Types of Obesity                  
There are many different ways to classify obesity. In accordance with endocrine and pathogeny of the metabolic disease, obesity can be divided into simple obesity, secondary obesity and drug-induced obesity.
 Types of Obesity(1):Simple obesity
 The simple obesity, called as primary obesity, is due to excessive energy intake and too little consumption , also known as diet-induced obesity and has the largest proportion in all types of obesity. About 95% of obese patients are of this type. The simple obesity are generally caused by the heredity factor, the nutrition surplus and a lack of exercise, and characterized by the even distribution of the whole body fat, many obese people in the family obesity , no special pathogeny which possibly cause obesity.
   Simple obesity is a special disease that is different from secondary obesity. The exact pathogenesis of this obesity is not very clear, but it is certain that any factor likely cause simple obesity as long as they can make energy intake more than energy consumption. These factors include eating too much, too little physical activity, psychosocial factors, genetic factors, neuroendocrine factors and so on.
A. According to the change of pathology, simple obesity can be classified as “hypertrophic fat” and “corpulent obesity.”
 a. Hyperplastic obesity. Not only the size of fat cells of become larger, but also the number of fat cells increase.
 b.Corpulent obesity. Only the size of fat cells become larger, but the number are unchanged.
 B.According to the age of suffering from this disease, simple obesity can be divided into ” juvenile onset obesity” and “adult onset obesity.”
a. Juvenile onset obesity. It is also called constitutional obesity. Due to excessive nutrition during infancy,the number and the volume of fat cells increase, resulting in the obesity. These patients are fatter than their peers since childhood, so they are referred to as juvenile onset obesity. If we do not control the situation, the degree of obesity will  be very severe, and obesity can even last a lifetime. Such obesity is not sensitive to the therapy of diet weight loss, and some patients may have a hereditable tendency. From this point,the concept of Chinese people to have a fat new born baby need to do some what change.
 b. Adult onset obesity. It is also known as acquired obesity or exogenous obesity. It is induced by the increase of the volume of the fat cells because of excessive nutrient after age 20 to 25. The reason why lots women become obese or have shape deformation is that they  pay no attention to control diet after middle-age. Generally speaking, the number of fat cells in obese body of this type does not increase ,but the size increase. Patients who are suffering from acquired obesity generally prefer to eat sweets or fried foods. Such patients are often become obese in adulthood because of excessive nutrition that they are referred to as adult onset obesity. While the therapy of diet weight loss can effectively control the development of acquired obesity.
C. Accordind to fat distribution in the different parts of the body, simple obesity can be classified as “abdominal obesity” and ” pygal obesity.”
a. Abdominal obesity. The fat of this type patients mainly accumulates beneath the skin of the abdomen and within abdominen. The fatest part of the body is the abdomen, waist is often bigger than the hip, limb is relatively slenderer — these are common character of the obesity of adult male, so it is also known as the centripetal obesity, male pattern obesity and visceral obesity. From the appearance, these patients are always with obese abdominen like an apple, therefore it is also called “apple-type obesity.”

b. Pygal obesity. The fat of these patients generally distribute uniformly, and the fat in the hip is significantly more than the abdominen. The fatest part of the body is the buttocks, and the hip of the patient is bigger than waist — these are common in women, therefore, it is also known as non- centripetal obesity and female obesity. From the appearance, patients with pygal obesity are like pear, so it is also called “pear-shaped obesity”, which have smaller harm than the apple-type obesity.

   compared with pygal obesity , abdominal obesity have higher risk of suffering from complications. someone observed a group of white women, and found that the risk of suffering from diabetes of the obese people was 3.7 times higher than that of ordinary people, and the possibility of women with abdominal obesity to suffer from diabetes was 10.3 times higher than that of ordinary women. Of course, compared with non-obese people, pygal obesity are still very harmful while the harm is slightly smaller than abdominal obesity. It should be noted that we can not interpret above terms too literally, for example, male-type obesity is not particular to the males, and there are plenty of women with abdominal obesity, in other words, women can also have male obesity.

Types of Obesity(2):Secondary obesity

Secondary obesity is metabolic disorder resulted by endocrine or metabolic obstructed diseases and genetic diseases. Obesity is only clinical symptoms of patients , while close scrutiny reveals patients with symptoms in addition to obesity and at the same time a variety of clinical manifestations, such as Cushing’s disease, hypothyroidism, pancreatic β – cell tumors, gonadal dysfunction, polycystic ovary syndrome, morgangni-stewartmorel syndrome.

To the secondary Obese patients, if primary diseases can not get  effective treatment, symptom of obesity can not be significantly improved, so the treatment of secondary obesity is mainly to treat primary diseases, such as exercise and diet weight loss methods are unsuitable.

Secondary obesity can be subdivided into the hypothalamic obesity, pituitary obesity,, pancreatic obesity, hypothyroid obesity, adrenal dysfunction obesity, sexual gland dysfunction obesity and so on.

A. Hypothalamic obesity

Causes: there are two types of nerve nuclei in hypothalamus regulating food intake. One is ventromedial nuclei as satiety center to send out a sense of satiety to antifeedant when excited. Another is ventral lateral nucleus  as hunger center to increase appetite when excited. They can mutually adjust and restrict each other and is in a state of dynamic equilibrium under the physiological condition to make the appetite in the normal range and maintain normal body weight. When hypothalamic lesions occurr, such as inflammation, trauma, a new bio-stimulation and other pathological changes, the satiety center of ventromedial nuclei is damaged, so it can not restrict the hunger center of the ventral lateral nucleus. Then it will occur some clinical symptoms such as good appetite and easy hunger, so we will take in a large number of food , resulting in obesity.

Symptoms: Patients with hypothalamic obesity may have symptoms such as fatigue, lethargy, sexual dysfunction.

The most common pathogeny of hypothalamic obesity in children is craniopharyngioma, in adults inflammation, trauma and new bio-stimulation. The main treatment is to deal with the primary disease which causes hypothalamic obesity.

B. Pituitary obesity

Causes: Pituitary obesity is induced by pituitary dysfunction and belong to hypothalamic syndrome. The causes are due to pituitary dysfunction, resulting in the decreased secretion of growth hormone, corticotropin, thyroid-stimulating hormone, so that the rate of metabolism decline, body fat decomposition reduce, synthesis increase.

Symptoms: Hyperplasia and hypertrophy of body bone, soft tissue and  internal organs.

C. pancreatic obesity

Causes: excessive secretion of insulin and the decrease of metabolic rate lead to the decrease of lipolysis while the increase of synthesis.

Symptoms: obese at every pore.

D. Hypothyroid obesity

Causes: hypothyroidism.

Symptoms: obesity and mucus-type edema.

E. sexual gland dysfunction obesity

Causes: the Cerebral obesity, accompanied by the loss of sexual function, or loss of libido.

Symptoms: breast, lower abdomen, near the genitals of obesity.

Types of Obesity(3):Drug-induced obesity

Sometimes in order to treat diseases clinically, doctors may give patients with long-term use of certain drugs that can easily lead to obesity at whiles with a little mistake. For example, the application of adrenal cortex hormones drugs (such as prednisone, dexamethasone and hydrocortisone, etc.) to treat anaphylactic disease, rheumatoid arthritis, bronchial asthma and other diseases, can also lead to obesity; drugs for mental disease like the phenothiazine drugs, can also induce sexual dysfunction and obesity. Patients with this type of obesity take up the proportion about 2 percent. In general, when patients stop using these drugs, obesity will disappeare by itself. But unfortunately, some people even develop into a patient with “refractory obesity”. So some people classify drug-induced obesity into secondary obesity.

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