Diabetes Complications Research Centre, UCD Conway Institute of Biomedical and Biomolecular Research, School of Medicine, University College Dublin, Belfield, Dublin D04 VIW8, Ireland.
Independent Researcher, Dublin D04 VIW8, Ireland.
Nutrients. 2022 Dec 20;15(1):12. doi: 10.3390/nu15010012.
Obesity has become a global epidemic, representing a major health crisis, with a significant impact both in human and financial terms. Obesity was originally seen as a condition, not a disease, which was considered self-inflicted. Thus, it was understandable that a simplistic approach, such as eat less and move more was proposed to manage obesity. Over the last 25 years, the perception of obesity has been gradually changing and the awareness has risen that it is a disease in its own right and not just a precipitating factor for type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), etc. Creation of a comprehensive algorithm for the management of obesity needs to be informed by an in-depth understanding of the issues impacting the provision of treatment. Promotion of healthy behaviours is essential to help the population become healthier, but these are not obesity treatment strategies. Twenty percent of patients with obesity may respond to approaches based on healthy behaviour, but the 80% who do not respond should not be stigmatised but rather their treatment should be escalated. The unintended consequences of promoting healthy behaviours to patients with obesity can be mitigated by understanding that obesity is likely to be a subset of complex diseases, that require chronic disease management. Once the biology of the disease has been addressed, then healthy behaviours may play an invaluable role in optimising self-care within a chronic disease management strategy.
肥胖已成为全球性流行病，代表着重大的健康危机，无论在人类还是财务方面都产生了重大影响。肥胖最初被视为一种状况，而不是一种疾病，被认为是自找的。因此，可以理解的是，人们提出了一种简单的方法，即少吃多动来管理肥胖。在过去的 25 年中，人们对肥胖的认识逐渐发生变化，人们越来越意识到肥胖本身就是一种疾病，而不仅仅是 2 型糖尿病、非酒精性脂肪性肝病（NAFLD）等疾病的诱发因素。制定全面的肥胖管理算法需要深入了解影响治疗提供的问题。促进健康行为对于帮助人们变得更健康至关重要，但这些并不是肥胖的治疗策略。20%的肥胖患者可能会对基于健康行为的方法产生反应，但 80%没有反应的患者不应该受到歧视，而应该加大他们的治疗力度。通过了解肥胖可能是需要慢性病管理的复杂疾病的一个子集，可以减轻向肥胖患者宣传健康行为的意外后果。一旦解决了疾病的生物学问题，那么健康行为可能在优化慢性病管理策略中的自我护理方面发挥无价的作用。
