Bomberg Eric M, Ryder Justin R, Brundage Richard C, Straka Robert J, Fox Claudia K, Gross Amy C, Oberle Megan M, Bramante Carolyn T, Sibley Shalamar D, Kelly Aaron S
Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, 717 Delaware Street SE, Room 371, Minneapolis, MN 55414, USA.
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Ther Adv Endocrinol Metab. 2019 Jul 27;10:2042018819863022. doi: 10.1177/2042018819863022. eCollection 2019.
It remains largely unknown as to why some individuals experience substantial weight loss with obesity interventions, while others receiving these same interventions do not. Person-specific characteristics likely play a significant role in this heterogeneity in treatment response. The practice of precision medicine accounts for an individual's genes, environment, and lifestyle when deciding upon treatment type and intensity in order to optimize benefit and minimize risk. In this review, we first discuss biopsychosocial determinants of obesity, as understanding the complexity of this disease is necessary for appreciating how difficult it is to develop individualized treatment plans. Next, we present literature on person-specific characteristics associated with, and predictive of, weight loss response to various obesity treatments including lifestyle modification, pharmacotherapy, metabolic and bariatric surgery, and medical devices. Finally, we discuss important gaps in our understanding of the causes of obesity in relation to the suboptimal treatment outcomes in certain patients, and offer solutions that may lead to the development of more effective and targeted obesity therapies.
为何有些人在肥胖干预措施下体重显著减轻，而接受相同干预的其他人却没有，这在很大程度上仍然未知。个体特异性特征可能在这种治疗反应的异质性中发挥重要作用。精准医学的实践在决定治疗类型和强度时会考虑个体的基因、环境和生活方式，以优化益处并将风险降至最低。在本综述中，我们首先讨论肥胖的生物心理社会决定因素，因为了解这种疾病的复杂性对于认识制定个性化治疗方案有多困难是必要的。接下来，我们展示关于与各种肥胖治疗（包括生活方式改变、药物治疗、代谢和减肥手术以及医疗设备）的体重减轻反应相关并可预测该反应的个体特异性特征的文献。最后，我们讨论在理解肥胖原因与某些患者治疗效果欠佳之间的重要差距，并提供可能导致开发更有效和针对性更强的肥胖治疗方法的解决方案。
