Dixon John B
Centre for Obesity Research and Education, Monash University, Victoria.
Aust Fam Physician. 2006 Aug;35(8):576-9.
Obesity is a chronic disease requiring a similar long term approach to management as that of other chronic conditions.
This article discusses the role of medications in the overall management of obesity.
Management needs to be multifaceted, aiming to alter the patient and family micro-environment to one favouring better weight control through sustainable behavioural changes to physical activity and diet. Weight loss medications may provide additional benefit. Currently we have only two medications suitable for long term therapy--orlistat and sibutramine. Sibutramine, which acts centrally to suppress appetite, has shown efficacy for up to 2 years. Orlistat, a lipase inhibitor, reduces fat absorption and has been shown to reduce and maintain weight for up to 4 years. The effect of these medications is modest, generally providing less than 5 kg weight loss when compared with placebo. Patients need to have realistic expectations and understand the benefits of sustained modest weight loss. It is important that weight loss medications are prescribed in combination with lifestyle modification.
肥胖是一种慢性病，其管理需要采取与其他慢性病类似的长期方法。
本文讨论药物在肥胖症整体管理中的作用。
管理需要多方面进行，旨在通过对身体活动和饮食进行可持续的行为改变，将患者及其家庭的微环境转变为更有利于体重控制的环境。减肥药物可能会带来额外益处。目前我们仅有两种适用于长期治疗的药物——奥利司他和西布曲明。西布曲明通过作用于中枢抑制食欲，已显示出长达两年的疗效。奥利司他是一种脂肪酶抑制剂，可减少脂肪吸收，已证明能减轻体重并在长达四年内维持体重。这些药物的效果较为适度，与安慰剂相比，通常体重减轻不足5千克。患者需要有现实的期望，并了解持续适度减重的益处。重要的是，减肥药物应与生活方式改变相结合使用。
