Systemic damage caused by obesity: kidneys, respiratory system, bones, and prevention

**18. What is the relationship between obesity and kidney disease?**

The kidneys are vital excretory organs, their basic functions being to remove toxins and metabolic waste from the blood and maintain the body's water and electrolyte balance. In obese patients, increased fat content in the kidneys, leading to fat deposits in the renal tubules and glomeruli, impairs kidney function. Furthermore, conditions such as hypertension, diabetes, and renal artery sclerosis associated with obesity further burden the kidneys, easily causing proteinuria. In severe cases, this can lead to kidney damage, increased serum creatinine and blood urea nitrogen, and even kidney failure.

**19. What is the relationship between obesity and respiratory diseases?**

Obese individuals experience a decrease in vital capacity due to thickened chest walls and elevated diaphragms. Severe cases may lead to hypoxia, cyanosis, and hypercapnia, accompanied by drowsiness, pulmonary hypertension, and heart failure. In extreme cases, obesity-related cardiopulmonary insufficiency syndrome may develop.

Some severely obese individuals may experience symptoms such as drowsiness, cyanosis, elevated central venous pressure, decreased vital capacity, dyspnea, inability to lie flat, tachycardia, edema, and cyanosis, which is known as cor pulmonale syndrome.

**20. What is the relationship between obesity and gout?**

Gout is a group of diseases caused by long-term purine metabolism disorders. Gout, also known as hyperuricemia, is caused by abnormal purine metabolism in the body, resulting in elevated uric acid concentration in the blood. Uric acid is converted into urate crystals, which accumulate in the joints and connective tissues, causing inflammatory lesions of the joints, leading to joint swelling and pain.

Reports indicate that obese individuals are three times more likely to have hyperuricemia than non-obese individuals. The greater the degree of obesity, the higher the incidence of gout. Controlling one's diet and losing weight can reduce the frequency of gout attacks.

**21. What is the relationship between obesity and osteoarthritis?**

Osteoarthritis has a slow onset, manifesting as joint pain, difficulty walking and moving, with symptoms worsening after prolonged sitting and improving after slight activity. In severe cases, joint swelling and even joint deformities may occur.

Obese patients experience increased weight gain, which places greater strain on the spine, pelvis, and lower limbs. Combined with impaired circulation, poor peripheral blood flow, and joint wear and tear, as well as the pressure and irritation between bone surfaces, obese patients have a significantly higher incidence of osteoarthritis than those of normal weight. Osteoarthritis is most commonly seen in the lumbar spine, knee joints, and ankle joints of the lower limbs.

**22. What is the relationship between obesity and pulmonary heart syndrome?**

Pulmonary heart syndrome, also known as Pickwickian syndrome, is a clinical syndrome that occurs in severely obese individuals (weighing over 100 kg). In severely obese patients, excessive adipose tissue around abdominal organs and in the chest wall increases intra-abdominal pressure, causing the diaphragm to rise and its range of motion to decrease, resulting in reduced gas exchange efficiency. Due to the reduced gas exchange in the lungs, the alveoli's capacity for exchanging oxygen and carbon dioxide decreases, leading to increased carbon dioxide partial pressure and decreased oxygen partial pressure. Consequently, patients experience shortness of breath, fatigue, inability to tolerate strenuous physical activity, and a reluctance to move. The latter further contributes to obesity. Long-term elevated arterial carbon dioxide partial pressure crosses the blood-brain barrier, gradually increasing carbonate levels in cerebrospinal fluid and decreasing pH, resulting in chronic cerebral hypoxia. The patient not only experiences symptoms such as dizziness, headache, rapid pulse, palpitations, excessive sweating, and weakness, but also, due to long-term hypoxia, is prone to secondary polycythemia, resulting in a plethora of blood types, increased blood viscosity, increased circulatory resistance, venous reflux, elevated venous pressure, jugular venous distension, hepatomegaly, high pulmonary artery pressure, and increased right ventricular load. Over time, this leads to right ventricular hypertrophy. In obese patients, the significant increase in adipose tissue naturally increases total circulating blood volume, leading to increased cardiac output and stroke volume, ultimately increasing the load on the left ventricular and resulting in high-stroke-output heart failure.

In summary, this syndrome is characterized by the following: extreme obesity; dyspnea after activity; somnolence; periodic breathing during sleep; secondary polycythemia; right ventricular hypertrophy; and left heart failure.

**23. How to prevent obesity**

(1) Prevent obesity from childhood

Obesity prevention should begin in early childhood. Preventive measures primarily involve appropriately controlling food intake, limiting high-fat and high-sugar foods, and actively participating in exercise and household chores. During periods when obesity is more likely to occur, such as childhood, puberty, postpartum and menopause, recovery from illness, and middle and old age, it is crucial to take preventative measures. For individuals with a family history of obesity, effective preventative measures should be implemented from early childhood. It is important to change misconceptions; the idea that the fatter the infant, the better, and to avoid force-feeding infants from the breastfeeding period, which can lead to overnutrition. Furthermore, children should not be overindulged, given excessive supplements, or allowed to develop unhealthy eating habits such as excessive snacking and sweets. Children should be encouraged to engage in necessary outdoor activities and physical exercise.

(2) We need to raise awareness and attach importance to weight loss.

It is crucial to fully recognize the serious harm that obesity poses to human health and even lifespan. Understand the knowledge and prevention methods for weight gain during different stages, including infancy, adolescence, pregnancy, menopause, and middle and old age. Utilize every possible method and persevere long-term to achieve successful weight loss. Weight loss efforts must be consistent and emphasize a comprehensive treatment approach primarily based on diet, behavioral therapy, and exercise. The goal of weight loss is to achieve a negative energy balance through diet and exercise, thereby eliminating excess body fat, reducing weight, and lessening the burden on vital organs such as the heart, kidneys, and liver, thus effectively preventing the harmful effects of obesity-related complications.

(3) Maintain a cheerful mood and a regular lifestyle.

A positive mood and a happy, fulfilling life allow the body's various systems to function properly, playing a positive role in preventing obesity. Conversely, if a person is depressed, constantly downcast, and unhappy, their metabolism will slow down, making them more prone to fat accumulation and obesity. Furthermore, developing healthy lifestyle habits is crucial for preventing obesity. For example, eating regular, measured meals, aiming for about 60% fullness, avoiding overeating, waking up at the same time every morning and engaging in exercise, and going to bed on time, but avoiding oversleeping. All of these are highly beneficial in preventing and controlling obesity.

(4) Maintain a light diet and exercise regularly.

To achieve a slim and fit body, a light and balanced diet is crucial. A low-fat, light diet is more effective for weight loss than strict dietary control, and it's also important to pay attention to water intake. A healthy adult should drink at least 8-10 cups of water per day. Warm boiled water, mineral water, and tea are all ideal beverages for those trying to lose weight. Some experts also believe that insufficient water intake is one of the causes of obesity. Drinking enough water accelerates the excretion of water from the body, eliminating water retention and thus aiding in weight loss.

Preventing obesity requires consistent exercise. As the saying goes, life lies in movement. Exercise improves endurance, burns excess energy, and prevents it from turning into fat and causing obesity. Suitable exercises include walking, cycling, swimming, jogging, tennis, hiking, gymnastics, and dancing. These activities burn excess energy, improve physical fitness, promote a healthy physique, and effectively prevent obesity.