Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, Frederiksberg, 2000, Denmark.
The Boden Initiative, The Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
Curr Obes Rep. 2024 Dec;13(4):832-842. doi: 10.1007/s13679-024-00587-8. Epub 2024 Sep 17.
Despite decades of development and testing of weight-loss interventions, the adult populations worldwide have witnessed a continuous rise in body weight. There is an ongoing debate about how to move forward. Some argue that this rise calls for more intensive and possibly life-long treatments, including the new effective GLP1 weight loss medications, while others have called for a fundamental shift away from weight and on to a broader understanding of health. The two strategies are represented as a weight-centric health strategy and a weight neutral health strategy. This paper debates the benefits and potential harms related to the use of these two strategies.
While major weight loss may have substantial health benefits, many individuals will need intensive treatment including weight loss medication to achieve it, as generally few are able to sustain a lifestyle induced weight loss in the long term. Both the weight loss and the weight-neutral health strategies have advantages and limitations emphasizing the need for further research comparing the two strategies. Currently, not everyone is offered, can afford, will tolerate or even desire treatment with weight loss medication, and weight neutral health strategies may be a desirable alternative intervention offering a more holistic approach to health and addressing psychological and social issues including the burden of experienced and internalized weight stigma. However, this method still needs to be tested for effectiveness with regards to both physical and long-term psychological benefits.
目的综述：尽管几十年来不断开发和测试减肥干预措施，但全球成年人口的体重仍持续上升。关于如何继续前进，目前存在争议。一些人认为，这种上升需要更密集和可能终生的治疗，包括新的有效的 GLP1 减肥药，而另一些人则呼吁从体重上彻底转变，转而更广泛地理解健康。这两种策略被表示为以体重为中心的健康策略和体重中立的健康策略。本文讨论了使用这两种策略的相关益处和潜在危害。
最近发现：虽然体重显著减轻可能会带来重大的健康益处，但许多人需要进行强化治疗，包括使用减肥药，才能实现这一目标，因为一般来说，很少有人能够长期维持生活方式引起的体重减轻。减肥和体重中立的健康策略都有其优点和局限性，强调需要进一步研究比较这两种策略。目前，并非每个人都能得到、负担得起、愿意或甚至渴望接受减肥药治疗，而体重中立的健康策略可能是一种理想的替代干预措施，提供更全面的健康方法，并解决心理和社会问题，包括所经历和内化的体重耻辱感的负担。然而，这种方法仍需要在身体和长期心理益处方面进行有效性测试。
