Overweight and obesity has become a serious health problem in China, on October 12, 2004, the State Council press conference announced the Ministry of Health and other departments of the “Chinese residents of nutrition and health status survey” results. Overweight and obesity in China’s adult prevalence rate of 22.8% and 7.1%, estimated the existing number of overweight and obesity were 200 million and more than 60 million, compared with the 1992 survey, the adult overweight rate increased by 39%, the rate of obesity increased by 97%. 1, what is overweight and obesity? Obesity is a chronic disease characterized by excessive body fat, usually by the body mass index (Body Mass Index, BMI) to indicate that BMI = weight (kg) / height (meters squared), BMI = 25 ~ 29.9 for overweight, BMI ≥ 30 is obese. As early as 1948, obesity was defined as a disease, obesity has a high prevalence worldwide, and is a risk factor for a variety of chronic diseases such as coronary heart disease, stroke, hypertension, type 2 diabetes mellitus, dyslipidemia, certain cancers, sleep apnea syndrome, osteoarthritis, and biliary tract diseases. Obesity has become the third most prevalent disease affecting human health after AIDS and smoking. An in-depth study of obesity can help to recognize and treat obesity-related diseases. 2, overweight and obesity etiology research on overweight and obesity research has penetrated the biological, biochemical, physiological, pharmacological, clinical and other disciplines, the prevailing view that: obesity occurs because of energy intake is greater than the energy consumption leads to the accumulation of fat in the body. But overweight and obesity is far from being so simple. Fat in physiology as the body’s energy reserves, the normal body’s energy reserves to maintain a fixed level. There are many feedback mechanisms in the body, so that the body is in a state of equilibrium, the hypothalamus in the lack of energy to send out signals to eat, when the energy is saturated with signals to terminate the energy intake. Therefore, the formation of obesity means the disruption of this balance. In the body’s energy surplus, the hypothalamus is still sending feeding information, so obesity is not simply more energy intake than consumption, that is, not the so-called overnutrition, but the human metabolism of the biochemical mechanism of the serious disorders, indicating that the human body’s own energy balance mechanism has suffered damage. Obesity is the result of the interaction between genetic and environmental factors. Genetic predisposition of individuals to obesity, in a large number of high-calorie food intake and insufficient exercise environment, the body fat is easy to accumulate too much or / and the distribution of abnormalities and the formation of obesity. There are many factors that lead to overweight and obesity, including race, genetics (leptin theory, etc.), anxiety related, and with the central nervous system, endocrine system, metabolic abnormalities and other factors. Obesity occurs with corresponding changes in complex physiology and biochemistry. Today’s productivity provides the material basis for the occurrence of obesity. Modern comfortable conditions and lower labor intensity, reduce the movement is more likely to be obese. People are highly alert to obesity, but the incidence of obesity is still increasing. Obesity has become a problem in today’s society. 3, the necessity of obesity intervention treatment Obesity, especially central obesity, fat cell secretion of leptin increases, lipocalin decreases, resulting in insulin resistance, and insulin resistance will cause insulin compensatory secretion increases, so that the body produces a series of metabolic anomalies: fat mobilization increases, blood free fatty acids, triglyceride synthesis increases, and then the reduction of high-density lipoprotein; angiotensinogen, angiotensin-converting enzyme, type 1 angiotensin receptor and renin-binding protein genes can be elevated, which are involved in the regulation of blood pressure, and renal tubular reabsorption of sodium is increased, resulting in hypertension; hyperglycemia occurs when compensatory secretion of insulin fails to maintain normal glucose metabolism. Insulin resistance is the core of metabolic syndrome, and obesity is a key factor causing insulin resistance. Some scholars have tracked 1 million Americans for 14 years on the BMI and mortality survey statistics show that the BMI in 19 ~ 24.9 people have the longest life expectancy. According to the epidemiological investigation, the relationship between BMI and life expectancy exists “J” curve, “J” curve shows that the mortality rate is much lower than that of obesity, the higher the BMI life expectancy is ultra-short, and the life expectancy of obese people is shorter than that of normal-weight people by 10-20 years. The life expectancy of obese people is 10-20 years shorter than that of normal-weight people. Treatment of obesity is beneficial to the decline of blood glucose: a prospective study of 11,428 women aged 30-55 years over a 14-year period reported that the risk of type 2 diabetes in women with a BMI between 23-25 is 4 times higher than that of women with a BMI ≤, and the risk of type 2 diabetes in people with a BMI >35 is 93.2 times higher. In obese patients with abnormal glucose tolerance (IGT), blood glucose can be completely normalized in about >50% of patients if they lose 2%-4% of their body weight. Obesity combined with diabetes mellitus patients, in weight loss of 7.5%, fasting blood glucose decreased by 2.1mmol / L, postprandial blood glucose decreased by 3.2mmol / L. Total cholesterol decreased by 9.2%. Treatment of obesity can reduce blood pressure: the prevalence of hypertension in obese patients is twice as high as that of normal-weight people. In recent years, some large-scale clinical research found that, in the blood pressure critical patients, the average weight loss of 5 kg, systolic blood pressure can be reduced by 5 mmHg, diastolic blood pressure decreased by 3 mmHg. Treatment of obesity can reverse fatty liver: in the liver biopsy evaluation of weight loss on fatty liver research found that the incidence of fatty liver in male obese patients as high as 91%. When liver biopsies were reviewed 27 months after successful weight loss, the percentage of patients with moderate fatty liver decreased from 37% to 23%, and the percentage of patients with severe fatty liver decreased from 42% to 15%. On the other hand, the treatment of obesity can reduce the incidence of abnormal lipid metabolism and coronary heart disease. 4, obesity treatment measures Diet therapy: most obese patients have hyperphagia, especially at night, appetite, easy to hunger. Diet therapy is an extremely difficult and painful process, requiring strong will and perseverance. High-fiber food can satisfy the appetite and can reduce caloric intake, someone on the 2909 18-30-year-old healthy people for a period of 10 years of research shows that a high-fiber diet can reduce blood insulin levels, high-fiber diet can also reduce cardiovascular obesity, lower blood pressure and blood lipids. Soup before meals can dilute stomach acid, reduce hunger and appetite, can reduce eating. Therefore, there are “soup before meals is good for health, soup after meals, the more you drink the more fat”. In addition, reduce salt intake, daily salt control in the following 5 grams can reduce appetite. Exercise therapy: energy consumption when climbing stairs is 10 times that of sitting still, and 1.7 times that of walking. A person weighing 65 kilograms, with normal speed stairs, up and down 1 layer of stairs about 74.4 kilocalories of energy consumption, if the family lives on the 6th floor, three times a day to walk up and down the stairs without taking the elevator, to consume 2000 kilocalories per day. Behavioral therapy: Studies have shown that reducing the time spent watching TV and videos can significantly reduce body weight. Diet, exercise and behavioral modification are recommended as obesity treatment and should be adhered to. Drug therapy: Drugs are only considered for weight loss if the BNI is greater than 30 and BMI is greater than 27, but there are complications of obesity, and regular diet, exercise and behavioral therapy has been ineffective for more than 3 months. Metformin: It can increase the utilization of glucose by the brain and muscle tissues, and also reduce the intestinal absorption of sugar, increase the body’s sensitivity to insulin, and reduce blood lipids. Taking metformin can significantly reduce appetite and reduce weight. The total amount of 1.70-2.0 grams per day divided into 3 times, the weight loss effect is obvious, generally does not occur hypoglycemia. Metformin is very inexpensive, 1.7 grams per day costs about$149 for 1 year, and there is an ample supply of the drug. It is especially suitable for obese patients suffering from abnormal glucose tolerance, central obesity, dyslipidemia and suffering from type 2 diabetes. Thyroid tablets: obese patients often show thyroid hormone resistance and subclinical hypothyroidism, the application of low-dose thyroid tablets to such patients can significantly reduce body weight, large doses of thyroxine can cause pharmacological hyperthyroidism, especially for obese patients with cardiovascular disease may be dangerous. Sibutramine (Tramet): for the central appetite suppressant, there is a certain increase in energy consumption. STORM test showed that obese patients taking sibutramine weight loss can be 5%, in taking 69 months about 50% of the patients weight can be reduced by 10%. Use while controlling caloric intake. It can be used in obese patients with hyperphagia, low basal metabolic rate and normal blood pressure. Disadvantages are more expensive, taking 10mg per day for 1 year costs about$3,360, taking 15mg per day for 1 year costs about$5,040, and long-term use is required. Orlistat (Seneco): the main mechanism of weight loss is that it can inhibit intestinal lipase, so that fat can not be broken down in the intestine, so it can reduce fat absorption by 30%. Each dose is 120mg, three times a day. In the first year of using the drug can effectively reduce weight, the second year weight can be maintained, and can reduce the level of triglycerides and cholesterol. It is suitable for obese patients with big halo and big oil eating habit, good absorption function, accompanied by constipation, the annual cost is about 10,192 dollars, also need to be used for a long time. Surgical therapy: extreme obesity (BMI ≥ 40), or severe obesity (BMI ≥ 35) accompanied by serious complications of obesity should be actively surgical treatment. At present, the more mature surgical method is laparoscopic vertical banding gastroplasty, which has precise weight loss efficacy and few complications. The average weight loss after surgery is 30-40 kilograms, so that the combined diabetes, hypertension, hyperlipidemia has been significantly alleviated or even disappeared. Obesity is a chronic disease that requires long-term prevention and treatment. Intervention and prevention of obesity is one of the key efforts to reduce the morbidity and mortality of cardiovascular and cerebrovascular diseases and to prolong life expectancy. The etiology and pathogenesis of obesity have not been clarified, and the treatment of obesity is not satisfactory at this stage. It is believed that with the development of medical science, the treatment of obesity is no longer a global problem.