Painful obesity, also known as Dercum’s disease, is a rare autonomic nervous system disease of unknown etiology, manifested as abnormal accumulation of subcutaneous fat in certain parts of the trunk, and accompanied by spontaneous pain in that area. Clinical manifestations 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 sexual decompensation and other symptoms. The main manifestation is the appearance of painful nodules or fat masses on the basis of obesity, varying in size, with fat deposited in the trunk, neck, axilla and waist and hip areas, with asymmetric distribution. The fat nodules are soft in the early stage and hard in the late stage. As the fat nodules increase in size, the pain also increases, and numbness, weakness and sweating disorder also appear. Painful obesity is divided into the following types: 1.Type I Widely distributed type, widely distributed painful adipose tissue, not accompanied by clear lipoma. 2.Type II widespread nodular type, widespread pain in adipose tissue, and with multiple lipomas and severe pain around them. 3.Type III Localized nodular type with multiple lipomas and pain around them. 4.Type IV Para-articular type, an isolated excessive fat deposition next to the joint, such as in the medial knee joint.