Grunvald Eduardo
Weight Management Program, Bariatric and Metabolic Institute, University of California, San Diego, California.
Clin Obstet Gynecol. 2014 Sep;57(3):465-84. doi: 10.1097/GRF.0000000000000041.
Obesity has reached epidemic proportions, accounting for increased morbidity, disability, health care expenditures, and mortality. Certain metabolic and comorbid conditions disproportionately affect women. Unfortunately, nonsurgical options for treatment are limited. Knowledge accrued over the past 2 decades regarding physiological and hormonal determinants of weight regulation has contributed to growing evidence regarding efficacious behavioral, dietary, and pharmacologic treatments. In this review, the biology of excess adiposity is summarized in the context of a shifting paradigm, approaching obesity as a chronic metabolic disease. Relevant updates are discussed regarding long-term lifestyle approaches and novel drug therapies, with attention to some issues specific to women.
肥胖已达到流行程度，导致发病率、残疾率、医疗保健支出和死亡率上升。某些代谢和合并症对女性的影响尤为严重。不幸的是，非手术治疗选择有限。过去20年积累的关于体重调节的生理和激素决定因素的知识，为有效的行为、饮食和药物治疗提供了越来越多的证据。在这篇综述中，我们在一种转变的范式背景下总结了肥胖过多的生物学机制，即将肥胖视为一种慢性代谢疾病。讨论了关于长期生活方式方法和新型药物疗法的相关更新，并关注了一些女性特有的问题。
