Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 530, Chicago, IL.
Prog Cardiovasc Dis. 2018 Jul-Aug;61(2):246-252. doi: 10.1016/j.pcad.2018.06.001. Epub 2018 Jun 8.
Obesity is one of the most serious and prevalent non-communicable diseases of the twenty-first century. It is also a patient-centered condition in which affected individuals seek treatment through a variety of commercial, medical and surgical approaches. Considering obesity as a chronic medical disease state helps to frame the concept of using a three-stepped intensification of care approach to weight management. As a foundation, all patients should be counseled on evidence-based lifestyle approaches that include diet, physical activity and behavior change therapies. At the second tier, four new pharmacological agents, lorcaserin, phentermine/topiramate, naltrexone/bupropion and liraglutide have been approved since 2012 as adjuncts to lifestyle modification. The third step, bariatric surgery, has been demonstrated to be the most effective and long-term treatment for individuals with severe obesity or moderate obesity complicated by co-morbid conditions that is not responsive to non-surgical approaches. By using a medical model, clinicians can provide more proactive and effective treatments in assisting their patients with weight loss.
肥胖是 21 世纪最严重和普遍的非传染性疾病之一。它也是一种以患者为中心的疾病，受影响的个体通过各种商业、医疗和手术方法寻求治疗。将肥胖视为一种慢性疾病有助于构建使用三步强化护理方法来管理体重的概念。作为基础，应向所有患者提供基于证据的生活方式方法的咨询，包括饮食、身体活动和行为改变疗法。在第二层，自 2012 年以来，有四种新的药物制剂——lorcaserin、phentermine/topiramate、naltrexone/bupropion 和 liraglutide——已被批准作为生活方式改变的辅助手段。第三步，减重手术已被证明是治疗严重肥胖或伴有合并症的中度肥胖的最有效和长期治疗方法，这些合并症对非手术方法没有反应。通过使用医疗模式，临床医生可以为患者提供更积极有效的治疗，帮助他们减肥。
