Nguyen, 52, the youngest, and her two older sisters, Ha, 55, and Thu, 57, have been obese since childhood. Recently, Nguyen gained 10 kg without a clear cause, experiencing discomfort and fatigue. Her two sisters also frequently experienced leg pain, with dark blue, twisted veins visible on both legs, making walking difficult. They all sought treatment at Tam Anh General Hospital, Ho Chi Minh City, where Doctor Lam Van Hoang, Head of Endocrinology and Diabetes, noted that all three were obese and in either pre-menopausal or menopausal stages.

InBody measurements and blood tests revealed Ha weighed 87 kg with a BMI of 37,2, indicating severe obesity. Thu weighed 68 kg, and Nguyen 70 kg, both falling into obesity grade 2. All three had visceral fat levels 2,5 times above the safe threshold, along with high blood pressure and dyslipidemia.

Doctor Hoang consults on a weight loss regimen for the three sisters. Photo: Tam Anh General Hospital

Additionally, Ha and Thu suffered from varicose veins in both lower limbs, characterized by twisted, enlarged, dark blue veins visible under the skin. This condition occurs when veins dilate due to weakened valves, causing blood to pool instead of circulating effectively. Sufferers often experience swelling, aching, heavy legs, and sometimes a burning sensation. "Excessive weight places significant pressure on the lower limbs, a major risk factor for varicose veins," Doctor Hoang explained.

Nguyen, in addition to obesity, was diagnosed with elevated blood sugar, a sign of type 2 diabetes.

According to Doctor Hoang, genetic factors contribute partly to the obesity in these three women. Furthermore, a shared living environment, similar eating habits, and daily routines also increase the risk of overweight. During pre-menopause and menopause, women are more prone to weight gain and fat accumulation than at other ages due to hormonal changes that increase insulin resistance. Ineffective insulin utilization in the body promotes the development of type 2 diabetes.

Based on each patient's underlying conditions and individual health, Doctor Hoang developed personalized treatment regimens.

Ha and Thu were prescribed oral and injectable medications to reduce calorie intake, while also maintaining a nutritious diet rich in fiber, green vegetables, and fruits. For their varicose veins, an exercise specialist advised appropriate leg exercises, such as ankle rotations and leg presses while sitting or lying down.

Nguyen uses new-generation diabetes medication to both reduce fat and stabilize blood sugar.

Doctor Hoang noted that women's bodies during menopause undergo significant hormonal changes, altering fat distribution, leading to accumulation in the abdomen, buttocks, and thighs, and affecting metabolic processes. Treating obesity in middle-aged women requires time and persistence to ensure effective, safe results without exacerbating existing underlying conditions.

Duc Hanh

Patient names have been changed.