单纯性肥胖与认知行为治疗_培训课件.pptVIP

Physical Activity (PA)证据等级 证据陈述 证据等级 预防体重增加 150 - 250 min-wk-1 1200 to 2000 kcal-wk-1 A 减重 225–420 min-wk-1 5-7.5kg B 减重后体重维持 200-300 min-wk-1 B 生活方式PA 生活方式的PA是一个模棱两可的术语和定义，必须仔细评估文献及解读。生活PA对改善大多数成年人肥胖能量不平衡有益 B 联合适度节食 有助于体重下降 A 阻力训练（RT) 单独RT无减重作用，联合饮食治疗能增加或维持？体组织、减少脂肪，RT能改善多种慢性疾病危险因素 B Med Sci Sports Exerc.?2009 Feb;41(2):459-71 BIGGEST LOSER 减重效果惊人 （10）参考书 肥胖终身性疾病，与环境相关，在物质丰富的年代，无论肥胖的预防与治疗都相当不易 内科医生缺少工具（药物），饮食指导单一，更缺少对肥胖认知行为的认识 * Figure 1. Mean (±SE) Changes in Weight from Baseline to Week 62. The weight-loss program was started at week 0 and completed at week 10. ITT denotes intention to treat * * Figure 3. Mean (±SE) Fasting and Postprandial Ratings of Hunger and Desire to Eat at Baseline, 10 Weeks, and 62 Weeks. Ratings were based on a visual-analogue scale ranging from 0 to 100 mm. Higher numbers indicate greater hunger or desire. * These findings support the possibility that compensatory physiological changes eventually overpower the patient’s behavioral ability to adhere to a reduced number of calories required to maintain the reduced body weight state. It also supportsIt also supports the hypothesis that weight regain has a strong physiological basis and is not simply the result of the voluntary resumption of poor eating habits. This is an important concept for endocrinologists to understand whentreating obese patients because it validateswhymedications that change one’s physiology or hormone levels may be indicated and helpful in long-term weight loss treatment. 生长激素促分泌素受体(GHSR)的内源性 配体 * 单纯性肥胖与认知行为疗法 广州市红十字会医院 内分泌科 郭坚 肥胖的原因 减重需长期坚持、综合治疗 能量负平衡：减少能量摄入 通过提高基础代谢 及运动量，增加能  量消耗节食治疗是最基础也是最重要的治疗手段 肥胖治疗核心 DDPOS研究 Lancet. 2009 Nov 14;374(9702):1677-86. March , 2007 Comparison of the Atkins, Zone, Ornish,and LEARN Diets for Change in Weightand Related Risk Factors Among OverweightPremenopausal Women Gardner et al,JAMA,2007.296-298 N Engl J Med.?2011 Oct 27;365(17):1597-604 体重变化 N Engl