Obesity brings us endless pain, because of obesity, we can’t live well, can’t fall in love well, can’t act like normal people. What should we do in the face of obesity? Is minimally invasive gastric resection and weight loss surgery feasible? Obesity: The external causes are mainly too much diet and too little activity. Caloric intake more than caloric consumption, so that fat synthesis increase is the material basis of obesity. Internal because of fat metabolism disorder and cause obesity. 1. genetic factors human simple obesity onset has a certain genetic background. Some studies think, one of the two parents is obese, its children obesity rate is about 50%; Both parents are obese, its children obesity rate rises to 80%. Human obesity is generally considered to be polygenic inheritance, genetics plays a predisposing role in its development. The formation of obesity is also related to the way of life behavior, ingestion behavior, hobbies, climate and the interaction of psychosocial factors. 2. neuropsychological factors It is known that in the hypothalamus of human and many kinds of animals, there exist two pairs of nuclei related to feeding behavior. One pair is the ventral contralateral nucleus, also known as the satiety center; the other pair is the ventral lateral nucleus, also known as the hunger center. When the satiety center is excited, there is a feeling of satiety and refusal to eat, but when it is destroyed, there is a great increase in appetite; when the hunger center is excited, there is a great appetite, but when it is destroyed, there is anorexia and refusal to eat. Both of them regulate each other and restrain each other, and are in dynamic balance under physiological conditions, so that appetite is regulated in the normal range and normal weight is maintained. When hypothalamic lesions occur, whether it is the sequelae of inflammation (such as meningitis, encephalitis), or trauma, tumor and other pathological changes, if the medial ventral nucleus is destroyed, the lateral ventral nucleus will be relatively hyperfunctional and anorexic, causing obesity. Conversely, when the ventral lateral nucleus is destroyed, the ventral medial nucleus is relatively hyperfunctional and anorexic, causing emaciation. 3. endocrine factors many hormones such as thyroxine, insulin, glucocorticoids, etc. can regulate feeding, so it is presumed that these hormones may be involved in the pathogenesis of simple obesity. Obese people to insulin resistance and lead to high insulinemia, and high insulinemia can make insulin receptor down regulation and increase insulin resistance, thus forming a vicious circle. Increased insulin secretion can stimulate increased food intake and at the same time inhibit lipolysis, thus causing fat accumulation in the body. Sex hormones may play a role in the pathogenesis of simple obesity. Excessive eating can produce excess gastrointestinal inhibitory peptide (GIP) through stimulation of the small intestine, and GIP stimulates insulin release from pancreatic beta cells. Specific types of obesity can occur in the presence of hypopituitarism, especially hypogonadism and hypothyroidism caused by reduced growth hormone, gonadotropic and thyroidotropic hormones, and may be associated with reduced fat mobilization and relatively increased synthesis. Clinical obesity is more frequent in women, especially in women who have undergone maternity or menopause or who take oral female contraceptives, suggesting that estrogen is related to fat anabolism. When the adrenal cortex is hyperactive, the secretion of cortisol increases, promoting glycogen xenobiogenesis, increasing blood sugar and stimulating insulin secretion, so fat synthesis increases, while cortisol promotes lipolysis. Minimally invasive gastric reduction surgery: The full name is laparoscopic gastric reduction surgery, also known as sleeve gastrectomy (LaparoscopicSleeveGastrectomy). The principle of gastric reduction surgery is to use a laparoscope to cut out the large curve of the stomach vertically, so that the stomach forms a small gastric sac of about 150cc, which can hold about 4-5 ounces of food. It has the advantage of not requiring the placement of foreign objects in the body and the procedure is remarkably effective for weight loss. Method: 2-6 cm of the sinus above the pylorus is preserved in the direction of the greater curvature of the stomach, the greater part of the stomach is removed along the long axis of the stomach, and the entire fundus is removed, leaving a “banana-shaped” stomach with a volume of about 60-80 ml Principle: Reduces the volume of the stomach and reduces the secretion of hormones that stimulate hunger. Evaluation: Sleeve gastrectomy has good effect on the treatment of type 2 diabetes and is a widely used surgery in Europe for weight loss and diabetes. Weight loss surgery can reduce 60-80% of your excess weight, and if your post-operative diet and exercise habits are well coordinated with the support and assistance of a professional health manager, the results will be even better. Efficacy: 60%-80% of excess weight loss. Relief of hypertension in 70% of patients. Significant improvement in obstructive sleep apnea. 90% of patients with type II diabetes return to normoglycemia with discontinuation of the drug. Improvement in venous thromboembolic disease. Improved low back pain and joint pain relief.