Metabolism and Diabetes Unit, Evgenidion Hospital, Athens University Medical School, Athens, Greece.
Obes Facts. 2008;1(2):106-16. doi: 10.1159/000126822. Epub 2008 Apr 18.
The development of consensus guidelines for obesity is complex. It involves recommending both treatment interventions and interventions related to screening and prevention. With so many publications and claims, and with the awareness that success for the individual is short-lived, many find it difficult to know what action is appropriate in the management of obesity. Furthermore, the significant variation in existing service provision both within countries as well as across the regions of Europe makes a standardised approach, even if evidence-based, difficult to implement. In formulating these guidelines, we have attempted to use an evidence-based approach while allowing flexibility for the practicing clinician in domains where evidence is currently lacking and ensuring that in treatment there is recognition of clinical judgment and of regional diversity as well as the necessity of an agreed approach by the individual and family. We conclude that i) physicians have a responsibility to recognise obesity as a disease and help obese patients with appropriate prevention and treatment, ii) treatment should be based on good clinical care and evidence-based interventions and iii) obesity treatment should focus on realistic goals and lifelong management.
肥胖症共识指南的制定较为复杂。它不仅涉及治疗干预,还涉及筛查和预防相关的干预。有如此多的出版物和主张,而且个体的成功是短暂的,许多人发现很难知道在肥胖症管理中采取什么措施是合适的。此外,即使是基于证据的方法,在国家内部以及欧洲各地区之间现有的服务提供方面也存在显著差异,因此难以实施标准化方法。在制定这些指南时,我们试图在证据基础上采取灵活的方法,同时允许临床医生在证据不足的领域发挥作用,并确保在治疗中认识到临床判断以及地区差异,以及个人和家庭达成一致意见的必要性。我们的结论是:i)医生有责任认识到肥胖是一种疾病,并帮助肥胖患者进行适当的预防和治疗;ii)治疗应基于良好的临床护理和基于证据的干预措施;iii)肥胖症的治疗应注重现实目标和终身管理。