Core Viewpoint - Obesity is a chronic metabolic disease that poses significant health risks, including diabetes, coronary heart disease, and stroke. It is essential to recognize the complex nature of obesity beyond simple lifestyle factors and to adopt a comprehensive approach to its management [4][21]. Summary by Sections Understanding Obesity - Obesity is often misunderstood as merely a result of personal behavior, but it is influenced by societal changes and has become a significant health issue in China, which has the fastest-growing obesity rates globally [4][6]. - The World Health Organization defines obesity with a BMI threshold of ≥30.0 kg/m², while Chinese guidelines set it at ≥28 kg/m², reflecting local health characteristics [7]. Health Risks Associated with Obesity - Obesity can lead to severe health issues, including a 6 to 14-year reduction in life expectancy. It is linked to increased risks of type 2 diabetes, hypertension, and psychological disorders [6][21]. - The importance of maintaining a healthy BMI (18.5-23.9 kg/m²) is emphasized as a critical factor in preventing chronic diseases [6]. Classification of Obesity - Obesity is not a single disease but has various classifications based on genetic, metabolic, and anatomical factors. This includes primary and secondary obesity, as well as classifications based on fat distribution and metabolic health [7][12]. - The evolution of obesity classification reflects a deeper understanding of its underlying causes, necessitating tailored treatment strategies for different obesity types [7][12]. Specific Conditions Related to Obesity - **Hypothyroidism**: Symptoms include weight gain, fatigue, and cold intolerance, often misattributed to general health issues, leading to delayed diagnosis [8]. - **Cushing's Syndrome**: Characterized by excessive cortisol levels, leading to central obesity and other systemic effects. Early recognition of symptoms is crucial for effective management [10][11]. - **Polycystic Ovary Syndrome (PCOS)**: Affects a significant portion of women in China, with high rates of hyperandrogenism leading to abdominal obesity and insulin resistance [12]. - **Genetic Obesity**: Rare but significant, often linked to specific genetic mutations affecting metabolic pathways. Early genetic testing is recommended for individuals with early-onset obesity [13][15][16]. Contributing Factors to Obesity - **Medication-Induced Obesity**: Certain medications, including diabetes treatments and psychiatric drugs, can lead to weight gain, highlighting the need for careful medication management [18]. - **Psychological Factors**: Increased anxiety and depression in modern society contribute to unhealthy eating behaviors and sedentary lifestyles, exacerbating obesity rates [19]. - **Endocrine Disorders**: Conditions like hypogonadism can complicate obesity management, necessitating a comprehensive evaluation of hormonal health [20]. Conclusion - Recognizing obesity as a chronic condition requiring long-term management is vital. A scientific understanding of its multifaceted nature can help in developing effective intervention strategies to prevent related health complications [21].

Core Viewpoint - Obesity is a significant health risk that can lead to various chronic diseases, and it is essential to understand its complex nature beyond simple lifestyle choices [4][6][21]. Group 1: Understanding Obesity - Obesity is often misperceived as merely a result of personal behavior, but it is influenced by societal changes and has become a major health issue in China, which has the fastest-growing obesity rates globally [4][6]. - The World Health Organization defines obesity with a BMI threshold of ≥30.0 kg/m², while Chinese guidelines set it at ≥28 kg/m², indicating a need for tailored approaches to obesity diagnosis and management [7][21]. - Obesity is not a singular disease but a complex health issue with various classifications based on genetic, metabolic, and environmental factors, necessitating comprehensive evaluation for effective treatment [7][21]. Group 2: Health Risks Associated with Obesity - Obesity significantly increases the risk of developing type 2 diabetes, hypertension, sleep apnea, and can reduce life expectancy by 6 to 14 years [6][21]. - The relationship between obesity and psychological issues, such as anxiety and depression, is critical, as these can exacerbate unhealthy behaviors leading to further weight gain [19][21]. Group 3: Specific Conditions Related to Obesity - Conditions like hypothyroidism, Cushing's syndrome, and polycystic ovary syndrome (PCOS) are linked to obesity, with specific symptoms and metabolic disruptions that require targeted management [8][10][12]. - Genetic factors play a role in obesity, with certain rare genetic syndromes leading to early-onset obesity and associated metabolic disorders, highlighting the need for genetic screening in specific populations [13][15][16]. Group 4: Treatment and Management Strategies - Effective obesity management requires a multifaceted approach, including lifestyle changes, psychological support, and medical interventions tailored to individual needs [21]. - Identifying and addressing medication-induced weight gain is crucial, as certain drugs can significantly contribute to obesity [18][21].