Berchtold P, Berger M, Gries F A, Zimmermann H
Schweiz Med Wochenschr. 1980 Mar 29;110(13):470-8.
The classification of obesity into a hypertrophic and a hyperplastic type is apparently becoming less accepted since preadipocytes are not covered by investigation of adipose tissue cellularity. Obesity-associated insulin resistance is probably due to a decrease in number of insulin receptors, induced by hyperinsulinemia. Metabolic factors may contribute to insulin resistance. Long-standing hypersecretion of insulin may exhaust the B-cell, resulting in glucose intolerance and diabetes. There is increasing interest in the (possibly) disturbed energy metabolism in obesity, though clearcut conclusions are not yet possible. For the management of obesity an integrated treatment schedule is recommended including a 1000 calorie mixed diet, intensive nutritional education, motivation, group and individual psychotherapy, physical exercise and physiotherapy. Drastic methods for the treatment of obesity are critically reviewed.
将肥胖分为肥厚型和增生型的分类方法显然越来越不被认可，因为脂肪组织细胞构成的研究并未涵盖前脂肪细胞。肥胖相关的胰岛素抵抗可能是由于高胰岛素血症诱导胰岛素受体数量减少所致。代谢因素可能导致胰岛素抵抗。长期胰岛素分泌过多可能使胰岛B细胞衰竭，从而导致葡萄糖不耐受和糖尿病。人们对肥胖中（可能）紊乱的能量代谢越来越感兴趣，尽管尚未得出明确结论。对于肥胖的管理，建议采用综合治疗方案，包括1000卡路里的混合饮食、强化营养教育、激励措施、团体和个体心理治疗、体育锻炼和物理治疗。对治疗肥胖的极端方法进行了批判性综述。
