减肥后体重反弹的机制和应对策略  

Mechanisms of weight rebound after weight loss and coping strategies

作　　者：叶建平 Ye Jianping(Zhengzhou Key Laboratory of Obesity-Related Energy Metabolism,Institute of Trauma and Metabolism,Zhengzhou University,Zhengzhou,Henan 450001,China)

机构地区：[1]郑州市肥胖相关能量代谢重点实验室、郑州大学创伤与代谢研究院,河南郑州450001

出　　处：《中国药物与临床》2025年第6期342-346,共5页Chinese Remedies & Clinics

基　　金：国家自然科学基金(32271220);郑州市科技局项目(ZZGZS2022001)。

摘　　要：肥胖已成为常见多发慢性病的主要原因,其复杂性体现在发病机制及减重后体重反弹的难以控制。本文在总结文献和前期工作的基础上,探讨减肥后体重反弹的机制与应对策略。体重反弹的机制有4种假说:肥胖记忆(脂肪组织炎症与表观遗传学改变)、神经内分泌功能紊乱(神经激素变化)、心理因素影响(情绪性进食、自我控制能力下降)以及遗传背景作用(特定基因变异)。针对体重反弹,提出了多种预防策略,包括饮食管理、运动与身体活动、心理与行为干预、药物与医疗干预、生活方式与环境调整等。此外,以下丘脑肥胖为例,介绍了遗传性和获得性肥胖的发病机制、诊断与治疗方法。最后,展望未来研究方向,强调需要克服当前研究面临的挑战,加强多学科合作以更好地解决体重反弹问题。Obesity has become a major cause of common and frequent chronic diseases.Its complexity is reflected in the pathogenesis and the difficulty of controlling weight rebound after weight loss.This paper discusses the mechanisms and coping strategies of weight rebound after weight loss,based on a summary of the literature and the authors′work.There are four hypotheses for the mechanism of weight rebound.The first hypothesis is related to obesity memory,which involves inflammation and epigenetic alterations in adipose tissue.The second hypothesis is based on neuroendocrine dysfunction,which is characterized by changes in neurohor-monal levels.The third hypothesis suggests that psychological factors,such as emotional eating and decreased self-control,play a role in weight rebound.The fourth hypothesis proposes that the genetic background,including specific gene variants,contributes to weight rebound.Several preventive strategies have been proposed to address weight rebound.These include dietary management,exercise and physical activity,psychological and behavioral interventions,pharmacological and medical interventions,and lifestyle and environmental modifications.The pathogenesis,diagnosis,and treatment of hereditary and acquired obesity are also discussed in this paper.Hereditary obesity,specifically hypothalamic obesity,is used as an example to illustrate the complexities of obesity.Finally,the authors emphasize the need for future research to overcome the challenges faced by current research and to strengthen multidisciplinary cooperation in addressing the problem of weight rebound.

关 键 词：体重反弹 肥胖记忆 神经内分泌紊乱 心理因素 遗传背景 

分 类 号：R58[医药卫生—内分泌]