Obesity is defined as excessive accumulation and/or uneven distribution of body fat and weight gain. If the energy contained in a person’s daily food intake is greater than the body’s consumption, this excess energy is stored in the body as fat and the body weight may exceed the normal weight standard. When assessing obesity, it is often described by the body mass index, or BMI, which is weight divided by height squared, with a normal range of 18.5 to 24. A BMI greater than 27 is considered obese, and greater than 40 is considered severely obese. Obesity is one of the ten risk factors listed by the World Health Organization as leading to the burden of disease, and it is not only an independent disease, but also easy to trigger a series of other diseases such as diabetes, hypertension, gallstones, brain infarction and cardiovascular disease. In recent years, with the development of China’s economy and the improvement of people’s living standards, obesity is becoming a “disease of wealth” that threatens people’s health and even life safety. How to reduce the excess weight, become in front of the majority of obese friends urgent solution to the problem. Find the cause If we can find the cause and carry out targeted treatment, we can achieve the effect of treating both the symptoms and the root cause. But in fact, most obesity actually can not find the cause, is the so-called simple obesity. What needs to be checked are mainly several endocrine organs, such as pituitary, adrenal, thyroid and gonads. Many women with polycystic ovary syndrome will have obesity associated with them. Exercise and dieting The root cause of obesity is too much intake and too little consumption. Many obese friends can’t control their mouths and eat a lot. At the same time, due to excessive weight, do not want to activity. In fact, in overweight patients, there is no way to do more exercise, because at this time the cardiovascular system simply can not bear the exercise load. Therefore, it is more feasible to start exercising before excessive weight gain. At the same time, one must use strong perseverance to control one’s mouth and minimize the intake of calories, protein and fat. You can try various meal replacement foods. The currently internationally recognized soy protein-based meal replacement is a more desirable option. A variety of commercialized meal replacements have been marketed and sold. Scientific medication There are a variety of weight loss methods in society. Those who want to lose weight need to remember that they must go to a regular medical unit for treatment. Weight loss drug therapy is divided into the following categories: (1) inhibit intestinal fat digestion and absorption such as lipase inhibitor orlistat, which can specifically irreversibly bind to the gastrointestinal pancreatic lipase triglyceride binding site, so that about 30% of triglycerides in the diet are not broken down and absorbed, and excreted in the feces. (2) Glucose-lowering drugs such as metformin and bactrim. Glucose-lowering drugs have the effect of mildly reducing body weight while controlling blood sugar. It is suitable for the treatment of obesity with diabetes. (3) Central appetite suppressants Appetite is regulated by the satiety center in the ventral medial hypothalamus and the feeding center in the lateral hypothalamus. These drugs are used to stimulate the production and release of one or more of the above-mentioned neurotransmitters and inhibit their reuptake, so as to achieve the therapeutic purpose of suppressing appetite, reducing food intake and reducing body weight. Intragastric hydrosphere therapy. Intragastric water balloon therapy is performed by placing a silicone balloon into the stomach under gastroscopic observation, followed by the injection of 500 ml of saline. The principle is to fill the stomach with water balloons to create a feeling of satiety in order to reduce food intake and thus achieve weight loss. After receiving a gastric water balloon placement for 6 months, the average weight loss was 16.4 kg (14.9% of the original weight). The placement of a foreign body such as a water balloon in the stomach often causes nausea and vomiting, which some patients cannot tolerate. Obesity surgery For overly obese patients, the above treatment methods are not effective or often rebound. Bariatric surgery is the only way to achieve long-term, stable weight loss in patients with severe obesity and is the most effective treatment for metabolic disorders such as obesity-related type 2 diabetes, hypertension, hyperlipidemia and obstructive whistle sleep apnea. The Endocrine Surgery Group of the Chinese Medical Association’s Surgery Branch has issued indications for surgery in obese patients in China based on the physical characteristics and morbidity of the national population. Mainly, they have BMI ≥ 32 and have concurrent metabolic problems, such as hypertension, diabetes, sleep apnea, etc. After non-surgical treatment effect is not good, or can not tolerate. At the same time, patients who choose to receive surgical treatment should fully understand the specific methods of bariatric surgery, understand and accept the risk of potential complications of surgery; understand the importance of postoperative lifestyle and diet changes on postoperative recovery, and have the ability to tolerate and actively cooperate with postoperative follow-up. Choice of bariatric surgery methods Currently, bariatric surgery can be accomplished with laparoscopic techniques. There are 3 types of bariatric surgery based on the principle of weight loss: laparoscopic gastric banding, diversion and gastric sleeve resection. Gastric banding is a procedure that restricts the patient’s diet by binding the base of the stomach with an adjustable band and controlling the diameter of the banding ring with a syringe. Laparoscopic gastric banding can reduce 30% to 40% of the overweight portion of body weight 1 year after surgery, 50% 2 years after surgery, and 50% to 60% 3 years after surgery, reducing preoperative BMI by 25%. The first water injection can be started 1 month after surgery, and thereafter the water injection is decided according to the weight loss. The problem with gastric banding is that the banding ring placed for a long time may be embedded in the stomach and cause complications such as gastric perforation. The use of this procedure is now gradually decreasing. Gastric diversion is the dissection of the stomach from the proximal end and anastomosis of the lower esophagus to the distal small intestine. It is characterized by better weight loss, but the operation is complicated, has a long learning curve, is traumatic, has a high complication rate, requires postoperative monitoring and supplementation of relevant nutrients, and has a high perioperative mortality rate. Postoperative gastroscopy cannot be performed. Gastric diversion usually reduces the overweight portion by 65% to 70% and reduces preoperative BMI by 35%. It is the most effective and the surgical method for weight reduction with the greatest impact on human nutrition and metabolism. Gastric sleeve resection is a longitudinal resection of the stomach, which reduces the volume of the stomach, resulting in less food entering and being digested and absorbed in the stomach. It also removes most of the endocrine cells in the fundus of the stomach that produce hunger, and the appetite decreases after surgery, resulting in weight loss. Compared to the other two types of weight loss surgery, gastric sleeve resection is less technically challenging, the simplest surgery, and the safest. It has the least impact on postoperative nutrition. Up to 70% of excess weight can be lost in the first year after surgery. This result is similar to gastric diversion surgery without the complications of post-gastric diversion such as anemia, osteoporosis, and vitamin deficiency. About surgery for type 2 diabetes and other metabolic problems. Obesity often causes many metabolic problems, such as hypertension, sleep apnea, and diabetes. After bariatric surgery, most patients with type 2 diabetes have decreased blood sugar and do not need insulin after bariatric surgery due to weight loss. All three surgical procedures are similarly effective in the treatment of diabetes, with an efficiency rate of about 80%. Other problems associated with obesity, such as high blood pressure, sleep apnea, and menstrual disorders, also improve or are cured with weight loss.