JCEM：新型药理学肥胖疗法指南

  肥胖药物疗法的首次临床实践指南中，为健康从业医生提供了一种新型工具来帮助其寻找治疗肥胖病人的最新的药物疗法，在过去两年里FDA批准了四种抗肥胖药物，即氯卡色林、托吡酯、安非他酮、利拉鲁肽。医学博士Donna Ryan表示，药物治疗指南中为临床医生提供了一种思路来选择抗肥胖药物疗法来治疗仅凭饮食和锻炼并不能达到减肥效果的个体。

  相关研究刊登于国际杂志The Journal of Clinical Endocrinology & Metabolism上，治疗指南中指出，医生们需要基于肥胖相关的并发症来为患者选择最佳的疗法，比如2型糖尿病和心血管疾病等，而且指南中还给出了特殊的意见，即切断导致病人体重增加的药物，转变治疗患者体重增加的疗法模式。

  研究者指出了药物治疗指南中的关键指导准则，即持续和中断药物治疗的影响，指导医生如何开处方来促进个体体重降低或者对体重并不产生影响；2013版的指导准则可以帮助医生发现那些受药物治疗获益的病人，而本文中提出的新版的药物治疗指南则可以帮助医生们选择最佳的抵御肥胖的疗法。

  研究者Ryan说道，将不同的指南结合起来或许将会尽可能地填补肥胖疗法的空缺，肥胖可以增加患者30多种以上疾病的风险，比如2型糖尿病及心血管疾病等；作为饮食和锻炼的补充疗法，由FDA批准的治疗肥胖的疗法或许可以帮助有效改善肥胖个体疾病的治疗，所有的关于肥胖的治疗准则都可以提供一种基于研究证据的工具，来帮助医生们鉴别并且治疗那些需要额外帮助的肥胖患者。

  最后研究者希望后期可以制定出更多的关于肥胖的管理治疗准则，从而来更加有效地帮助治疗那些因肥胖而影响机体健康的个体。（转化医学网360zhyx.com）

  以上为转化医学网原创翻译整理，如需转载，请联系 info@360zhyx.com
转化医学网推荐的原文摘要：

Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline
JCEM doi:10.1210/jc.2014-3415
Caroline M. Apovian, Louis J. Aronne, Daniel H. Bessesen, Marie E. McDonnell, M. Hassan Murad, Uberto Pagotto, Donna H. Ryan, and Christopher D. Still
Objective:
To formulate clinical practice guidelines for the pharmacological management of obesity.
Participants:
An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society.
Evidence:
This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence.
Consensus Process:
One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the European Society of Endocrinology, and The Obesity Society reviewed and commented on preliminary drafts of these guidelines. Two systematic reviews were conducted to summarize some of the supporting evidence.
Conclusions:
Weight loss is a pathway to health improvement for patients with obesity-associated risk factors and comorbidities. Medications approved for chronic weight management can be useful adjuncts to lifestyle change for patients who have been unsuccessful with diet and exercise alone. Many medications commonly prescribed for diabetes, depression, and other chronic diseases have weight effects, either to promote weight gain or produce weight loss. Knowledgeable prescribing of medications, choosing whenever possible those with favorable weight profiles, can aid in the prevention and management of obesity and thus improve health.