Overcoming Misconceptions: Ten Warning Signs of Overweight vs. Obesity and Morbid Obesity

Is being overweight the same as being obese?

We can determine whether we are overweight or obese by calculating our standard weight and referring to a body mass index table. However, it is important to note that we cannot conclude that we have obesity simply because we are overweight.

In some cases, weight cannot be used as a standard for judging obesity. For example, if you are an athlete or a sports enthusiast, a large portion of your weight may come from developed muscle rather than fat. In this case, weight cannot be used as a standard for judging obesity. Furthermore, certain medical conditions, such as edema, pleural effusion, or ascites caused by certain diseases, can also lead to weight gain. This pathological weight gain cannot be simply judged as obesity. There are many similar situations; therefore, you cannot simply conclude that you are obese based on weight gain alone.

What tests should be done after becoming obese?

Once a person discovers they are obese, the first thing they should do is determine what type of obesity they have, which requires some necessary examinations:

(1) Measure height and weight. This is the most basic examination item.

(2) Check fasting blood glucose and 2-hour postprandial blood glucose, and perform a glucose tolerance test to determine whether there is impaired glucose tolerance or diabetes.

(3) Check plasma total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides to determine whether there is dyslipidemia.

(4) Have an abdominal ultrasound to check for fatty liver and gallbladder disease.

(5) Measure blood pressure to determine if you have high blood pressure.

(6) Checking triglycerides, combined with B-ultrasound, can reveal the intrinsic link between obesity and fatty liver.

(7) Check kidney function to determine whether Cushing's syndrome and pituitary tumor are present.

(8) Checking growth hormone levels can reveal whether weight loss is effective.

(9) Examining sex hormones is a good way to observe the relationship between the sites of action of estrogen and androgen and obesity, which is helpful in determining a weight loss plan.

In addition, attention should be paid to changes in body temperature, pulse, respiration, basal metabolic rate, etc.

These examinations can uncover some hidden illnesses, allowing for appropriate treatment to reduce the harm these diseases cause to the body.

**Ten Warning Signs of "Morbid Obesity"**

Morbid obesity refers to obesity caused by certain primary diseases. Based on years of clinical experience, medical experts have summarized ten common symptoms associated with morbid obesity, reminding people to pay attention and seek timely treatment.

**1. Purple Stripes**

Its main manifestations include: spindle-shaped, light purplish-red stripes on both sides of the abdomen and inner thighs, as well as a moon face, buffalo hump, and potbelly. These symptoms indicate an increase in cortisol, which can lead to osteoporosis, high blood pressure, weakness, and hypokalemia if it progresses. In some patients, it may also be caused by pituitary and adrenal gland disorders.

**2. Hairy**

Obese children with hirsutism are highly likely to have a congenital genetic disease or gonadal abnormality, which should be taken seriously by parents. If precocious puberty and skeletal abnormalities are also present, vigilance is crucial, and a systematic examination of chromosomes and endocrine glands at a reputable hospital is necessary.

**3. Acanthosis nigricans**

The main symptoms are skin pigmentation and increased keratinization, with severe cases showing velvety bumps that give the impression of being constantly unclean. It is most common on the back of the neck and underarms. The appearance of acanthosis nigricans is a pathological signal, related to hyperinsulinemia, and if it progresses, it can lead to type 2 diabetes, hypertension, and lipid metabolism disorders.

4. Menstrual irregularities

Women of childbearing age experiencing amenorrhea, menopause, or menstrual irregularities should take this very seriously. Obesity itself and weight loss treatments can both cause menstrual irregularities; a normal body fat percentage is essential for maintaining the function of female hormones. Obesity accompanied by amenorrhea is most commonly seen in young women due to polycystic ovary syndrome (PCOS) and hyperprolactinemia. If symptoms such as galactorrhea, headache, or chest tightness occur, prompt medical examination and treatment are necessary.

**5. Male breast development**

Physiological gynecomastia (male breast development) that occurs in children during puberty usually resolves on its own. However, in obese children, endocrine disorders and hormonal imbalances can also cause abnormal changes such as gynecomastia, hypogonadism, and feminization.

**6. Fatty liver**

Approximately 60% of obese patients develop hepatic steatosis. Most patients are asymptomatic, but in severe cases, hepatomegaly may be detected during a physical examination, with ultrasound revealing significant fatty infiltration and abnormal liver function tests showing elevated transaminase levels. In such cases, weight loss can restore liver function to normal.

**7. Increased waist circumference**

Some patients with normal weight may only experience an increase in waist circumference, but they can still develop obesity-related complications such as diabetes, hyperlipidemia, and coronary heart disease. Chinese men with a waist circumference greater than 90 cm and women with a waist circumference greater than 80 cm should be particularly vigilant.

**8. Yellowish skin and swollen eyelids**

This condition often occurs in obese women after childbirth or around menopause, manifesting as increasing weight gain, general weakness, chest tightness, shortness of breath, swollen eyelids, and stiff hands and feet. It is often caused by hypothyroidism resulting from postpartum thyroiditis and chronic lymphocytic thyroiditis.

**9. Abnormal appetite**

Feeling constantly hungry, getting hungry right after eating, and feeling hungrier the more you eat, should be taken seriously. This is because excessive appetite can sometimes be a symptom of hypothalamic syndrome or insulinoma.

**10. Sleep Apnea Syndrome**

Excessive obesity can cause both functional and organic damage to the lungs. Excessive fat accumulation restricts lung expansion and reduces oxygen exchange. Over time, this can lead to "obesity-related malventilation syndrome," characterized by daytime sleepiness and poor nighttime sleep. In severe cases, it can result in "sleep apnea syndrome," causing symptoms such as poor concentration and memory loss, and even complications like chronic lung and heart failure. Parents should pay close attention to children who are obese and experience severe snoring.