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GLP-1 时代的行为医学。

Behavioral medicine in the GLP-1 era.

作者信息

Tomiyama A Janet

机构信息

Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, United States.

出版信息

Ann Behav Med. 2025 Jan 4;59(1). doi: 10.1093/abm/kaae069.

Abstract

Glucagon-like peptide-1 (GLP-1) agonist medications are receiving high levels of attention because of their dramatic efficacy in causing weight loss. This commentary discusses several ways that those in behavioral medicine and health psychology might think about these medications-whether they should be fully in support of them or whether they pose a risk. The positive aspects of GLP-1s include their great promise in improving health independent of weight loss and the perspective that their efficacy frees individuals from the difficulties of behavioral weight maintenance and the associated stigma of "failing" to lose weight. However, GLP-1 agonist medications also risk medicalizing weight and increasing weight stigma (in addition to those on GLP-1 medications being stigmatized for taking the "easy way out"). From a social identity perspective, GLP-1 medications could even be perceived as a tool to eradicate an entire social group-those that identify as higher weight. In terms of clinical care, a patient-centered, weight-inclusive approach will allow for individuals to receive the treatment that fits with their own social and health context. In terms of research, behavioral medicine should shift away from weight loss interventions simply to lower body mass index, and instead intervene on actual health markers, disease endpoints, or healthy behaviors. Doing so will improve health regardless of a person's weight or whether they are on GLP-1 agonist medications.

摘要

胰高血糖素样肽-1(GLP-1)激动剂药物因其在减肥方面的显著疗效而备受关注。本评论探讨了行为医学和健康心理学领域的专业人士思考这些药物的几种方式——他们是应该全力支持这些药物,还是这些药物存在风险。GLP-1的积极方面包括,它们在改善健康方面具有巨大潜力,且与体重减轻无关;同时,从其疗效来看,个体无需面对行为性维持体重的困难以及因“减肥失败”而带来的相关污名。然而,GLP-1激动剂药物也存在将体重问题医学化并加剧体重污名化的风险(此外,服用GLP-1药物的人也会因采取了“捷径”而受到污名化)。从社会认同的角度来看,GLP-1药物甚至可能被视为根除整个社会群体——那些自认为体重较高的人群——的一种工具。在临床护理方面,以患者为中心、包容体重的方法将使个体能够接受适合其自身社会和健康状况的治疗。在研究方面,行为医学应从单纯以降低体重指数为目标的减肥干预措施,转向针对实际健康指标、疾病终点或健康行为的干预措施。这样做将改善健康状况,无论一个人的体重如何,也无论他们是否正在服用GLP-1激动剂药物。

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