Experts warn that this kind of obesity can be "life-threatening". Five years after giving birth, the weight soared by 80 kilograms
Ms. Guo, a 38-year-old woman, gained 80 kilograms of weight in the five years after giving birth. She suffered from menopause, difficulty breathing, light coma, and even a sense of near-death. A few days ago, she came to the Obesity and Fatty Liver Clinic of the Department of Endocrinology, Zhongshan Hospital, Fudan University for help. Severe obesity completely destroyed her life. In the end, the expert team performed a laparoscopic vertical sleeve gastrectomy on her. She was discharged at a lower weight than when she was admitted. She lost a total of 35 kilograms. One month after the operation, Ms. Guo's mental state improved significantly and her weight dropped to 102 kilograms.
Ms. Guo's weight continued to increase after giving birth in 2015. In 2020, when she was 160 centimeters tall, her weight had increased from 70 kilograms before giving birth to 90 kilograms. In the following three years, she increased by 60 kilograms again, reaching 150 kilograms. When Deputy Chief Physician Yan Hongmei received the consultation, Ms. Guo had developed listlessness, shortness of breath, purple lips, edema of the eyes, multiple skin ulcers, and pigmentation.
Further examination after admission showed that the patient's BMI was as high as 59, indicating he was extremely obese. The neck tissue and chest wall are thickened, causing the patient to have difficulty breathing and atelectasis. Hypoxia and hypercapnia increase the pulmonary artery pressure, causing right ventricular dysfunction and complicated type II respiratory failure and heart failure. During the visit, the patient could only remain seated throughout the day and relied on non-invasive ventilator-assisted treatment to barely maintain normal breathing.
Under the guidance of Director Li Xiaoying of the Department of Endocrinology, the expert team contacted the Department of Anesthesiology, General Surgery, Respiratory Medicine, Cardiology and Critical Care Medicine for consultation and formulated an individualized treatment plan. Considering that the patient has cardiopulmonary failure due to long-term extreme obesity, immediate surgical treatment can easily lead to respiratory and circulatory system collapse and systemic organ failure, which carries great risks. After discussion, the metabolic surgery multidisciplinary team of Zhongshan Hospital, which is composed of the Department of Endocrinology, General Surgery, Intensive Care Unit, Endoscopy Center, and Department of Anesthesiology, decided to improve the patient’s cardiopulmonary function through preoperative treatment first, and then make full preparations before treating the patient. Metabolic surgery is performed to improve organ function.
With the full assistance of Dr. Zhou Di from the Department of Anesthesiology and the operating room nursing team, Chief Physician Wu Haifu of the General Surgery Department performed a laparoscopic "vertical sleeve gastrectomy" on Ms. Guo, removing 70%-80% of the gastric body on the greater curvature of the stomach. Tissue, narrow the stomach into a tube, reduce gastric capacity, change hormone secretion, thereby reducing appetite and controlling food intake. In addition, the surgery improves the patient's own insulin sensitivity, which helps lower blood sugar and control fat storage, preventing the occurrence of chronic diseases.
After the operation, under the careful care of the surgical care unit, the patient's condition was relatively stable and he was successfully transferred back to the endocrinology ward. Through a series of symptomatic supportive treatments such as cardiotonic diuresis, improving breathing, maintaining water and electrolyte balance, wound care, and perioperative dietary adjustments, the patient's cardiopulmonary indicators have improved significantly. He can now be weaned from ventilator treatment during the day, and with the assistance of a non-invasive ventilator at night, Can sleep in a semi-recumbent position. At the time of discharge, the patient's weight was 35 kg lighter than when he was admitted.
Experts remind: Obesity has become a global health problem and can cause a variety of diseases, such as fatty liver, diabetes, hyperlipidemia, hyperuricemia, hypertension, heart failure, sleep apnea-hypopnea syndrome, etc., and even increase the risk of cardiovascular disease. Colorectal cancer risk. Current treatments for obesity can be divided into surgical and non-surgical treatments.
