Gigliotti Linda, Warshaw Hope, Evert Alison, Dawkins Colleen, Schwartz Julie, Susie Caroline, Kushner Robert, Subramanian Savitha, Handu Deepa, Rozga Mary
Irvine, California.
Hope Warshaw Associates, LLC, Asheville, North Carolina.
J Acad Nutr Diet. 2025 Mar;125(3):408-421. doi: 10.1016/j.jand.2024.10.023. Epub 2024 Nov 7.
The emergence of incretin-based therapies, specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide (GIP), as a new class of obesity medications, is dramatically changing obesity care. Use of these medications, known categorically as anti-obesity medications, as part of comprehensive obesity management is associated with significantly greater weight loss and health benefits than found with earlier-generation obesity medications. The outcomes reported from medication trials were often achieved in conjunction with lifestyle counseling sessions by a registered dietitian nutritionist (RDN) or other qualified health care professional. Research demonstrates that evidence-based obesity care should incorporate lifestyle interventions. Counseling by an RDN, paired with incretin-based therapies, can play a critical role in supporting adherence to the medication regimen, preventing and managing adverse effects, supporting adequate nutrient intake, and establishing lifestyle behaviors for long-term weight and health management. To date, minimal research has been reported on the impact of incretin-based therapies on food and nutrient intake. Until that research is conducted, RDNs and other health care professionals can apply knowledge and experience from clients who have undergone other intensive treatments. This article provides considerations for lifestyle interventions, with a focus on medical nutrition therapy provided by RDNs for adults prescribed incretin-based therapies. RDNs have the education and training to provide medical nutrition therapy for people with overweight or obesity, as well as lifestyle counseling on physical activity, stress management, sleep hygiene, goal setting, and other behaviors associated with positive health outcomes. RDNs have a critical role in the integration of incretin-based therapies into obesity management.
基于肠促胰岛素的疗法，特别是胰高血糖素样肽-1受体激动剂（GLP-1 RAs）和葡萄糖依赖性促胰岛素多肽（GIP），作为一类新型肥胖症药物的出现，正在极大地改变肥胖症的治疗方式。作为综合肥胖症管理的一部分，使用这些被统称为抗肥胖症药物的药物，与早期的肥胖症药物相比，能带来显著更多的体重减轻和健康益处。药物试验报告的结果通常是在注册营养师（RDN）或其他合格的医疗保健专业人员进行生活方式咨询的同时取得的。研究表明，循证肥胖症护理应纳入生活方式干预。RDN的咨询与基于肠促胰岛素的疗法相结合，在支持药物治疗方案的依从性、预防和管理不良反应、支持充足的营养摄入以及建立长期体重和健康管理的生活方式行为方面可以发挥关键作用。迄今为止，关于基于肠促胰岛素的疗法对食物和营养摄入影响的研究报道极少。在进行该项研究之前，RDN和其他医疗保健专业人员可以应用从接受过其他强化治疗的患者身上获得的知识和经验。本文提供了生活方式干预的注意事项，重点是RDN为接受基于肠促胰岛素疗法的成年人提供的医学营养治疗。RDN接受过相关教育和培训，能够为超重或肥胖人群提供医学营养治疗，以及就体育活动、压力管理、睡眠卫生、目标设定和其他与积极健康结果相关的行为提供生活方式咨询。RDN在将基于肠促胰岛素的疗法纳入肥胖症管理中起着关键作用。
