Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA.
Curr Obes Rep. 2018 Jun;7(2):130-138. doi: 10.1007/s13679-018-0301-3.
Obesity rates in the USA have reached pandemic levels with one third of the population with obesity in 2015-2016 (39.8% of adults and 18.5% of youth). It is a major public health concern, and it is prudent to understand the factors which contribute. Racial and ethnic disparities are pronounced in both the prevalence and treatment of obesity and must be addressed in the efforts to combat obesity.
Disparities in prevalence of obesity in racial/ethnic minorities are apparent as early as the preschool years and factors including genetics, diet, physical activity, psychological factors, stress, income, and discrimination, among others, must be taken into consideration. A multidisciplinary team optimizes lifestyle and behavioral interventions, pharmacologic therapy, and access to bariatric surgery to develop the most beneficial and equitable treatment plans. The reviewed studies outline disparities that exist and the impact that race/ethnicity have on disease prevalence and treatment response. Higher prevalence and reduced treatment response to lifestyle, behavior, pharmacotherapy, and surgery, are observed in racial and ethnic minorities. Increased research, diagnosis, and access to treatment in the pediatric and adult populations of racial and ethnic minorities are proposed to combat the burgeoning obesity epidemic and to prevent increasing disparity.
综述目的：美国的肥胖率已达到流行水平，2015-2016 年有三分之一的人口肥胖（成年人中 39.8%，青少年中 18.5%）。这是一个主要的公共卫生关注点，了解导致肥胖的因素是谨慎的。肥胖的流行率和治疗率在种族和民族之间存在明显差异，在对抗肥胖的努力中必须加以解决。
最新发现：从学龄前开始，少数族裔肥胖的流行率就存在差异，包括遗传、饮食、体育活动、心理因素、压力、收入和歧视等因素都必须考虑在内。多学科团队优化生活方式和行为干预、药物治疗以及获得减重手术的机会，以制定最有益和公平的治疗计划。综述研究概述了存在的差异，以及种族/民族对疾病流行率和治疗反应的影响。在少数族裔中，肥胖的患病率更高，对生活方式、行为、药物治疗和手术的治疗反应也更低。建议在少数族裔的儿科和成年人群体中增加研究、诊断和治疗机会，以应对日益严重的肥胖流行，并防止差距进一步扩大。
