Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnel Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
The Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil.
Lancet. 2024 Sep 7;404(10456):972-987. doi: 10.1016/S0140-6736(24)01210-8. Epub 2024 Aug 16.
Obesity has increased in prevalence worldwide and WHO has declared it a global epidemic. Population-level preventive interventions have been insufficient to slow down this trajectory. Obesity is a complex, heterogeneous, chronic, and progressive disease, which substantially affects health, quality of life, and mortality. Lifestyle and behavioural interventions are key components of obesity management; however, when used alone, they provide substantial and durable response in a minority of people. Bariatric (metabolic) surgery remains the most effective and durable treatment, with proven benefits beyond weight loss, including for cardiovascular and renal health, and decreased rates of obesity-related cancers and mortality. Considerable progress has been made in the development of pharmacological agents that approach the weight loss efficacy of metabolic surgery, and relevant outcome data related to these agents' use are accumulating. However, all treatment approaches to obesity have been vastly underutilised.
肥胖症在全球范围内的患病率不断增加,世界卫生组织已宣布其为全球性流行病。人群层面的预防干预措施不足以减缓这一趋势。肥胖症是一种复杂、异质、慢性且进行性的疾病,它会严重影响健康、生活质量和死亡率。生活方式和行为干预是肥胖症管理的关键组成部分;然而,当单独使用时,它们在少数人中提供了显著且持久的反应。减重(代谢)手术仍然是最有效的和持久的治疗方法,除了减肥之外,还具有心血管和肾脏健康方面的益处,以及降低肥胖相关癌症和死亡率。在开发接近代谢手术减肥效果的药物方面已经取得了相当大的进展,并且与这些药物使用相关的相关结果数据也在不断积累。然而,肥胖症的所有治疗方法都没有得到充分利用。