Abstract: Obesity is a chronic disease characterized by abnormal or excessive fat accumulation, that significantly increases the risk of multiple health complications. Weight loss among individuls with obesity can reduce disease risk and improve both physical and social functioning. Behavior and lifestyle interventions (BLIs) constitute the cornerstone of weight management and should adhere to the principles of effectiveness, gradual progression, comprehensiveness, and individualization. BLIs implementation strategies incorporate established behavior change theories, behavioral change techniques (BCTs), and cognitive behavioral therapy (CBT). Dietary behavioral intervention strategies encompass controlling total energy intake, adjusting dietary patterns, and scientifically managing eating time, manner, location, and emotional factors. Exercise intervention strategies include providing psychological and behavioral support and prescribing individualized exercise regimens. Psychological interventions should integrate BCTs with cognitive restructuring to modify values and beliefs regarding diet and physical activity. Sleep interventions should emphasize education and self-management, CBT, relaxation training, regular exercise, light therapy,and circadian rhythm regulation. The BLIs process comprises pre-intervention assessment, priority determination, intervention objectives, content, settings, delivery methods, intensity, duration, and outcome evaluation, while emphasizing the implementation of a multidisciplinary team (MDT) collaborative care model. Childhood and adolescent obesity interventions should adopt family-based, school-based, community-based, clinical, multi-sector, and full developmental life-cycle strategies. Digital technologies should focus on enhancing precision diagnosis, personalized interventions, and full-cycle monitoring. BLIs effectiveness evaluation includes formative evaluation, process evaluation, and outcome evaluation, integrated with comprehensive judgment based on high-quality research evidence. Other critical considerations include improving practical effectiveness, preventing weight regain, enhancing cultural adaptability, and ensuring rational application and standardized referral for pharmacotherapy and bariatric surgery.

Key words: Obesity, Weight-reduction, Behavioral and lifestyle interventions, Diet, Physical activity, Psychosocial intervention, Sleep, Pediatric obesity, Digital technology, Guidelines

摘要： 肥胖是以异常或过度脂肪蓄积为特征并可显著增加多种健康风险的慢性病。肥胖者减重可降低多种疾病发生风险，改善身体和社会功能。行为与生活方式干预（behavior and lifestyle interventions, BLIs）是体重管理的基石，应遵循有效性、循序渐进、综合性、个体化原则。BLIs 实施策略包括运用成熟的行为改变理论、行为改变技术（behavioral change techniques, BCTs）和认知行为疗法（cognitive behavioral therapy, CBT）。膳食行为干预策略包括控制总能量摄入，调整膳食模式，科学管理饮食时间、方式、地点和情绪。运动干预策略包括提供心理和行为支持、开具个体化运动处方。心理干预应结合 BCTs 和认知重构，改变关于饮食和身体活动的价值理念。睡眠干预应强调教育与自我管理、CBT、放松训练、规律运动、光疗法与生物钟调节。BLIs 流程包括干预前评估、确定优先级、干预目标、内容、场所、方式、强度、时限和效果评估，也要强调落实多学科协作（multi-disciplinary team, MDT）诊疗模式。儿童青少年肥胖干预应采用家庭、学校、社区、临床、多部门和全发育周期策略。数字技术重点强化精准化诊断、个性化干预和全周期监测。BLIs 的效果评价包括形成评价、过程评价和结果评价，并结合高质量研究证据进行综合判断。其他关键注意事项还包括提高实效性、预防体重反弹、增强文化适应性，以及药物和手术治疗的合理应用与规范转诊。

关键词: 肥胖, 减重, 行为与生活方式干预, 膳食, 身体活动, 心理社会干预, 睡眠, 儿童肥胖, 数字技术, 指南