Wirth Alfred, Wabitsch Martin, Hauner Hans
Bad Rothenfelde, Department of Pediatrics and Adolescent Medicine, Section of Pediatric Endocrinology and Diabetes, University Medical Center Ulm, Ulm, Else Kroener-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich.
Dtsch Arztebl Int. 2014 Oct 17;111(42):705-13. doi: 10.3238/arztebl.2014.0705.
The high prevalence of obesity (24% of the adult population) and its adverse effects on health call for effective prevention and treatment.
Pertinent articles were retrieved by a systematic literature search for the period 2005 to 2012. A total of 4495 abstracts were examined. 119 publications were analyzed, and recommendations were issued in a structured consensus procedure by an interdisciplinary committee with the participation of ten medical specialty societies.
Obesity (body-mass index [BMI] ge;30 kg/m2) is considered to be a chronic disease. Its prevention is especially important. For obese persons, it is recommended that a diet with an energy deficit of 500 kcal/day and a low energy density should be instituted for the purpose of weight loss and stabilization of a lower weight. The relative proportion of macronutrients is of secondary importance for weight loss. If the BMI exceeds 30 kg/m2, formula products can be used for a limited time. More physical exercise in everyday life and during leisure time promotes weight loss and improves risk factors and obesity-associated diseases. Behavior modification and behavioral therapy support changes in nutrition and exercise in everyday life. With respect to changes in lifestyle, there is no scientific evidence to support any particular order of the measures to be taken. Weight-loss programs whose efficacy has been scientifically evaluated are recommended. Surgical intervention is more effective than conservative treatment with respect to reduction of bodily fat, improvement of obesity-associated diseases, and lowering mortality. Controlled studies indicate that, within 1 to 2 years, a weight loss of ca. 4 to 6 kg can be achieved by dietary therapy, 2 to 3 kg by exercise therapy, and 20 to 40 kg by bariatric surgery.
There is good scientific evidence for effective measures for the prevention and treatment of obesity.
肥胖症患病率高（占成年人口的24%）及其对健康的不利影响需要有效的预防和治疗。
通过系统的文献检索获取2005年至2012年期间的相关文章。共审查了4495篇摘要。分析了119篇出版物，并由一个跨学科委员会在十个医学专业协会的参与下，通过结构化的共识程序发布了建议。
肥胖症（体重指数[BMI]≥30 kg/m²）被视为一种慢性病。其预防尤为重要。对于肥胖者，建议采用能量赤字为500千卡/天且能量密度低的饮食，以实现体重减轻并维持较低体重。宏量营养素的相对比例对体重减轻而言是次要的。如果BMI超过30 kg/m²，可在有限时间内使用配方产品。日常生活和休闲时间增加体育锻炼可促进体重减轻，并改善危险因素和肥胖相关疾病。行为改变和行为疗法有助于支持日常生活中的营养和运动变化。关于生活方式的改变，没有科学证据支持采取措施的任何特定顺序。建议采用经过科学评估疗效的减肥计划。手术干预在减少身体脂肪、改善肥胖相关疾病和降低死亡率方面比保守治疗更有效。对照研究表明，在1至2年内，饮食疗法可实现约4至6千克的体重减轻，运动疗法可实现2至3千克，减肥手术可实现20至40千克。
对于肥胖症的预防和治疗，有科学依据支持有效的措施。
