Mathus-Vliegen E M
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Maag-, Darm- en Leverziekten, Meibergdreef 9, 1105 AZ Amsterdam.
Ned Tijdschr Geneeskd. 2003 Jun 14;147(24):1168-72.
The aim of achieving a normal or ideal body weight in the treatment of obesity is an obsolete goal. It stems from the time that obesity was not yet seen as a chronic incurable disease. A more realistic treatment goal is to reduce the body weight by 10-15% over a prolonged period of time. This moderate weight loss will result in a decreased risk for and incidence of obesity-associated diseases. Weight reduction and maintenance is countered by a decrease in resting-energy expenditure and in thermogenesis by food intake, a decreased energy expenditure through physical exercise, a reduced fat oxidation, a relative leptin deficiency and an excess of the gastrointestinal hormone ghrelin. Just as with hypertension and diabetes, the only option is life-long management with the normalisation of abnormal values within a given range.
在肥胖治疗中追求正常或理想体重的目标已过时。这一目标源于肥胖尚未被视为一种慢性不治之症的时代。一个更现实的治疗目标是在较长时间内将体重降低10% - 15%。这种适度的体重减轻将降低肥胖相关疾病的风险和发病率。体重减轻及维持体重会受到静息能量消耗减少、食物摄入引起的产热减少、体育锻炼导致的能量消耗减少、脂肪氧化减少、相对瘦素缺乏以及胃肠道激素胃饥饿素过量的阻碍。正如高血压和糖尿病一样，唯一的选择是进行终身管理，使异常值在给定范围内恢复正常。
