Core Viewpoint - Obesity has become a global health challenge, with significant advancements in the development of anti-obesity drugs, with over 100 new treatments in development aimed at providing safer and more effective weight loss options for patients [1] Group 1: Upcoming Drug Approvals - Orforglipron from Eli Lilly is expected to be approved in 2026 as an oral small-molecule drug activating the GLP-1 receptor [2] - CagriSema from Novo Nordisk, also expected in 2026, is an injectable that activates both amylin and GLP-1 receptors [2] - Survodutide from Boehringer Ingelheim and Retatrutide from Eli Lilly are anticipated in 2027, both being injectables that activate multiple receptors [3] - MariTide from Amgen and Bimagrumab from Eli Lilly are projected for approval in 2028 and beyond, with unique mechanisms targeting GLP-1 and myostatin signaling respectively [3] Group 2: Mechanisms and Efficacy - New generation drugs are focusing on protecting muscle quality while promoting weight loss, addressing the limitations of traditional drugs like semaglutide, which can lead to muscle loss [4] - Dual-action drugs like tirzepatide, which mimics both GLP-1 and GIP, have shown superior weight loss results, with participants losing an average of 20% of their body weight [5] - CagriSema has demonstrated an average weight loss of nearly 23% in a 68-week Phase III trial [9] Group 3: Delivery Methods and Patient Compliance - The industry is exploring more convenient delivery methods, including monthly injections and oral medications, to improve patient compliance [13] - Orforglipron is expected to be the first oral anti-obesity drug, with a 15% weight loss observed in a 36-week Phase II study [13] Group 4: Genetic Insights and New Targets - Advances in genetic sequencing have identified new targets for obesity treatment, with companies like Alnylam Pharmaceuticals developing therapies based on gene mutations associated with lower body weight [14][17] - The potential of next-generation CB1 antagonists is being explored, aiming to avoid severe side effects while improving metabolic outcomes [18] Group 5: Muscle Preservation - Muscle preservation is becoming a key focus in obesity treatment, with existing GLP-1 drugs potentially leading to muscle loss [19] - Bimagrumab, a monoclonal antibody targeting myostatin, has shown promise in reducing muscle loss while promoting fat breakdown, with a 22% reduction in fat mass observed in a 48-week trial [20][22] - The development of muscle-targeting therapies is still in early stages but is gaining attention as a crucial component of future obesity treatment strategies [25]

Core Viewpoint - The article emphasizes the urgent need for effective weight management and obesity prevention strategies in China, highlighting the significant health, psychological, and economic burdens associated with obesity [6][7]. Group 1: Obesity Burden in China - In 2020, the overweight rate among adults aged 18 and above in China reached 34.3%, with an obesity rate of 16.4% [9] - By 2021, the number of overweight and obese individuals aged 25 and above had increased to 402 million, making China the country with the highest prevalence globally [9] - Projections indicate that by 2030, the adult overweight and obesity rate could rise to 70.5%, with school-aged children reaching 31.8% and preschool children at 15.6% [9] Group 2: Health Risks Associated with Obesity - Obesity significantly increases the risk of over 200 diseases, including diabetes, stroke, and heart disease, with 90% of obese individuals suffering from at least one comorbidity [12] - The risk of hypertension is 2.5 times higher for overweight individuals and 3.3 times for obese individuals compared to those with normal weight [12] - Obesity also negatively impacts reproductive health and increases the risk of complications during pregnancy [12] Group 3: Psychological and Social Impacts - Individuals with obesity often face social stigma and discrimination, particularly among children, adolescents, and women [13] - There is a strong correlation between obesity and mental health issues such as depression and anxiety [13] - Obesity can lead to decreased quality of life and reduced work productivity [13] Group 4: Economic Burden of Obesity - By 2030, annual medical costs associated with overweight and obesity in China are projected to reach 418 billion RMB, accounting for 22% of national healthcare expenditures [14] - Obesity increases hospitalization rates and healthcare resource consumption, placing additional economic pressure on individuals and families [14] Group 5: Risk Factors for Obesity - Key risk factors for obesity include unhealthy dietary habits, lack of physical activity, and genetic predisposition [15] - For children, significant risk factors include maternal pre-pregnancy weight, short breastfeeding duration, and excessive screen time [15] Group 6: Prevention Strategies - Establishing supportive environments for health, such as community fitness facilities and healthy dining options, is crucial [16] - Public education on the dangers of obesity and healthy weight management should be prioritized [16] - Encouraging regular physical activity and healthy eating habits is essential for obesity prevention [16] Group 7: Treatment and Management of Obesity - Lifestyle interventions, including dietary changes and increased physical activity, are the primary treatment methods for obesity [19] - For individuals with severe obesity or metabolic complications, pharmacological treatments and surgical options may be considered [19] - A multidisciplinary approach involving nutritionists, exercise specialists, and medical professionals is recommended for comprehensive obesity management [19]

整理 | GLP1减重宝典内容团队 埃隆·马斯克 (Elon Musk) 在从 Ozempic 升级为被称为"金刚"的减肥药Mounjaro的药物后，体重有所减轻。 53 岁的马斯克在其社交媒体平台 X 上的一篇节日帖子中承认转用 Mounjaro。 马斯克之前一直在服用 Ozempic， 他声称 "Mounjaro 的副作用似乎更少"，而且似乎"更有效" 。 Mounjaro是近年来越来越受欢迎的众多减肥药之一，目前由诊所和药房私下销售。 Mounjaro 于今年3月开始在英国国民医疗服务体系（NHS）也即英国公费医保体系逐步推出。 NHS 制定了一项长期计划，旨在让 Mounjaro 广泛普及。然而，这需要时间， 可能长达12 年才能确保能够满足所有患者的需求 ，由于担心该药物可能使NHS不堪重负，以及为了测试提供 新一代减肥药物的方法。从今年 3 月起，将通过体重管理服务向医疗需求最高的人提供此注射剂，即那些 至少有三种肥胖相关健康问题的人 。根据英国国家卫生与服务优化研究院（NICE）指南，该指南规定 Mounjaro 将通过NHS提供给 BMI 超过 35 且至少有一种肥胖相关健康问题 的人。 BB ...

整理 | GLP1减重宝典内容团队 最新研究显示，用于糖尿病和体重控制的药物——特别是胰高糖素样肽-1（GLP-1）受体激动剂——可能在治疗银屑病方面发挥作用。这是一 种慢性自身免疫性皮肤疾病，由于皮肤细胞生长过快，会导致皮肤出现红色、鳞屑状和发炎的斑块。科学家正探索这类具有抗炎特性的GLP-1 药物是否也能帮助缓解银屑病。 不过，二者之间的联系并不简单。美国皮肤病学会（AAD）年会上一项研究指出，尽管GLP-1药物似乎能降低银屑病患者的炎症水平，但这并 未显著改善患者的皮肤症状或生活质量。因此，GLP-1药物究竟是银屑病治疗的突破口，还是尚在验证的新尝试？ GLP-1药物在银屑病中的潜在作用 在AAD大会上，来自巴西的研究人员发布了一项荟萃分析结果，纳入了6项研究，共85名同时患有银屑病及糖尿病或肥胖的参与者。其中63人 接受了GLP-1药物治疗，疗程为8到20周不等。 研究人员指出，治疗后参与者体内的C反应蛋白（CRP）和肿瘤坏死因子α（TNF-α）水平有所下降，表明炎症有所缓解。TNF-α是一种引发炎 症反应的分子，在银屑病的发生中起重要作用。"一些用于治疗银屑病的生物制剂就是通过阻断TNF-α起效的， ...

Global Obesity Trends - The report indicates that since 2000, the global issue of obesity and overweight has been worsening, with the proportion of overweight and obese adults expected to rise from 36% in 2000 to 50% by 2030, equating to nearly 3 billion adults suffering from high BMI [6] - The increase in obesity is not limited to adults; childhood and adolescent obesity rates are also rising, with about one-third of adults and 81% of adolescents failing to meet WHO's recommended physical activity standards [6] Regional Obesity Trends - In Africa, the number of overweight and obese adults is projected to increase from 107 million in 2010 to 263 million by 2030, with a notable rise in female obesity rates [7] - In the Americas, the obesity rate in the US and Canada is expected to reach 594 million adults by 2030 [7] - In Europe, despite some countries stabilizing their obesity rates, the total number of overweight and obese adults is expected to reach 429 million by 2030 [7] - Southeast Asia, particularly India and Indonesia, is projected to have 619 million overweight and obese adults by 2030 [7] - In the Western Pacific, including China and Japan, the number of overweight and obese adults is expected to reach 662 million by 2030 [7] Obesity and Non-Communicable Diseases (NCD) - Obesity is a significant risk factor for various NCDs, including type 2 diabetes, cardiovascular diseases, cancers, and chronic respiratory diseases, with approximately 16 million adults dying prematurely from obesity-related NCDs in 2021, accounting for 15% of all NCD-related premature deaths [8][9] Global Health System Preparedness - The report highlights that most countries' healthcare systems are not adequately prepared to handle the dual pressures of obesity and NCDs, lacking systematic obesity management guidelines and effective public health policies [10] - Many countries have not implemented effective preventive measures, such as taxing unhealthy foods and limiting unhealthy food advertising, which are crucial for reducing obesity rates [10] National Policy Progress - Some countries, like Mexico, India, and Brazil, have begun implementing specific measures to combat obesity, such as sugary drink taxes and food labeling regulations [11] - However, 126 countries have yet to introduce any obesity-related policies, particularly in low- and middle-income countries [11] China's Obesity Characteristics - China's adult high BMI prevalence is expected to continue rising, with approximately 41% of adults projected to have high BMI by 2025, and 9% classified as obese [12] - By 2030, the total number of adults with high BMI in China is expected to reach 515 million, with significant gender differences in high BMI prevalence [16] Health Risks Associated with High BMI in China - High BMI is a major risk factor for type 2 diabetes, with about 40% of premature deaths from diabetes in China linked to high BMI [17] - High BMI significantly increases the risk of cardiovascular diseases, with approximately 15% of premature cardiovascular deaths attributed to high BMI in 2021 [17] - High BMI is also associated with various cancers, with around 16% of cancer-related premature deaths in China linked to high BMI [17] Policy and Action Recommendations - The report calls for immediate action from governments, international organizations, and society to address the growing obesity crisis, proposing science-based policy recommendations [21] - Recommendations include creating healthy living environments, enhancing public awareness and education on healthy diets and physical activity, and transforming health systems to better manage obesity and related chronic diseases [21]

整理 | GLP1减重宝典内容团队 周女士被商家的宣传打动，毫不犹豫地付了款。"我买的是基础款，数量比较少，六颗大约780元，加强版要上千元。" 随后，周女士收到了五颜六色、大小不一的药片，用透明塑料袋分装成小包，每包是一天的服用量，疗程30天。这些药没有生产厂家、生产地 址、成分说明，更没有使用说明。 刚开始服药的三天，周女士没有觉得异常。渐渐地，她开始出现口渴口干、无精打采、心慌恶心、失眠的症状。商家客服却表示，这是正常反 应。 服药十天后，周女士感觉自己瘦了，但是头晕、烦躁、失眠等不良反应接踵而至，身体和精神状态一落千丈。在家人的劝说下，周女士报了 警。 公安机关等部门将周女士提供的减肥药送到市场监管部门进行检测。结果显示，这些减肥药中含有麻黄碱、伪麻黄碱、芬特拉明、氟西汀等多 种有毒有害成分，对人的心脑血管、中枢神经，甚至免疫力都有极大的毒害性。 ● 麻黄碱服用后可使人亢奋，降低饥饿感，且有成瘾性和戒断反应，长期使用者会出现头痛、心悸、失眠等问题。 五月的风一吹短袖一穿，糟糕腰上的肉肉藏不住了！ 据央视新闻报道，江苏南京的周女士在网上看到一款减肥药，号称"无需运动节食，十天瘦十斤，明星都在吃，安全不反 ...

整理 | GLP1减重宝典内容团队 替尔泊肽是一种基于GIP序列改造的多肽，是目前研究进展最快的GLP-1/GIP双受体激动剂，也是GIP受体激动剂中的领军药物。临床试验表 明，替尔泊肽在控制血糖和减轻体重方面优于GLP-1单一受体激动剂司美格鲁肽。那么，它能否成为减重手术的替代方案？ 自美国食品和药物管理局于 2021 年中期批准 Wegovy（第一种旨在减肥的 GLP-1 药物）以来，该药物以及 Ozempic、Mounjaro 和 Zepbound 等相关 GLP-1 药物的销量飙升。 快速减肥一直是这些药物的标志，其作用在于让人们更早感到饱腹。在 GLP-1 问世之前，饮食和运动或减肥手术是肥胖美国人减肥的主要途 径。然而"Ozempic 时代"可能已经改变了这一切。据传闻，在美国，由于需求减少，卫生系统已经关闭了部分医院的代谢减肥手术项目。实践 中，政策制定者和临床医生应继续密切监测药物治疗和手术治疗肥胖症之间的权衡，以确保获取有效的肥胖症治疗的最佳途径。 ▍ GLP-1RA使用量激增，同期减肥手术数量锐减 美国的研究发现，司美格鲁肽和其他减肥药的兴起正在改变体重管理的格局。这些药物为想要减肥的人提 ...

整理 | GLP1减重宝典内容团队 信达生物宣布，其 GLORY-1 三期临床研究结果在《新英格兰医学杂志》(NEJM) 上发表。该研究评估了玛仕度肽（一种胰高血糖素 (GCG) 和胰高血糖素样肽-1 (GLP-1) 受体双激动剂）在中国超重或肥胖成年患者中的疗效。 该研究的第一作者是北京大学人民医院的纪立农教授和河南科技大学第一附属医院的蒋宏伟教授。纪立农教授和信达生物的钱镭博士 为共同通讯作者。 这是首个提交监管审批的GCG/GLP-1受体双激动剂玛仕度肽的临床试验首次发表在顶级同行评议期刊上。这也标志着中国研发的创 新肥胖治疗药物首次登上《新英格兰医学杂志》(NEJM)，体现了中国在生物制药创新方面的进步。该研究有望为全球肥胖管理临床 指南提供参考。 在NEJM的一篇相关社论中，哈佛大学医学院的Vanita R. Aroda教授和科罗拉多大学安舒茨医学院的Leigh Perreault教授指出了中国 和西方人群在肥胖相关健康结果方面的关键差异。他们强调，中国年轻人出现代谢功能障碍的几率与西方老年人口相当。玛仕度肽不 仅显著降低了体重和BMI，还改善了更广泛的肥胖相关健康指标。他们强调了在中国开展个性化干 ...

国家卫生健康委最新发布的《体重管理指导原则（2024年版）》警示： 如果当前趋势无法得到有效遏制，到2030年，我国成年人和儿童的超重肥胖率预计将分别飙升至70.5%和31.8%。 在这样的背景下，2024年6月，国家卫生健康委、国家疾控局等16个部门联合出台了《"体重管理年"活动实施方案》，计划用三年时间，全力 遏制国民体重持续上升的势头。 值得注意的是，"减肥"这一话题，今年首次在全国两会上被提升到国家层面进行深入讨论。 国家卫健委对此高度重视，专门发布了《成人肥胖食养指南》，详细列出了各地的食谱样例与能量分布，手把手教大家如何健康饮食、科学减 重。 根据《柳叶刀》最新研究，2021年中国25岁及以上的超重和肥胖人群已达4.02亿，成为全球肥胖人数最多的国家。 世界卫生组织将肥胖定义为一种"慢性代谢性疾病"，其主要特征是体内脂肪过度堆积，导致体重超标，并对健康造成不良影响。 医学研究发现，肥胖与2型糖尿病、高血压、冠心病、脂肪肝、睡眠呼吸暂停等200多种疾病密切相关，还会显著提升13种癌症的发病风险。与 肥胖相关的疾病，占据了我国总疾病负担的70%以上。 值得注意的是，中国人更容易出现腹部肥胖，这种体型更 ...

整理 | GLP1减重宝典内容团队 本研究纳入了 31 项随机对照试验，涉及 35,000 多名患者。 与 GLP-1 受体激动剂和其他减肥药相比， 替尔泊肽15mg在体重相关参数、血糖 概况（糖基化血红蛋白）、脂质参数（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯）和血压方面始终排名前三 。与安 慰剂相比，替尔泊肽15mg的减重疗效最高，可达到 ≥15% 的体重减轻（风险比10.24）。 | 药物的减肥效果的比较 | | --- | 在最近的一篇论文中，研究者在 MEDLINE、Embase 和 Cochrane CENTRAL 中搜索了美国食品药品管理局批准的关于替尔泊肽、GLP-1 RAs和其他减肥药的随机对照试验。进行了网络荟萃分析，对治疗组进行了直接和间接比较。对主要（≥5%、≥10%、≥15%、绝对体重减轻） 和次要结果和不良反应进行了网络图和优选概率排名曲线分析(SUCRA)。 独特的作用机制 ：替尔泊肽是一种新型的双重GIP和GLP-1受体激动剂，其分子结构经过特殊修饰，具有更长的半衰期和更强的受体亲和力。 这种独特的结构使得替尔泊肽能够同时激活GIP和GLP-1受体，从而发挥协 ...