Barrea Luigi, Boschetti Mara, Gangitano Elena, Guglielmi Valeria, Verde Ludovica, Muscogiuri Giovanna
Dipartimento di Benessere, Nutrizione e Sport, Centro Direzionale, Università Telematica Pegaso, Via Porzio, Isola F2, Naples, 80143, Italy.
Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, 16132, Italy.
Curr Obes Rep. 2025 Jan 3;14(1):1. doi: 10.1007/s13679-024-00602-y.
This review examines the long-term efficacy and safety of various nutritional and pharmacological strategies for managing obesity. The focus is on the Mediterranean diet (MedDiet), very low-energy ketogenic therapy (VLEKT), and pharmacological interventions such as naltrexone/bupropion and liraglutide. Given the chronic nature of obesity, understanding the sustainability and impact of these treatments over time is critical.
The MedDiet has shown significant benefits for cardiovascular health and moderate long-term weight loss, though it does not always outperform other diets in terms of weight reduction. VLEKT is highly effective for rapid weight loss, but concerns remain about its long-term sustainability. Pharmacological treatments, including naltrexone/bupropion and liraglutide, have shown promise in promoting significant weight loss and improving metabolic markers. However, issues related to long-term adherence and potential side effects need further exploration. Both nutritional and pharmacological strategies offer valuable tools in obesity management. While treatments like VLEKT and pharmacological options provide significant short-term benefits, the MedDiet remains a sustainable long-term approach. The long-term efficacy and safety of naltrexone/bupropion and liraglutide require more investigation to address challenges in weight maintenance and side effects. Further studies are needed to establish the optimal duration and combination of these therapies for sustained obesity management.
本综述探讨了多种用于管理肥胖的营养和药物策略的长期疗效及安全性。重点关注地中海饮食（MedDiet）、极低能量生酮疗法（VLEKT）以及纳曲酮/安非他酮和利拉鲁肽等药物干预措施。鉴于肥胖的慢性性质，了解这些治疗方法随着时间推移的可持续性和影响至关重要。
地中海饮食已显示出对心血管健康有显著益处且能实现适度的长期体重减轻，不过在体重减轻方面并不总是优于其他饮食。极低能量生酮疗法对快速减肥非常有效，但对其长期可持续性仍存在担忧。包括纳曲酮/安非他酮和利拉鲁肽在内的药物治疗在促进显著体重减轻和改善代谢指标方面已显示出前景。然而，与长期依从性和潜在副作用相关的问题需要进一步探索。营养和药物策略在肥胖管理中都提供了有价值的工具。虽然极低能量生酮疗法和药物选择等治疗方法提供了显著的短期益处，但地中海饮食仍然是一种可持续的长期方法。纳曲酮/安非他酮和利拉鲁肽的长期疗效和安全性需要更多研究，以应对体重维持和副作用方面的挑战。需要进一步研究来确定这些疗法用于持续肥胖管理的最佳持续时间和组合。
