CMAJ：抑制及管理成年人肥胖的新型指导准则

  近日，一篇刊登在国际杂志CMAJ上的研究论文中，来自加拿大卫生保健预防机构的研究人员制定了一种新型指导准则，其或可有效帮助控制和管理成年肥胖个体；肥胖是当今世界公认的公众健康问题，因为过重是引发心脏疾病、糖尿病、癌症等一系列疾病的风险因子，当前加拿大成年肥胖个体的数量较1978年翻了将近一翻，即从14%增加到了26%，而且目前超过三分之二的男性个体（67%）及超过一半的女性个体（54%）都处于超重或者肥胖的状态。

  大约三分之二的超重和肥胖个体在其青少年时期都处于健康体重状态，但是当其进入成年期体重发生了增加，平均每两年增加0.5至1.0kg，因此对体重的微小增加进行适当的管理对于有效预防肥胖非常关键。Paula Brauer博士说道，近年来随着过重成为增加许多慢性疾病的风险因子，很多医生就必须对患者的体重进行追踪调查，来帮助患者有效控制、避免和肥胖相关的疾病的发生。

  研究者表示，该新型指导准则中的要点包括：

  1）应该在初级卫生保健时期进行体重指数的测定来帮助抑制和管理肥胖；

  2）对于正常体重个体而言，初级治疗医师不能够提供结构化的程序来帮助抑制个体体重的增加；

  3）对于过重和肥胖个体，医师们应当提供结构化的程序来改变个体的行为从而帮助减轻患者体重，尤其是针对那些有患糖尿病风险的个体；

  4）针对个体而言，并不总是要服药来减轻体重。

  研究者表示，对于过重和肥胖个体进行结构化的行为干预包括一系列步骤，比如改变饮食、进行体育锻炼或改变生活方式等；最后研究者希望本文中制定的新型管理肥胖的指导准则或可帮助更多患者有效管理及抑制肥胖的发生。（转化医学网360zhyx.com）

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转化医学网推荐的原文阅读：

Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care
CMAJ DOI: 10.1503/cmaj.140887
Paula Brauer et al.
The prevalence of obesity in adults has increased worldwide and has almost doubled in Canada, from 14% in 1978/791to 26% in 2009–2011,2with 2% of men and 5% of
women having a body mass index (BMI) score greater than 40 (Appendix 1, available at www
.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.140887/-/DC1).3Over two-thirds of Canadian men (67%) and more than half of Canadian women (54%) are overweight or obese, based on measured weight.2–4 Excess weight is a well-recognized risk factor for several common chronic conditions, such as cardiovascular disease, cancer, type 2 diabetes, osteoarthritis and back pain.5About two-thirds of adults who are overweight or obese were in the healthy weight range as adolescents, but gained weight in adulthood (about 0.5–1.0 kg every two years on average).6,7 Slow weight gain may go unnoticed until health problems develop in middle age. However, this overall mean increase masks substantial variation in the population, and some people remain weight stable over long periods, whereas others experience substantial gains and losses. Currently, we cannot predict future health effects of weight gain over the life course.