Brawer Rickie, Brisbon Nancy, Plumb James
Department of Family and Community Medicine, Thomas Jefferson University, 1015 Walnut - Suite 401, Philadelphia, PA 19107, USA.
Prim Care. 2009 Sep;36(3):509-31. doi: 10.1016/j.pop.2009.04.005.
Obesity has become the second leading preventable cause of disease and death in the United States, trailing only tobacco use. Weight control, dietary choices, and levels of physical activity are important modifiable determinants of cancer risk. Physicians have a key role in integrating multifactorial approaches to prevention and management into clinical care and advocating for systemic prevention efforts. This article provides an introduction to the epidemiology and magnitude of childhood and adult obesity; the relationship between obesity and cancer and other chronic diseases; potential mechanisms postulated to explain these relationships; a review of recommended obesity treatment and assessment guidelines for adults, adolescents, and children; multilevel prevention strategies; and an approach to obesity management in adults using the Chronic Care Model.
肥胖已成为美国第二大可预防的疾病和死亡原因，仅次于吸烟。体重控制、饮食选择和身体活动水平是癌症风险的重要可改变决定因素。医生在将多因素预防和管理方法纳入临床护理以及倡导系统性预防工作方面发挥着关键作用。本文介绍了儿童和成人肥胖的流行病学及严重程度；肥胖与癌症及其他慢性病之间的关系；为解释这些关系而假定的潜在机制；对成人、青少年和儿童推荐的肥胖治疗和评估指南的综述；多级预防策略；以及使用慢性病护理模型对成人进行肥胖管理的方法。
