Guseinova R M, Dorovskikh A V, Vasyukova O V, Shestakova E A, Okorokov P L, Mokrysheva N G
Endocrinology Research Centre.
Probl Endokrinol (Mosk). 2023 Nov 2;70(3):67-73. doi: 10.14341/probl13275.
The main problem of obesity treatment is the difficulty of long-term weight maintenance. From one point of view, it can easily be explained by patients' low compliance and absence of self-control. From another point of view, body weight is regulated not only by persons will, but also by multiple physiological mechanisms. Moreover, studies demonstrate that the attempts to reduce body weight stimulate the activation of adaptive biological process that block weight reduction.Despite the variety of obesity treatment methods, only few patients are able to achieve significant (at least 5-7%) weight loss and maintain the result. In most cases people return to the initial weight in about 3-5 years. Therefore it is relevant to study weight regain mechanisms in order to identify new effective obesity treatment strategies.The objective of this review is to summarize the information about the main issues of central, peripheral and behavioral pathogenic mechanisms which lead to disease relapse after obesity treatment and ideas for future strategies to resolve them.
肥胖治疗的主要问题在于长期维持体重存在困难。一方面,这很容易解释为患者依从性低且缺乏自控力。另一方面,体重不仅受个人意志调节,还受多种生理机制影响。此外,研究表明,减重尝试会刺激适应性生物学过程的激活,从而阻碍体重减轻。尽管有多种肥胖治疗方法,但只有少数患者能够实现显著(至少5 - 7%)的体重减轻并维持这一结果。在大多数情况下,人们会在大约3 - 5年内恢复到初始体重。因此,研究体重反弹机制以确定新的有效肥胖治疗策略具有重要意义。本综述的目的是总结有关中枢、外周和行为致病机制的主要问题的信息,这些机制会导致肥胖治疗后疾病复发,以及解决这些问题的未来策略思路。