Dalle Grave Riccardo
Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, VR, Italy.
Diabetes Metab Syndr Obes. 2024 Jan 15;17:227-230. doi: 10.2147/DMSO.S447582. eCollection 2024.
Incretin-based medications for treating obesity produce substantial short- and long-term weight loss and improve obesity-related comorbidities. However, associating lifestyle modification with new medications to treat obesity is generally advisable for several reasons. Firstly, healthy eating patterns and physical activity may offer important additional benefits, enhancing the patient's health and well-being. In addition, regular specialist counselling in lifestyle modification can help patients maintain their motivation levels and develop specific skills for addressing obstacles during the lengthy process of weight loss and maintenance, potentially improving outcomes in the long term. Given the high efficacy of the new weight-loss drugs, it would be timely to streamline and simplify the current gold standard of obesity management based on lifestyle modification. For example, it now seems redundant to prescribe strict diets or meal replacements to reduce calorie intake, or to recommend patients practice 200 to 300 minutes of moderate-to-vigorous-intensity exercise for enhanced weight loss. Moderate calorie restriction and, at least 150 minutes of moderate-intensity aerobic exercise and two sessions of muscle-strengthening activities per week may be more achievable and appropriate goals for sustainable weight loss in most patients on pharmaceutical obesity treatment. As regards lifestyle modification counselling, future studies should assess its optimal intensity and duration in the "new medications for obesity era".
用于治疗肥胖症的肠促胰岛素类药物可产生显著的短期和长期体重减轻,并改善与肥胖相关的合并症。然而,出于多种原因,将生活方式改变与治疗肥胖症的新药物相结合通常是可取的。首先,健康的饮食模式和体育活动可能会带来重要的额外益处,增强患者的健康和幸福感。此外,定期接受关于生活方式改变的专业咨询可以帮助患者保持积极性,并培养在漫长的减肥和维持体重过程中应对障碍的特定技能,从长远来看可能会改善治疗效果。鉴于新型减肥药物的高效性,适时精简和简化当前基于生活方式改变的肥胖症管理金标准是很有必要的。例如,现在开具严格的节食或代餐处方以减少热量摄入,或者建议患者进行200至300分钟的中等强度到高强度运动以增强减肥效果,似乎有些多余。对于大多数接受药物治疗肥胖症的患者来说,适度的热量限制以及每周至少150分钟的中等强度有氧运动和两次肌肉强化活动,可能是更可行且合适的可持续减肥目标。关于生活方式改变咨询,未来的研究应评估其在“肥胖症治疗新药时代”的最佳强度和持续时间。