整理 | GLP1减重宝典内容团队 ▍ 注意事项和好处 数以百万计的人蜂拥购买司美格鲁肽等药物来减肥和治疗健康问题。医生表示，有一群人可能从这些药物中受益，但他们却错过了，那就是 ——老年人。 医生表示，对于老年人来说，这些GLP-1药物的作用远不止减肥。 体重减轻可以提高行动能力和平衡能力 ，让老年人变得更加活跃。这 可以 改善情绪、改善整体健康状况 ，有时甚至可以决定让他们自由行走还是使用轮椅或拐杖。 根据一项民意调查，9% 的 65 岁以上人群表示服用 GLP-1 药物，如 Ozempic、Wegovy 和 Zepbound，而 50 至 64 岁人群的这一比例为 19%。 体重健康计划医学主任、达拉斯德克萨斯大学西南医学中心内科副教授Jaime Almandoz博士表示，当他为老年患者治疗减肥时，他也会让他 们去看营养师。如果他担心平衡和跌倒问题，他会将他们转介到物理医学或康复计划，以帮助他们学习如何安全地进行更积极的活动或进行阻 力训练。 他还可能会在老年人中 更缓慢地增加 GLP-1 的剂量 ，因为许多老年人还服用其他药物，如降压药或甲状腺药物，当体重波动时，这些药物 的剂量可能需要改变。 他说， ...

以下文章来源于体重管理三年行动 ，作者体重管理三年行动 体重管理三年行动 . 响应国家"健康中国2030"战略，落实"体重管理年"三年行动，本账号发布权威资讯 不久前，国家卫生健康委员会主任雷海潮在新闻发布会上宣布，将启动为期三年的"体重管理年"专项行动，旨在全面推广健康的生活方式。 雷主任介绍，这项行动由国家卫生健康委联合16个部门共同发起，早在去年就已正式实施。其核心目标是引导全民关注体重管理，养成科学饮 食和积极锻炼的健康习惯，让健康生活成为社会新风尚。 这一消息一经发布，立刻引发热议，登上各大热搜榜。网友们纷纷表示："连国家都开始督促减肥了，这次必须认真对待！""减肥，真的是刚需 啊！" 其实，我们身边关于"变胖"的吐槽几乎每天都在发生，这并非无病呻吟。因为，事实就是——中国人正在变得越来越胖！ 在医学领域，"胖"有着明确的衡量标准。世界卫生组织将身体质量指数（BMI）18.5-25视为正常，25-30为超重，超过30则为肥胖。而我国标 准略有不同，BMI在18-24为正常，24-28为超重，超过28则被定义为肥胖。 也就是说，日常所说的"胖"，其实对应的就是医学上的超重和肥胖。 那么中国目前的状况如 ...

Core Insights - The article discusses the dual role of Neuropeptide Y (NPY) in regulating appetite and energy expenditure, revealing its complex functions in both the brain and peripheral fat tissues [7][12][16]. Group 1: NPY's Role in Appetite Regulation - NPY is known to stimulate appetite in the brain, but its absence does not significantly affect food intake in mice [11]. - Mutations in the NPY gene are associated with higher Body Mass Index (BMI) in humans, indicating a more complex relationship between NPY and weight regulation beyond just appetite stimulation [11][17]. Group 2: NPY's Role in Energy Expenditure - In peripheral fat tissues, NPY helps maintain the thermogenic capacity of brown adipose tissue (BAT) and promotes energy expenditure [7][12]. - Research shows that when NPY is knocked out in the sympathetic nerves of mice, their brown fat turns "white," leading to reduced thermogenic ability and increased susceptibility to weight gain, even without changes in food intake or activity levels [14][16]. Group 3: Mechanisms of NPY Action - Approximately 40% of sympathetic neurons in white adipose tissue express NPY, indicating its significant presence in fat tissue regulation [12][14]. - NPY promotes the proliferation of perivascular cells, which can differentiate into thermogenic fat cells, thus playing a crucial role in fat tissue regulation [14][16].

Core Viewpoint - The article discusses the effectiveness of GLP-1 medications, such as semaglutide, in delaying weight loss plateaus, which are common among dieters after approximately one year of weight loss efforts [4][7][8]. Group 1: Research Findings - A study indicates that semaglutide and other GLP-1 medications can extend the time before patients reach a weight loss plateau by an average of one year compared to those who only restrict calorie intake [8]. - Bariatric surgeries, like gastric bypass, show even greater effectiveness, delaying the plateau by an additional year on average [9]. - The research highlights that the body's resistance to weight loss is akin to a survival mechanism, where increased weight loss leads to heightened appetite [5][8]. Group 2: Understanding Obesity - Obesity is defined as a complex disease influenced by genetic, socioeconomic, behavioral, and environmental factors, with risks potentially starting in utero [10]. - The American Medical Association recognizes obesity as a disease, yet stigma persists, often leading to oversimplified advice like "eat less, move more," which fails to address the chronic nature of obesity [10][14]. - There is a need for compassionate and supportive approaches to tackle obesity, recognizing it as a medical condition rather than a personal failing [14][12].

Core Viewpoint - Obesity is a chronic metabolic disease that poses significant health risks, including diabetes, coronary heart disease, and stroke. It is essential to recognize the complex nature of obesity beyond simple lifestyle factors and to adopt a comprehensive approach to its management [4][21]. Summary by Sections Understanding Obesity - Obesity is often misunderstood as merely a result of personal behavior, but it is influenced by societal changes and has become a significant health issue in China, which has the fastest-growing obesity rates globally [4][6]. - The World Health Organization defines obesity with a BMI threshold of ≥30.0 kg/m², while Chinese guidelines set it at ≥28 kg/m², reflecting local health characteristics [7]. Health Risks Associated with Obesity - Obesity can lead to severe health issues, including a 6 to 14-year reduction in life expectancy. It is linked to increased risks of type 2 diabetes, hypertension, and psychological disorders [6][21]. - The importance of maintaining a healthy BMI (18.5-23.9 kg/m²) is emphasized as a critical factor in preventing chronic diseases [6]. Classification of Obesity - Obesity is not a single disease but has various classifications based on genetic, metabolic, and anatomical factors. This includes primary and secondary obesity, as well as classifications based on fat distribution and metabolic health [7][12]. - The evolution of obesity classification reflects a deeper understanding of its underlying causes, necessitating tailored treatment strategies for different obesity types [7][12]. Specific Conditions Related to Obesity - **Hypothyroidism**: Symptoms include weight gain, fatigue, and cold intolerance, often misattributed to general health issues, leading to delayed diagnosis [8]. - **Cushing's Syndrome**: Characterized by excessive cortisol levels, leading to central obesity and other systemic effects. Early recognition of symptoms is crucial for effective management [10][11]. - **Polycystic Ovary Syndrome (PCOS)**: Affects a significant portion of women in China, with high rates of hyperandrogenism leading to abdominal obesity and insulin resistance [12]. - **Genetic Obesity**: Rare but significant, often linked to specific genetic mutations affecting metabolic pathways. Early genetic testing is recommended for individuals with early-onset obesity [13][15][16]. Contributing Factors to Obesity - **Medication-Induced Obesity**: Certain medications, including diabetes treatments and psychiatric drugs, can lead to weight gain, highlighting the need for careful medication management [18]. - **Psychological Factors**: Increased anxiety and depression in modern society contribute to unhealthy eating behaviors and sedentary lifestyles, exacerbating obesity rates [19]. - **Endocrine Disorders**: Conditions like hypogonadism can complicate obesity management, necessitating a comprehensive evaluation of hormonal health [20]. Conclusion - Recognizing obesity as a chronic condition requiring long-term management is vital. A scientific understanding of its multifaceted nature can help in developing effective intervention strategies to prevent related health complications [21].

Core Insights - The article discusses the rising prevalence of obesity and diabetes in modern society, highlighting that the number of obese individuals globally has quadrupled since 1975 [6] - It emphasizes the metabolic dysfunction of adipose tissue as a key reason for the difficulty in reversing obesity, particularly focusing on mitochondrial impairment [7][8] Group 1: Obesity and Metabolic Dysfunction - Obesity is not merely an accumulation of fat but involves complex metabolic changes, including inflammation and hormonal resistance, which contribute to insulin resistance and increased diabetes risk [8] - Recent research indicates that mitochondrial dysfunction in fat cells is a significant factor in obesity, where excessive energy intake leads to mitochondrial impairment and reduced energy expenditure [7][8] Group 2: Role of RalA Gene - The study identifies the RalA gene as a critical player in the fragmentation of mitochondria in obese individuals, which exacerbates fat accumulation [10][12] - In normal conditions, RalA is activated by insulin to promote glucose absorption and assist in the degradation of damaged mitochondria, maintaining metabolic health [10] - In obesity, RalA becomes overactive, leading to excessive mitochondrial fragmentation and loss of function, further promoting weight gain [10][12] Group 3: Potential Therapeutic Target - The research suggests that targeting the RalA gene could be a promising approach for obesity intervention, as knocking out this gene in mice resulted in lower fat content and improved glucose tolerance [12] - Enhancing mitochondrial energy metabolism through RalA modulation may lead to new obesity therapies aimed at increasing energy expenditure and reducing fat accumulation [12]

Core Insights - An international research team discovered a hidden "calorie-burning" mechanism in brown fat that continues to generate heat even when the conventional mitochondrial thermogenic system is limited, providing potential avenues for developing safer and more manageable metabolic enhancement methods to address insulin resistance and obesity [1][2]. Group 1: Brown Fat Mechanism - Brown fat differs from white fat as it can convert food energy (calories) into heat, helping maintain body temperature in cold environments [1]. - Previous research focused on mitochondrial functions in brown fat, but findings indicated that mice lacking mitochondrial-related proteins could still generate heat, suggesting alternative pathways are involved [1]. Group 2: Peroxisomes as Heat Sources - The study identified peroxisomes, small cellular structures that process fats, as alternative heat sources in brown fat [1]. - When exposed to cold, the number of peroxisomes significantly increased, especially in mice lacking mitochondrial-related proteins, indicating that peroxisomes can compensate when mitochondrial thermogenic capacity is lost [1]. Group 3: Role of Specific Proteases - Further research revealed that peroxisomes metabolize certain fatty acids through a specific protease to release heat [2]. - Mice lacking this protease exhibited reduced cold tolerance, lower body temperature, decreased insulin sensitivity, and increased susceptibility to obesity on a high-fat diet; conversely, mice with enhanced protease expression showed improved thermogenic capacity and metabolic indicators [2]. Group 4: Future Research Directions - The findings provide new targets for activating brown fat, with long-term goals including testing dietary interventions that increase fatty acid levels or protease activity to regulate the identified thermogenic pathways, potentially aiding weight loss and improving metabolic health [2].

Core Viewpoint - Hypertension has become a common health threat, and the article identifies eight groups of people who are more susceptible to developing high blood pressure, aiming to promote preventive measures for better health. Group 1: Dietary Factors - Individuals with a long-term high-salt diet, consuming more than 5 grams of sodium daily, are at increased risk due to elevated blood volume and vascular pressure [4] Group 2: Psychological Factors - People experiencing chronic mental stress are prone to hypertension, as stress leads to excessive secretion of catecholamines, causing blood vessel constriction and increased blood pressure [6][7] Group 3: Alcohol Consumption - Those who consume more than 25 grams of alcohol daily are also at risk, as regular high alcohol intake can contribute to elevated blood pressure [9] Group 4: Obesity - Individuals with a body mass index (BMI) over 28 are at risk, as excess fat tissue secretes more angiotensinogen, increasing vascular tension and blood pressure [11][13] Group 5: Diabetes - There is a significant correlation between diabetes and hypertension, with 60% of diabetes patients also suffering from high blood pressure [14] Group 6: Sleep Disorders - Patients with sleep apnea, characterized by severe snoring and recurrent nighttime oxygen deprivation, experience sustained sympathetic nervous system activation, leading to hypertension [15][16]

Core Insights - The article emphasizes that weight loss is not merely about the numbers on a scale but involves significant changes in the underlying fat tissue, which can reverse aging processes in metabolic cells [7][9][10]. Group 1: Research Findings - A study published in July 2025 in *Nature* revealed that obesity accelerates the aging of metabolic and vascular cells within fat tissue, but weight loss can significantly reverse this premature aging phenomenon [7]. - The research highlights that while weight loss reduces inflammation, the memory of immune responses remains, posing a risk for potential weight regain [10][12]. - The study focused on subcutaneous abdominal fat, which is linked to central obesity and metabolic disorders like type 2 diabetes and hyperlipidemia, suggesting that understanding its dynamic changes is crucial for unlocking the health benefits of weight loss [8]. Group 2: Mechanisms of Weight Loss - Weight loss not only leads to a decrease in body weight but also transforms the structure and function of fat tissue towards a healthier state, driven by complex immune regulatory mechanisms [10][15]. - Despite improvements in local inflammation and reductions in inflammatory markers, some macrophages remain in a pre-activated state, which could trigger inflammation again upon encountering new stimuli, potentially leading to weight regain [10][15]. Group 3: Long-term Effects of Obesity - Research indicates that even after successful weight loss, changes at the cellular level persist, with fat cells retaining characteristics from the obese state, which may lead to faster fat accumulation upon re-exposure to high-fat diets [15][19]. - Animal studies corroborate these findings, showing that fat tissue in obese mice retains a form of epigenetic memory that influences their metabolic responses even after weight loss [19]. Group 4: Implications for Weight Management - The persistent "obesity memory" in fat tissue and immune cells suggests that weight management strategies must consider these long-term changes to prevent weight regain and associated metabolic diseases [19]. - The article underscores the importance of developing comprehensive weight management approaches that address both the physiological and psychological aspects of obesity [19].

Core Insights - The article emphasizes that weight loss is not merely about the numbers on the scale but involves significant changes in the underlying fat tissue, which can reverse aging processes in metabolic cells [7][9][10] - It highlights the persistent "memory" of inflammation in immune cells and fat tissue, which can lead to weight regain after initial weight loss [10][15][19] Group 1: Research Findings - A study published in July 2025 in *Nature* revealed that obesity accelerates the aging of metabolic and vascular cells in fat tissue, while weight loss can significantly reverse this premature aging [7] - The research indicates that while weight loss reduces inflammation, the immune system retains a "memory" of the previous obese state, which may contribute to weight regain [10][12] - The study focused on subcutaneous abdominal fat, linking it to metabolic disorders such as type 2 diabetes and hyperlipidemia, suggesting that understanding its dynamics is key to unlocking the health benefits of weight loss [8] Group 2: Mechanisms of Weight Loss - Weight loss not only reduces body weight but also transforms the structure and function of fat tissue towards a healthier state, involving complex immune regulatory mechanisms [10][15] - Despite improvements in local inflammation and reduced expression of inflammatory factors, some macrophages remain in a pre-activated state, posing a risk for future inflammation and weight regain [10][12] - Research shows that even two years after successful weight loss, fat cells retain changes from the obese state, leading to increased absorption of sugars and fats, which can accelerate fat accumulation upon re-exposure to high-calorie diets [15][19] Group 3: Experimental Evidence - Animal studies using C57BL/6J mice demonstrated that after weight loss, the fat tissue still exhibited increased macrophage presence and persistent gene expression changes associated with obesity [17][19] - The findings indicate that these "obesity memories" in fat cells can lead to abnormal responses to metabolic stimuli, contributing to the risk of weight regain and the recurrence of obesity-related metabolic diseases [19]