Painful obesity disease mainly manifests as painful nodules or fat masses on top of obesity. Painful obesity is a rare autonomic nervous system disorder of unknown etiology, manifested by abnormal accumulation of subcutaneous fat in certain parts of the trunk and accompanied by spontaneous pain in that area. This disease was first described by Dercum (1892), so it is also called Dercum’s disease. How to check obesity and painful nodules or fat mass symptoms? 1, the disease female patients account for the vast majority, the age of onset is mostly 30 to 50 years old, that is, women of childbearing age, often accompanied by premature menopause, early sexual function decompensation and other symptoms. The main manifestation is the appearance of painful nodules or fat blocks on the basis of obesity, varying in size, fat deposits in the trunk, neck, axilla and waist and hip, asymmetric distribution. The fat nodules are soft in the early stage and hard in the late stage. As the fatty nodules increase in size, the pain increases, and numbness, weakness and sweating disorders appear at the same time. 2. The nature of the pain is sharp needle-like or knife-like pain, paroxysmal or continuous, and there may be pressure pain along the nerve trunk. It is often accompanied by arthralgia, and generalized weakness is the prominent symptom, but there is no evidence of organic lesion. 3, the disease is chronic progression, often in the later stages of the emergence of psychiatric symptoms such as depression and mental retardation, as well as mental decline, and the trend of gradually developing into dementia. On the basis of obesity, the characteristic painful fat nodules appear, which can be diagnosed according to the age of onset and gender. Blood and urine routine examination and cerebrospinal fluid routine examination are mostly non-specific; blood glucose and islet antibody examination have auxiliary and differential diagnostic significance; head and limb imaging examination are mostly normal results. Autonomic function examination may have sweating disorder, etc.