Obesity therapy
Obesity therapy
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DOI：
10.1016/j.clnesp.2020.04.013
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发表时间：
2020-08-01
影响因子：
3
通讯作者：
Schweinlin, Anna
中科院分区：
文献类型：
--
作者：
Bischoff, Stephan C.;Schweinlin, Anna
肥胖是一种慢性全身性疾病，定义为病理性脂肪量增加，与健康风险增加有关。BMI >30 kg/m2通常被认为是肥胖的标志。肥胖症需要多学科和多模式治疗，这取决于疾病的阶段和目的（例如减肥，体重维持）。治疗应基于证据。肥胖治疗的目标是通过长期减少脂肪量并结合行为改变来减轻体重，旨在改善肥胖相关的风险因素，减少肥胖相关疾病，降低过早死亡，失能和提前退休的风险，并提高生活质量。非手术生活方式疗法包括营养、运动、行为改变（“基本疗法”），当与初始配方饮食结合时，其变得更有效。如果预期相对体重减轻超过10%，则应使用配方饮食作为初始治疗。一个成功和持续的肥胖治疗需要一个清晰的结构，训练有素的专业团队，以及成本的覆盖范围。药物可以支持肥胖治疗，而其他药物可以促进体重增加。多模式方法是最有效的非手术治疗，导致相对体重减轻15- 25%。主要的肥胖治疗应该是非手术方法，但如果不能通过其他方法解决问题，可能需要减肥手术。一个清晰和现实的界面减肥手术需要定义。体重维持策略包括和超越饮食的概念，通常需要在整个生命的长期稳定体重。(c)2020年欧洲临床营养与代谢学会。由爱思唯尔有限公司出版。保留所有权利。
Obesity is a chronic, systemic disease defined as a pathologically increased fat mass, which is associated with an increased health risk. A BMI >30 kg/m2 is usually considered as a sign of obesity. Obesity requires a multidisciplinary and multimodal treatment, which varies depending on the phase of disease and the purpose (e.g. weight loss, weight maintenance). The treatment should be based on evidence. The goal of obesity therapy is to reduce the body weight by reducing fat mass in the long term in combination with a change in behavior, which aims to improve obesity-associated risk factors, reduce obesity-related illnesses, reduce the risk of premature mortality, incapacitation and early retirement, and improve quality of life. Non-surgical lifestyle therapy comprises nutrition, exercise, behavior change ("basic therapy") which becomes more effective when combined with initial formula diet. A formula diet as initial therapy is indicated if a relative weight loss more than 10% is intended. A successful and sustained obesity therapy needs a clear structure, a well-trained team of professionals, and the coverage of the costs. Drugs can support obesity therapy, while other drugs can promote weight gain. The multimodal approach is the most effective non-surgical therapy resulting in a relative weight loss of 15-25%. The primary obesity therapy should be with a non-surgical approach, but bariatric surgery may be needed if the problem cannot otherwise be solved. A clear and realistic interface to bariatric surgery needs to be defined. Weight maintenance strategies including and beyond dietetic concepts are usually needed throughout life for long-term stabilization of body weight. (c) 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.