Highway to the danger zone? A cautionary account that GLP-1 receptor agonists may be too effective for unmonitored weight loss.
Highway to the danger zone? A cautionary account that GLP-1 receptor agonists may be too effective for unmonitored weight loss.
复制标题
通往危险区的高速公路？
DOI：
10.1111/obr.13709
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Khalsa,SahibS
中科院分区：
文献类型：
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作者：
Richards,JesseR;Khalsa,SahibS
胰高血糖素样肽1（GLP-1）受体激动剂正在彻底改变肥胖和2型糖尿病的治疗，提供显着的减肥效果。这些药物通过对外周和中枢神经系统靶点的作用，利用胰岛素调节激素GLP-1的作用，以其减肥手术相媲美的结果带来了希望。然而，其长期安全性和有效性仍存在问题。借鉴我们在肥胖医学和精神病学方面的专业知识，我们反思了这些药物的临床使用经验，并深入研究了它们所带来的微妙挑战和风险，特别是对于那些容易饮食失调或被诊断患有罕见遗传性肥胖疾病的人。我们认为，在这个“危险区”内有效管理体重减轻需要（1）主动筛查和持续监测饮食失调，（2）警惕监测与食欲相关的适应不良反应，包括食物厌恶和脱水，以及（3）持续评估更广泛的健康影响。融合医学，心理，饮食和行为策略的多方面，跨学科的方法对于为每位患者提供量身定制的全面护理至关重要。
Glucagon‐like peptide 1 (GLP‐1) receptor agonists are revolutionizing obesity and type 2 diabetes treatment, delivering remarkable weight loss outcomes. These medications, leveraging the effects of the insulin‐regulating hormone GLP‐1 via actions on peripheral and central nervous system targets, have raised hopes with their bariatric surgery‐rivaling results. However, questions remain about their long‐term safety and efficacy. Drawing from our expertise in obesity medicine and psychiatry, we reflect upon our experiences with the clinical use of these medications and delve into the nuanced challenges and risks they pose, particularly for those prone to disordered eating or those diagnosed with rare genetic diseases of obesity. We contend that effectively managing weight loss within this “danger zone” necessitates (1) proactive screening and continuous monitoring for disordered eating, (2) vigilant monitoring for appetite‐related maladaptive responses, including food aversion and dehydration, and (3) ongoing assessment for broader health impacts. A multifaceted, interdisciplinary approach that melds medical, psychological, dietary, and behavioral strategies is crucial to delivering tailored and thorough care to each patient.