving the co-existing disorders of glucose metabolism in most patients. After undergoing bariatric and diabetic surgery, some obese patients have achieved clinical remission or even complete clinical remission of their preoperative coexisting diabetes. At the end of 2013, the prestigious Cleveland Medical Center announced the top 10 medical innovations of 2013, and bariatric surgery for diabetes topped the list. Bariatric and diabetes surgery was performed in 480,000 cases worldwide in 2013; in the United States it reached 250,000 cases in 2014, a rapid increase.