Department of Surgery and Cancer, Imperial College London, London, UK.
Imperial Weight Centre, St Mary's Hospital, London, UK.
Obes Surg. 2018 Aug;28(8):2537-2549. doi: 10.1007/s11695-018-3285-x.
Obesity in the young is increasingly prevalent. Early, effective intervention is paramount. Treatment options are lifestyle modifications, pharmacological therapies, endoscopic treatments and bariatric surgery. However, the relative effectiveness of these treatments in young patients remains unclear. We systematically identify and meta-analyse studies evaluating weight loss treatments in young people (< 21 years) with obesity. From 16,372 identified studies, 83 were eligible for meta-analysis. Bariatric surgery resulted in high short/medium-term weight loss (pooled estimate 14.04 kg/m). Lifestyle and pharmacological therapies impacted weight more moderately (pooled estimate 0.99 and 0.94 kg/m respectively). Due to its high efficacy, bariatric surgery should be considered earlier when treating obesity in young people. However, due to the invasiveness and inherent risks of bariatric surgery, all other weight loss routes should be exhausted first.
肥胖在年轻人中越来越普遍。早期、有效的干预至关重要。治疗选择包括生活方式改变、药物治疗、内镜治疗和减肥手术。然而，这些治疗方法在年轻患者中的相对有效性尚不清楚。我们系统地确定并荟萃分析了评估肥胖青少年（<21 岁）减肥治疗的研究。在 16372 项已确定的研究中，有 83 项符合荟萃分析的条件。减肥手术可导致短期/中期体重显著减轻（汇总估计值为 14.04kg/m）。生活方式和药物治疗对体重的影响较为适度（汇总估计值分别为 0.99kg/m 和 0.94kg/m）。由于其高效性，当治疗年轻人的肥胖时，应更早考虑减肥手术。然而，由于减肥手术的侵袭性和固有风险，应首先用尽所有其他减肥途径。
