University of Kansas Medical Center, Kansas City, KS.
Brigham and Women's Hospital, Boston, MA.
Med Sci Sports Exerc. 2024 Oct 1;56(10):2076-2091. doi: 10.1249/MSS.0000000000003520.
Excessive body weight and adiposity contribute to many adverse health concerns. The American College of Sports Medicine (ACSM) recognizes that the condition of excess body weight and adiposity is complex, with numerous factors warranting consideration. The ACSM published a position stand on this topic in 2001 with an update in 2009, and a consensus paper on the role of physical activity in the prevention of weight gain in 2019. This current consensus paper serves as an additional update to those prior ACSM position and consensus papers. The ACSM supports the inclusion of physical activity in medical treatments (pharmacotherapy, metabolic and bariatric surgery) of excess weight and adiposity, as deemed to be medically appropriate, and provides perspectives on physical activity within these therapies. For weight loss and prevention of weight gain, the effects may be most prevalent when physical activity is progressed in an appropriate manner to at least 150 min·wk-1 of moderate-intensity physical activity, and these benefits occur in a dose-response manner. High-intensity interval training does not appear to be superior to moderate-to-vigorous physical activity for body weight regulation, and light-intensity physical activity may also be an alternative approach provided it is of sufficient energy expenditure. Evidence does not support that any one single mode of physical activity is superior to other modes for the prevention of weight gain or weight loss, and to elicit holistic health benefits beyond the effects on body weight and adiposity, multimodal physical activity should be recommended. The interaction between energy expenditure and energy intake is complex, and the effects of exercise on the control of appetite are variable between individuals. Physical activity interventions should be inclusive and tailored for sex, self-identified gender, race, ethnicity, socioeconomic status, age, and developmental level. Intervention approaches can also include different forms, channels, and methods to support physical activity.
超重和肥胖会导致许多健康问题。美国运动医学学院（ACSM）认识到超重和肥胖的状况很复杂，有许多因素需要考虑。ACSM 在 2001 年就这一主题发表了立场声明，并在 2009 年进行了更新，在 2019 年还就身体活动在预防体重增加方面的作用发表了共识文件。本共识文件是对 ACSM 之前的立场声明和共识文件的补充更新。ACSM 支持将身体活动纳入超重和肥胖的医疗治疗（药物治疗、代谢和减肥手术）中，只要被认为是医学上合适的，并且还提供了这些治疗方法中身体活动的观点。对于减肥和预防体重增加，当身体活动以适当的方式进展到至少 150 分钟/周的中等强度身体活动时，效果可能最为明显，并且这些益处呈剂量反应关系。高强度间歇训练似乎并不比中等到剧烈的身体活动更有利于体重调节，而低强度身体活动也可能是一种替代方法，只要它的能量消耗足够。有证据表明，没有一种单一的身体活动模式在预防体重增加或减肥方面优于其他模式，并且除了对体重和体脂的影响之外，还能带来整体健康益处，因此应该推荐多模式身体活动。能量消耗和能量摄入之间的相互作用很复杂，运动对食欲控制的影响因人而异。身体活动干预措施应该具有包容性，并根据性别、自我认同的性别、种族、民族、社会经济地位、年龄和发育水平进行调整。干预方法还可以包括不同的形式、渠道和方法来支持身体活动。
