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. The disease was first described by Dercum (1892) and is therefore also known as Dercum’s disease. How to diagnose obesity and painful nodules or fat mass symptoms? 1, the majority of female patients with this disease, the age of onset is mostly 30 to 50 years old, that is, women of childbearing age, often accompanied by premature menopause, early decompensation of sexual function 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. The characteristic painful fatty nodules appear on the basis of obesity, which can be diagnosed according to the age of onset and gender. The disease may be associated with metabolic disorders. It has also been reported to be associated with immune dysfunction, but this has not been elucidated. However, Pimenta et al. (1992) confirmed that the pituitary, adrenal, thyroid and gonadal secretion functions are normal in patients with this disease, and found that patients have peripheral insulin resistance, normal sugar uptake and oxidation, low response to norepinephrine, and lack of insulin anti-lipolytic effect. be related to metabolic disorders. Local pain may be caused by abnormal fat accumulation affecting the dermal nerves, or hyperalgesia may be caused by degeneration of the dermal nerves. It has also been suggested in the literature that it is related to immune dysfunction, but this has not been elucidated.