Weight gain

Introduction Symptoms that weigh more than usual and continue to rise. When the human body eats more calories than calories, the excess calories are stored in the body in the form of fat, and the amount exceeds the normal physiological requirement, and the symptoms of weight gain occur.

Cause

1. Internal cause: Obesity caused by disorder of fat metabolism in the human body.

(1) genetic factors

Epidemiological surveys have shown that some of them have family morbidity, and both parents are obese. The children who are born with simple obesity are 5-8 times higher than those born to both parents, and Vanllallie was born in 1965~ A longitudinal survey of children during the 1970 period also found that one parent had obesity, and their children grew older, and their odd ratio increased. The obese children aged 1-2 years went to adults. Early obesity was 1.3, 3-4 in 3 to 5 years old, 8.8 in 6 to 9 years old, 22.3 in 10 to 14 years old, and 17.5 in 15 to 17 years old.

(2) Neuropsychiatric factors

It is known that there are two pairs of nerve nuclei related to feeding behavior in the hypothalamus of humans and various animals. One pair is the contralateral contralateral nucleus (VMH), also known as the satiety center; the other pair is the ventrolateral nucleus (LHA). Also known as the hunger center, when the center is full of excitement, there is a feeling of fullness and refusal to eat. When it is destroyed, the appetite is greatly increased. When the hunger center is excited, the appetite is strong, and when it is destroyed, it is anorexia and antifeeding. The two regulate each other, restrict each other, and are in dynamic balance under physiological conditions. State, the appetite is regulated in the normal range and maintains normal body weight. When the hypothalamus develops lesions, whether it is inflammation sequelae (after encephalitis), trauma, tumor and other pathological changes, such as ventromedial nucleus destruction, the ventrolateral nucleus The function is relatively phlegm and then gluttony, causing obesity. Conversely, when the ventrolateral nucleus is destroyed, the ventromedial nucleus functions relatively sputum and then anorexia, causing weight loss. In addition, the area has a close anatomical relationship with higher-level nerve tissue. The feeding center can also be regulated to a certain extent, and the blood-brain barrier at the hypothalamus is relatively weak. This anatomical feature makes it easy for many biologically active factors in the blood to migrate to the place. Thus affecting the feeding behavior, these factors include: glucose, free fatty acids, norepinephrine, dopamine, serotonin, insulin, etc. In addition, mental factors often affect appetite, the function of the prey center is subject to mental state, when mental excess When nervous and sympathetic stimulation or adrenergic nerve stimulation (especially receptor predominance), appetite is inhibited; when vagus nerve is excited and insulin secretion increases, appetite is often hyperthyroidism, ventromedial nucleus is sympathetic center, ventrolateral The nucleus is the parasympathetic center, which plays an important role in the pathogenesis of this disease.

(3) hyperinsulinemia

In recent years, the role of hyperinsulinemia in the pathogenesis of obesity has attracted attention. Obesity often coexists with hyperinsulinemia, but it is generally believed that hyperinsulinemia causes obesity, and insulin release in hyperinsulinemia obesity is about normal. 3 times the person.

Insulin has a significant role in promoting fat accumulation. It is believed that insulin can be used as an indicator of total lipid content and can be used as a monitoring factor for obesity in a certain sense. Some people think that plasma insulin concentration is significantly positively correlated with total lipid content. .

(4) Abnormal brown adipose tissue

Brown adipose tissue is an adipose tissue that has been discovered in recent years. It corresponds to white adipose tissue mainly distributed under the skin and around the internal organs. The distribution of brown adipose tissue is limited, only distributed between the shoulder blades, the neck and back, and the armpit. The mediastinum and the periphery of the kidney have a light brown appearance and a relatively small change in cell volume.

White adipose tissue is a form of energy storage. The body stores excess energy in the form of neutral fat. When the body needs energy, the neutral fat is hydrolyzed in the fat cells. The volume of white fat cells changes with the release energy and storage energy. Big.

The brown adipose tissue is functionally a thermogenic organ, that is, when the body ingests or is stimulated by the cold, the fat in the brown fat cells burns, thereby determining the energy metabolism level of the body. The above two conditions are called feeding-induced heat production. And cold induces heat production.

Of course, the function of this special protein is affected by many factors. It can be seen that the brown adipose tissue is directly involved in the total regulation of the body mass, and the excess heat in the body is dissipated into the body, so that the body's energy metabolism tends to balance. .

(5) Other

Excessive consumption can produce excessive intestinal inhibitory peptide (GIP) by stimulating the small intestine. GIP stimulates islet -cells to release insulin. In the lower pituitary function, especially growth hormone is reduced, gonads and thyroid stimulating hormone are reduced. A special type of obesity may occur in hypothyroidism, which may be related to a decrease in fat mobilization and a relative increase in synthesis. Clinically, obesity is more common in women, especially in women who are maternal or menopausal or oral contraceptives. Hormones are related to fat anabolism. When the adrenal cortex is hyperactive, cortisol secretion increases, promotes gluconeogenesis, increases blood sugar, stimulates insulin secretion, and thus increases fat synthesis, while cortisol promotes fat breakdown.

2. External causes: Too much activity due to excessive diet.

When the calorie intake exceeds the energy required for consumption, it is almost completely converted into fat and stored in the whole body fat storehouse, except for storage in the form of liver and muscle glycogen, mainly triglycerides. Due to limited glycogen storage, Therefore, fat is the main storage form of human body heat, such as frequent intake of excessive neutral fat and sugar, which accelerates fat synthesis and becomes an external cause of obesity, often in the case of too little activity, such as stopping physical exercise. To reduce physical labor or disease recovery period bed rest, postpartum rest and other obesity.

In short, the cause of simple obesity is still unclear. It may be the result of the interaction of various factors including genetic and environmental factors. However, regardless of the cause of the disease, simple obesity must be caused by the energy consumed rather than the energy consumed.

an examination

Related inspection

Blood test body mass index

Regular weight measurement can be diagnosed.

1. Blood lipid examination includes cholesterol, triacylglycerol (triglyceride), and high-density lipoprotein.

2. Blood glucose examination includes glucose tolerance test and blood insulin measurement.

3. Fatty liver examination B ultrasound, SGPT.

4. Water metabolism test for antidiuretic hormone determination.

5. Sex hormones determine estradiol, testosterone, FSH, LH.

6. Check blood cortisol, T3, T4, TSH, etc., in order to exclude inter-cerebral, pituitary, adrenal cortical function, thyroid function and autonomic nervous disorder.

The most important thing is to find out the cause! In order to prevent the disease from becoming more serious.

Differential diagnosis

It should be identified whether it is physiological or pathological weight gain.

Diagnosis of obesity

The diagnosis of obesity is divided into two steps. First, determine whether there is obesity, and then identify the cause of obesity.

First, determine whether there is obesity

(1) Diagnostic methods and standards

1. Calculate the standard weight according to height, age and gender.

Standard weight (kg) = height (cm) -100

This law applies to persons under 155 cm in height;

Standard weight (kg) = [height (cm) - 100] × 0.9

This law applies to persons over 155 cm in height.

More than 20% of the standard weight is obese, and more than 10% is overweight or overweight.

2. Body mass index [body weight/height 2 (kg/m2)] if it exceeds 24, regardless of gender, it is obese. The World Health Organization and the United Kingdom and the United States are men>27, and women>25 are diagnosed with obesity.

3. The skin wrinkle thickness is measured by special skin wrinkle calipers. The skin wrinkle thickness in the subscapular region is 9.1 to 14.3 mm, with an average of 13.1 mm; the female is 9 to 12 mm, with an average of 11.5 mm. If more than 14 mm, the obesity can be diagnosed. . Men in the deltoid area are 7.9 to 17.8 mm, with an average of 12.3 mm; women are 13 to 25 mm, with an average of 18.1 mm. For men over 23 mm, women over 30 mm are obese.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.