Guggenheim F G
Med Clin North Am. 1977 Jul;61(4):781-96. doi: 10.1016/s0025-7125(16)31297-4.
The recognition and treatment of obesity has undergone marked changes in the past two decades. Along with the abandoning of the concept of exogenous obesity, the physician has discovered a variety of developmental, psychological, pharmacologic, socioeconomic, neurological, and genetic roots for the syndrome. The clinician has also found medical treatment modalities (fasting and behavior modification) that hold much more promise than traditional supportive relationships with dietary consultation and anorexogenic medications. Surgical treatment also, ileojejunal bypass, is gradually emerging as a treatment of choice for certain well-motivated, super-obese people for whom all other treatment modalities have failed. Future research into central serotonergic mechanisms offers hope that we can begin to know what it is that turns on hunger, turns off appetite, and regulates weight in such a stable manner over such a long period of time.
在过去二十年中，肥胖症的识别与治疗发生了显著变化。随着对外源性肥胖概念的摒弃，医生发现了该综合征的多种发育、心理、药理、社会经济、神经和遗传根源。临床医生还发现了一些医疗治疗方式（禁食和行为矫正），这些方式比传统的饮食咨询和厌食药物支持性治疗更具前景。外科治疗，即回肠空肠旁路手术，也逐渐成为某些有强烈意愿、超级肥胖且其他所有治疗方式均无效的患者的首选治疗方法。对中枢血清素能机制的未来研究带来了希望，即我们能够开始了解是什么在很长一段时间内以如此稳定的方式引发饥饿、抑制食欲并调节体重。
