成人肥胖的预防与管理：从六大关键词看2025年度进展与趋势

doi:10.12114/j.issn.1007-9572.2026.0035

中国全科医学 ›› 2026, Vol. 29 ›› Issue (20): 2753-2758.DOI: 10.12114/j.issn.1007-9572.2026.0035

• 特稿·"体重管理年"专题研究 • 下一篇

成人肥胖的预防与管理：从六大关键词看2025年度进展与趋势

陈向阳¹, 黄红梅¹, 李舍予²^,^*()

1．610200　四川省成都市双流区第一人民医院内分泌代谢科
2．610041　四川省成都市，四川大学华西医院内分泌代谢科

收稿日期:2026-03-10 修回日期:2026-04-20 出版日期:2026-07-15 发布日期:2026-06-05
通讯作者: 李舍予
作者贡献：
陈向阳负责文章的构思、论文撰写；黄红梅提供学术指导、知识贡献与技术建议；李舍予负责文章的质量控制及审校，对文章整体负责，监督管理。
基金资助:
国家自然科学基金资助项目(82570964，72342014); 癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项项目(2025ZD0550604); 成都市科学技术局重点研发支撑计划(2025-YF09-00033-SN); 四川大学135高端人才项目(ZYYC24001)

Prevention and Management of Adult Obesity: Progress and Trends from Six Keywords in 2025

CHEN Xiangyang¹, HUANG Hongmei¹, LI Sheyu²^,^*()

1. Department of Endocrinology and Metabolism, the First People's Hospital of Shuangliu District, Chengdu 610200, China
2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China

Received:2026-03-10 Revised:2026-04-20 Published:2026-07-15 Online:2026-06-05
Contact: LI Sheyu

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摘要/Abstract

摘要： 2025年肥胖诊疗进入以疾病分层和长期管理为主线的新阶段。本文围绕肥胖分型、临床指南、新型药物、共病共治、体重门诊和营养标签6个关键词，总结2025年国内外肥胖领域的重要进展。《柳叶刀·糖尿病与内分泌学》委员会提出了临床前肥胖与临床肥胖的新框架，美国临床内分泌医师学会（AACE）、欧洲肥胖研究学会（EASO）和WHO进一步强调了以并发症和功能受损决定治疗强度。替尔泊肽、玛仕度肽、口服胰高血糖素样肽1受体激动剂及多靶点药物推动减重药物进入高效和多样化阶段。肥胖相关2型糖尿病、射血分数保留的心力衰竭、代谢相关脂肪性肝炎、骨关节炎和阻塞性睡眠呼吸暂停等共病管理成为临床重点。我国同步推进健康体重管理门诊建设和预包装食品数字标签实施，肥胖防治正在从医院治疗延伸到医防融合。本文旨在为2026年肥胖临床研究、专科建设以及肥胖临床实践、研究及学科发展提供年度参考。

关键词: 肥胖管理, 肥胖症, 诊疗指南, 肥胖分型, 胰高血糖素样肽1受体激动剂, 慢性病共病, 体重管理门诊, 数字营养标签

Abstract:

In 2025, obesity diagnosis and management entered a new stage characterized by disease stratification and long-term care. Focusing on six key topics: obesity classification, clinical guidelines, novel pharmacotherapies, comorbidity management, weight management clinics, and nutrition labeling, this paper summarizes the major advances in obesity research and practice worldwide in 2025. The Lancet Diabetes and Endocrinology Commission proposed a new framework distinguishing pre-clinical obesity and clinical obesity. American Association of Clinical Endocrinology (AACE), European Association for the Study of Obesity (EASO), and WHO further emphasized that treatment should be determined by obesity-related complications and functional impairment. Tirzepatide, mazdutide, oral GLP-1 receptor agonists, and multi-target agents have propelled anti-obesity medications into an era of high efficacy and diversification. The management of obesity-related comorbidities and diseases, including type 2 diabetes, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatohepatitis, osteoarthritis, and obstructive sleep apnea, has become a clinical priority. China is concurrently advancing the establishment of standardized weight management clinics and the implementation of digital labeling for pre-packaged foods, marking a strategic shift in obesity management from purely clinical treatment toward integrated prevention and care. This paper aims to provide an annual reference for clinical research, specialty development, and practice in the field of obesity for the year 2026.

Key words: Obesity management, Obesity, Diagnostic and treatment guideline, Obesity classification, Glucagon-like peptide-1 receptor agonists, Multiple chronic conditions, Weight management clinics, Digital nutrition labels

中图分类号:

R 589.25

陈向阳,黄红梅,李舍予. 成人肥胖的预防与管理：从六大关键词看2025年度进展与趋势[J]. 中国全科医学, 2026, 29(20): 2753-2758. DOI: 10.12114/j.issn.1007-9572.2026.0035.
CHEN Xiangyang,HUANG Hongmei,LI Sheyu. Prevention and Management of Adult Obesity: Progress and Trends from Six Keywords in 2025[J]. Chinese General Practice, 2026, 29(20): 2753-2758. DOI: 10.12114/j.issn.1007-9572.2026.0035.

图/表 2

参考文献 51

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模型	主要分层	进入强化治疗的依据	临床启示
《柳叶刀·糖尿病与内分泌学》委员会提出的二元分期	临床前期与临床肥胖	是否已出现器官功能受损、症状或日常活动受限	有助于区分风险状态与已成病状态
AACE 2025年提出的ABCD模型	1~3期	ORCD的有无及严重程度	便于按并发症负担决定药物治疗、手术和随访强度

模型	主要分层	进入强化治疗的依据	临床启示
《柳叶刀·糖尿病与内分泌学》委员会提出的二元分期	临床前期与临床肥胖	是否已出现器官功能受损、症状或日常活动受限	有助于区分风险状态与已成病状态
AACE 2025年提出的ABCD模型	1~3期	ORCD的有无及严重程度	便于按并发症负担决定药物治疗、手术和随访强度

药物/方案	机制	2025—2026年关键进展	当前判断
替尔泊肽	GIP/GLP-1双受体激动剂	SURMOUNT-5头对头结果发表^[18]；国内临床应用加快	已成为高效减重药物代表
玛仕度肽	GLP-1/GCG双受体激动剂	2025年在中国获批上市；GLORY-1研究发布数据^[19]	本土原创双靶点代表
奥格列龙	小分子口服GLP-1受体激动剂	2025年递交监管申请，2026年进入关键审评阶段	口服化关键品种
口服司美格鲁肽	口服GLP-1受体激动剂	肥胖适应证研究结果明确；口服Wegovy获批上市	口服GLP-1受体激动剂已进入实际应用
CagriSema	GLP-1受体激动剂+胰淀素通路	REDEFINE结果发表并递交上市申请^[21]	复方增强路径受关注
Retatrutide	GLP-1/GIP/GCG三受体激动剂	临床Ⅲ期关键结果公布，待发表	疗效上限值得关注

药物/方案	机制	2025—2026年关键进展	当前判断
替尔泊肽	GIP/GLP-1双受体激动剂	SURMOUNT-5头对头结果发表^[18]；国内临床应用加快	已成为高效减重药物代表
玛仕度肽	GLP-1/GCG双受体激动剂	2025年在中国获批上市；GLORY-1研究发布数据^[19]	本土原创双靶点代表
奥格列龙	小分子口服GLP-1受体激动剂	2025年递交监管申请，2026年进入关键审评阶段	口服化关键品种
口服司美格鲁肽	口服GLP-1受体激动剂	肥胖适应证研究结果明确；口服Wegovy获批上市	口服GLP-1受体激动剂已进入实际应用
CagriSema	GLP-1受体激动剂+胰淀素通路	REDEFINE结果发表并递交上市申请^[21]	复方增强路径受关注
Retatrutide	GLP-1/GIP/GCG三受体激动剂	临床Ⅲ期关键结果公布，待发表	疗效上限值得关注

成人肥胖的预防与管理：从六大关键词看2025年度进展与趋势

Prevention and Management of Adult Obesity: Progress and Trends from Six Keywords in 2025

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