Beware of secondary obesity: How diseases and medications affect scientific weight loss
Secondary Obesity Due to Other Causes
1. Hypothalamic Syndrome
The hypothalamus is an important center in the energy balance regulation network. Obesity can occur when tumors, trauma, infection, drugs, or surgery affect the arcuate nucleus, ventrodorsolateral median nucleus, or paraventricular nucleus of the hypothalamus. Clinically, it mainly manifests as endocrine metabolic disorders and some non-endocrine functional impairments.
2. Hypothyroidism
Hypothyroidism is caused by insufficient secretion of thyroid hormones or weakened physiological effects, leading to a slowed metabolism. However, this type of obesity is due to increased intercellular fluid, increased leakage of albumin and mucin from microvessels, and significant fluid retention in the body, leading to myxedema and weight gain, rather than increased adipose tissue. Primary hypothyroidism includes thyroid hypoplasia, thyroiditis, and post-hypothyroidism resection; pituitary hypothyroidism is a type of secondary hypothyroidism.
3. Polycystic Ovary Syndrome (PCOS)
Due to hypothalamic-pituitary dysfunction, the pituitary gland becomes more sensitive to the release of luteinizing hormone from the corpus luteum, leading to increased LH secretion and an abnormal LH/FSH ratio, resulting in symptoms such as obesity and menstrual irregularities.
4. Menopausal Syndrome
Due to decreased ovarian function, the secretion of estrogen and progesterone by follicles decreases, causing neuroendocrine dysfunction, such as weakened stimulation of the satiety center and reduced sympathetic nerve activity, ultimately leading to abnormal glucose and lipid metabolism.
5. Insulinoma
Insulinomas are tumors formed by pancreatic β-cells. These tumor cells autonomously secrete insulin, and hyperinsulinemia and increased appetite increase anabolism, easily leading to obesity and excessive subcutaneous fat.
6. Cushing's Syndrome
Common causes include adrenal hyperplasia or adrenal cortical tumors and long-term use of high-dose glucocorticoids. Excessive cortisol levels in the body can lead to clinical manifestations such as moon face, central obesity, purple striae, and hypertension.
7. Drug Factors
Some medications can promote weight gain, primarily psychotropic drugs and hormones. These include tricyclic antidepressants, carbamazepine and sodium valproate (anti-epileptic drugs), cyproheptadine (a serotonin antagonist), insulin (a diabetes medication), and sulfonylureas.
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