中国全科医学 ›› 2025, Vol. 28 ›› Issue (30): 3747-3752.DOI: 10.12114/j.issn.1007-9572.2025.0131

• 指南·解读 • 上一篇    下一篇

2024意大利《成人超重、肥胖和代谢合并症行为治疗抵抗的管理指南》解读与启示

张鹏1, 刘力滴1, 张颖1, 杨梓钰1, 刘长明2, 唐以俊3, 廖晓阳1,*(), 贾禹1,*()   

  1. 1.610041 四川省成都市,四川大学华西医院全科医学中心
    2.610207 四川省成都市双流区西航港社区卫生服务中心全科医学科
    3.610094 四川省成都市高新区桂溪社区卫生服务中心全科医学科
  • 收稿日期:2025-03-10 修回日期:2025-06-15 出版日期:2025-10-20 发布日期:2025-08-18
  • 通讯作者: 廖晓阳, 贾禹

  • 作者贡献:

    张鹏负责文章的构思与设计、资料收集与整理分析、论文撰写与修订,对文章整体负责;刘力滴、张颖、杨梓钰、刘长明、唐以俊对论文修订;廖晓阳、贾禹进行文章的可行性分析、参与论文修订、负责监督管理、文章的质量控制及审校。

  • 基金资助:
    四川省科技厅软科学项目(2022JDR0325)

Interpretation and Clinical Implications of the 2024 Italian Guidelines for the Management of Adult Individuals with Overweight and Obesity and Metabolic Comorbidities That are Resistant to Behavioral Treatment

ZHANG Peng1, LIU Lidi1, ZHANG Ying1, YANG Ziyu1, LIU Changming2, TANG Yijun3, LIAO Xiaoyang1,*(), JIA Yu1,*()   

  1. 1. General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, China
    2. Department of General Practice, Xihanggang Community Health Service Center in Shuangliu District, Chengdu 610207, China
    3. Department of General Practice, Guixi Community Health Service Center in Chengdu High-tech Zone, Chengdu 610094, China
  • Received:2025-03-10 Revised:2025-06-15 Published:2025-10-20 Online:2025-08-18
  • Contact: LIAO Xiaoyang, JIA Yu

摘要: 肥胖症常合并代谢相关疾病,是代谢相关疾病的重要病因或危险因素且与不良预后相关,有效减重可改善甚至缓解这些合并症。仅生活方式干预效果欠佳且行为治疗抵抗普遍,我国目前尚缺乏针对行为治疗抵抗患者的指南。2024年意大利内分泌学会基于最新循证研究证据发布了《成人超重、肥胖和代谢合并症行为治疗抵抗的管理指南》,重点探讨药物和手术治疗在这些患者中的应用。本文结合我国相关指南,重点分析该指南中肥胖症评估和治疗,以期为我国行为治疗抵抗的超重或肥胖患者管理提供参考。

关键词: 肥胖管理, 超重, 代谢合并症, 行为治疗抵抗, 药物疗法, 减重代谢手术

Abstract:

Obesity is frequently accompanied by metabolism-related diseases, serving as a critical etiological factor or risk factor and being associated with adverse clinical outcomes. Effective weight reduction has been demonstrated to ameliorate or even alleviate these comorbidities. However, lifestyle interventions alone often yield suboptimal efficacy, and behavioral resistance is often observed. In China, there are currently no specific guidelines targeting patients with behavioral resistance. In 2024, the Italian Association of Clinical Endocrinologists released the Guidelines for the Management of Adult Individuals with Overweight and Obesity and Metabolic Comorbidities that are Resistant to Behavioral Treatment, grounded in the latest evidence-based research. The guidelines primarily focus on pharmacological and surgical interventions in this patient population. This paper, in conjunction with Chinese guidelines, delves into the obesity evaluation and treatment strategies from the Italian guidelines, aiming to offer a reference for managing Chinese overweight or obese patients with behavioral resistance.

Key words: Obesity management, Overweight, Metabolic comorbidities, Behavioral therapy resistance, Drug therapy, Metabolic-bariatric surgeries

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