Treatment of Obesity in Primary Care Practice: The Practice Based Opportunities for Weight Reduction (POWER) Trial at Johns Hopkins.
Treatment of Obesity in Primary Care Practice: The Practice Based Opportunities for Weight Reduction (POWER) Trial at Johns Hopkins.
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初级保健实践中的肥胖治疗：约翰·霍普金斯大学基于实践的减重机会 (POWER) 试验。
DOI：
10.1089/obe.2009.0506
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Appel,LawrenceJ
中科院分区：
文献类型：
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作者：
Jerome,GeraldJ;Yeh,Hsin-Chieh;Dalcin,Arlene;Reynolds,Jeffrey;Gauvey-Kern,MeganE;Charleston,Jeanne;Durkin,Nowella;Appel,LawrenceJ
肥胖已经成为美国和世界上大多数国家最重要和最常见的公共卫生问题之一。在美国，大约三分之一的成年人肥胖，BMI≥ 30 kg/m2，另外三分之一超重（BMI为25至29.9 kg/m2）。1肥胖与发病率和死亡率的风险显著增加有关，特别是心血管疾病（CVD）。2肥胖对CVD的不良影响可能是通过体重对传统CVD风险因素（如高血压、血脂异常和糖尿病）的影响介导的，也可能是通过独立于这些风险因素的机制介导的。在这种情况下，肥胖及其心血管疾病后果是医生在医疗实践中经常遇到的非常常见的问题。治疗肥胖患者的选择包括行为疗法（有或没有代餐），药物治疗和减肥手术。减肥手术非常有效，但不适合绝大多数超重或肥胖的美国人。3临床试验表明，药物治疗是有效的，然而，它只被推荐作为饮食和身体的辅助治疗。
Obesity has emerged as one of the most important and common public health problems in the United States and throughout most of the world. In the United States, approximately one third of adults are obese with a BMI≥ 30 kg/m2, and another third are overweight (BMI of 25 to 29.9 kg/m2). 1 Obesity is associated with a substantially increased risk of morbidity and mortality, especially from cardiovascular disease (CVD). 2 The adverse effects of obesity on CVD are likely mediated through the effects of weight on traditional CVD risk factors (eg, hypertension, dyslipidemia, and diabetes), and possibly through mechanisms that are independent of these risk factors. In this setting, obesity and its CVD consequences are extraordinarily common problems that physicians routinely encounter in medical practice. Options to treat obese patients include behavior therapy (with or without meal replacements), drug therapy, and bariatric surgery. Bariatric surgery is highly effective but is not appropriate for the vast majority of Americans who are overweight or obese. 3 Clinical trials have demonstrated that pharmacotherapy is effective, however, it is only recommended as an adjunct to diet and physical