司美格鲁肽等GLP-1如何用得更安全？肥胖专家给出判断标准

Core Viewpoint - The article emphasizes the importance of body composition analysis over mere weight or BMI for determining the suitability of GLP-1 medications for weight management [4][10]. Group 1: Suitability of GLP-1 Medications - The use of GLP-1 medications should not be based solely on weight or BMI but should include body composition analysis as a critical decision-making factor [4][6]. - Rocio Salas-Whalen, a specialist in obesity medicine, highlights that weight loss can result from muscle loss, water reduction, or minimal fat changes, which do not necessarily indicate improved metabolic health [6][10]. - Body composition metrics, such as skeletal muscle content, body fat percentage, and visceral fat levels, are essential for assessing health risks [6][8]. Group 2: Health Indicators - Visceral fat is identified as a particularly dangerous indicator, associated with inflammation and metabolic diseases, while body fat percentage reflects overall fat burden [8][10]. - Salas-Whalen recommends that women maintain a body fat percentage below 28% and men below 20% for optimal health [8]. - Skeletal muscle is crucial for metabolic health, as it plays a significant role in glucose utilization and reducing insulin resistance [8][10]. Group 3: Treatment Goals and Recommendations - The goal of weight loss treatment should focus on body recomposition, aiming to reduce fat while preserving or increasing muscle mass [8][10]. - GLP-1 medications should not be prescribed indiscriminately and should be based on clear medical indications [10]. - The World Health Organization suggests GLP-1 medications for adults with a BMI of 30 or higher, but this does not imply universal applicability for all individuals [10].