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肥胖的药物治疗:内分泌学会临床实践指南

Pharmacological management of obesity: an endocrine Society clinical practice guideline.

作者信息

Apovian Caroline M, Aronne Louis J, Bessesen Daniel H, McDonnell Marie E, Murad M Hassan, Pagotto Uberto, Ryan Donna H, Still Christopher D

机构信息

Boston University School of Medicine and Boston Medical Center (C.M.A.), Boston, Massachusetts 02118; Weill-Cornell Medical College (L.J.A.), New York, New York 10065; Denver Health Medical Center (D.H.B.), Denver, Colorado 80204; Brigham and Women's Hospital (M.E.M.), Boston, Massachusetts 02115; Mayo Clinic, Division of Preventative Medicine (M.H.M.), Rochester, Minnesota 55905; Alma Mater University of Bologna (U.P.), S. Orsola-Malpighi Hospital Endocrinology Unit, 40138 Bologna, Italy; Pennington Biomedical Research Center (D.H.R.), Baton Rouge, Louisiana 70808; and Geisinger Health Care System (C.D.S.), Danville, Pennsylvania 17822.

出版信息

J Clin Endocrinol Metab. 2015 Feb;100(2):342-62. doi: 10.1210/jc.2014-3415. Epub 2015 Jan 15.

Abstract

OBJECTIVE

To formulate clinical practice guidelines for the pharmacological management of obesity.

PARTICIPANTS

An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society.

EVIDENCE

This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence.

CONSENSUS PROCESS

One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the European Society of Endocrinology, and The Obesity Society reviewed and commented on preliminary drafts of these guidelines. Two systematic reviews were conducted to summarize some of the supporting evidence.

CONCLUSIONS

Weight loss is a pathway to health improvement for patients with obesity-associated risk factors and comorbidities. Medications approved for chronic weight management can be useful adjuncts to lifestyle change for patients who have been unsuccessful with diet and exercise alone. Many medications commonly prescribed for diabetes, depression, and other chronic diseases have weight effects, either to promote weight gain or produce weight loss. Knowledgeable prescribing of medications, choosing whenever possible those with favorable weight profiles, can aid in the prevention and management of obesity and thus improve health.

摘要

目的

制定肥胖症药物治疗的临床实践指南。

参与者

内分泌学会任命的专家特别工作组、一名方法学家和一名医学撰写人。本指南由欧洲内分泌学会和肥胖学会共同发起。

证据

本循证指南采用推荐分级、评估、制定与评价(GRADE)系统制定,以描述推荐强度和证据质量。

共识过程

通过一次小组会议、多次电话会议和电子邮件交流达成共识。内分泌学会、欧洲内分泌学会和肥胖学会的委员会及成员对这些指南的初稿进行了审查并提出意见。进行了两项系统评价以总结一些支持性证据。

结论

对于伴有肥胖相关危险因素和合并症的患者,体重减轻是改善健康的途径。已批准用于慢性体重管理的药物对于仅通过饮食和运动未取得成功的患者而言,可作为生活方式改变的有益辅助手段。许多常用于治疗糖尿病、抑郁症和其他慢性病的药物具有体重影响,要么促进体重增加,要么导致体重减轻。合理用药,尽可能选择对体重有有利影响的药物,有助于预防和管理肥胖症,从而改善健康状况。

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