整理 | GLP1减重宝典内容团队 ▍ 一半的人在一年内停止治疗 与安慰剂对照组相比，GLP-1 受体激动剂（如司美格鲁肽和替尔泊肽）分别在治疗 68 周和 72 周后导致体重减轻15%-20%。尽管多项 研究报告了这些减肥药的积极作用， 但由于其不良的胃肠道影响和高成本，长期坚持这些治疗很困难 。多达一半的人在处方的第一年 内停止治疗。 肥胖是一种与体内多余脂肪堆积有关的健康状况。多项研究表明， 肥胖不仅对健康造成多系统性损害，还与多种并发症和合并症密切 相关 ，包括代谢紊乱（如脂肪肝、胆结石、不孕、心脑血管疾病等）、躯体异常（如哮喘、胃食管反流、关节炎等）以及精神健康问 题（如抑郁、焦虑等）。近年来，已经开发出许多治疗方法和减肥计划来减少肥胖。例如，GLP-1 受体激动剂已获得全球监管机构批 准用于治疗肥胖和 2 型糖尿病。已证明 GLP-1 受体激动剂可以减少食欲，从而减少食物摄入量。 减肥的最大挑战之一是维持减肥效果。尽管这些新疗法很有效，但仍然看到很多人在停止治疗后体重反弹。许多研究表明，停用 GLP- 1 受体激动剂会导致体重增加。这些观察结果强调了继续使用 GLP-1 受体激动剂作为长期有利效果 ...

编者荐语： 日经中文网"开设了"日经BP精选"栏目。日经BP是日本经济新闻社媒体集团的一员，成立于1969年。作 为日本领先的B2B媒体公司，聚焦经营管理、专业技术及生活时尚三大主要领域。敬请读者关注。 以下文章来源于日经BP ，作者日经BP 饮食：饭前应该喝什么？ 饮食：饭前运动可防止吃多，真的吗？ 睡眠：一周的开始最好设定在星期几？ ※正确答案请向下阅读 虽然心里 明白，但 还 是会不小心吃多。 这样 的 烦恼 也可以通 过 吃 饭时 的技巧和改 善" 认 知" 等方式来消除。本文将针对 " 饮 食 " 以及导 致食欲失控的根本原因 " 睡眠 " 介 绍 一些立即 见 效的技巧。 饮食方面的要点 饭前需要做一件事情 只要改变大脑的"认知"，就能防止吃多 日经BP . 日经BP成立于1969年4月, 隶属于日本经济新闻社集团。作为日本领先的B2B媒体公司，我们聚焦"经营 管理"、"专业技术"及"生活时尚"三大主要领域，满足客户多元化的需求。 一提到减肥，人们 往往只关注 饮 食和运 动 。但需要注意的是合理的睡眠方法。其 实 ，睡眠与食欲密切相关，是减肥成功不可或缺的一大要点。本文将聚焦于每天在家安排到生 ...

Core Viewpoint - The article emphasizes the health risks associated with low carbohydrate diets, particularly the negative effects of insufficient carbohydrate intake on overall health and well-being [3][4][5][7][10]. Group 1: Health Risks of Low Carbohydrate Diets - Insufficient carbohydrate intake can lead to low blood sugar, metabolic dysfunction, and excessive protein consumption, negatively impacting various bodily functions [3]. - A study from March 2023 indicates that ketogenic diets can double the risk of cardiovascular diseases, including heart attacks and strokes [4]. - Participants who consume little to no staple foods have a twofold increased risk of cardiovascular diseases compared to those on regular diets [5]. Group 2: Long-term Consequences - A comprehensive study published in 2018 suggests that inadequate carbohydrate consumption may shorten lifespan, with both very low and very high carbohydrate intake associated with increased mortality risk [7]. - Regularly avoiding staple foods can impair memory and cognitive functions due to insufficient energy supply to the brain [9]. - Long-term lack of staple foods can lead to nutritional deficiencies, emotional instability, and various physical side effects such as bad breath, hair loss, and muscle loss [10][11]. Group 3: Dietary Recommendations - To effectively manage weight, it is essential to control total caloric intake while ensuring a balanced diet that includes carbohydrates [12]. - Recommended staple foods include whole grains and root vegetables, which provide satiety without high glycemic indices [14]. - According to the Chinese Dietary Guidelines, daily intake of grain foods should be 200-300 grams, including 50-150 grams of whole grains and legumes, and 50-100 grams of root vegetables [17].

Core Viewpoint - The article discusses the rising trend of weight loss among celebrities and public figures, highlighting the role of weight loss medications and social media in increasing awareness and interest in weight management solutions [4]. Group 1: Celebrity Weight Loss Stories - Sun Nan's transformation led to public astonishment, with a reported weight loss of over 20 pounds through a natural approach of healthy eating, good sleep, and moderate exercise [5][7]. - Yan Rujing successfully lost 55 pounds over six months, transitioning from a weight of 196 pounds and a BMI of 40.27 to a more fit appearance, emphasizing her rigorous training regimen of six hours daily [9][11]. - La Mu Yangzi achieved a weight loss of 20 pounds in one month through intense training and a strict low-carb diet during the filming of a reality show [12][16]. - Ma Weiwei lost 20 pounds in 45 days by adopting a low-carb diet and exercising, despite acknowledging the mental challenges associated with such a restrictive diet [17][19]. Group 2: Use of GLP-1 Medications - Celebrities like Elon Musk and Whoopi Goldberg have publicly shared their experiences with GLP-1 medications, reporting significant weight loss results, with Musk losing 30 pounds and Goldberg using medication to manage weight gained from steroid treatments [20][22]. - The effectiveness of semaglutide (Wegovy) in clinical trials shows an average weight reduction of 15% among participants, significantly outperforming previous weight loss medications [31][33]. - The STEP series of studies demonstrated that semaglutide can lead to substantial weight loss, with some participants losing over 20% of their body weight, and it has been approved by the FDA for long-term obesity management [35][34]. Group 3: Efficacy of Tirzepatide - Tirzepatide has shown promising results in clinical trials, with participants experiencing an average weight loss of up to 26.6% after a combination of lifestyle changes and medication [38][39]. - The SURMOUNT studies indicate that tirzepatide significantly reduces weight in patients with obesity or prediabetes, with a notable reduction in diabetes progression risk [36][38].

Core Viewpoint - The article emphasizes the importance of aligning meal times with the body's biological clock to effectively manage weight and reduce obesity risk, highlighting recent research on time-restricted feeding (TRF) and its effects on metabolism and energy expenditure [6][18][20]. Summary by Sections Obesity and Eating Habits - With rising living standards, the pursuit of delicious food has increased, leading to a rise in obesity rates, making weight loss a focal point of social concern and medical research [6]. Time-Restricted Feeding Research - A study published in the journal "Science" explores the biological mechanisms of time-restricted feeding in mice, indicating that eating during inactive periods (daytime) leads to significant weight gain compared to active periods (nighttime) [7][9]. - The research shows that energy consumption decreases when mice eat during inactive periods, contributing to weight gain despite similar food intake and digestion efficiency [9]. Metabolic Implications - Active period eating enhances energy expenditure by increasing glycolysis and the tricarboxylic acid cycle in fat tissues, which helps in weight management [11]. - Disruption of the biological clock due to high-fat diets affects the expression of clock genes in fat tissues, indicating that inappropriate eating times can disturb fat metabolism and increase obesity risk [13]. Genetic Factors and Thermogenesis - The study identifies key genes related to thermogenesis in fat tissues, showing that enhancing fat cell thermogenesis can help control weight gain during inactive periods [15][17]. - The absence of the ZFP423 gene promotes fat thermogenesis and improves energy metabolism, suggesting that proper meal timing can maximize fat tissue thermogenesis and minimize weight gain [17]. Practical Recommendations - To achieve effective weight loss, meal times should align with the body's biological rhythms, advocating for eating during the day when the biological clock is active and reducing or avoiding food intake at night [18][19].

Core Viewpoint - The market regulatory authorities and consumer associations in China have issued a warning to consumers about the misleading claims of ordinary food products being marketed as health supplements or having health benefits, emphasizing the importance of distinguishing between ordinary food, health food, and pharmaceuticals [1][2]. Group 1: Regulatory Framework - There is a strict legal distinction between ordinary food, health food, and pharmaceuticals in China, with laws prohibiting false advertising and claims related to disease prevention and treatment [2]. - The laws such as the Anti-Unfair Competition Law, Advertising Law, and Consumer Rights Protection Law explicitly forbid misleading commercial promotions of food products [2]. Group 2: Consumer Guidance - Consumers are advised to carefully check product labels to identify whether they are ordinary food, health food, or pharmaceuticals, and to look for the "blue hat" symbol on health food products [3]. - It is recommended to purchase health food from reputable e-commerce platforms and physical stores, avoiding unverified sources such as social media or informal groups [3].

Core Viewpoint - The article highlights the significant health risks associated with the consumption of ultra-processed foods (UPF), linking it to obesity, cardiovascular diseases, and increased mortality rates. It emphasizes the need for dietary guidelines to recommend a reduction in UPF intake due to its adverse health effects [2][3][12]. Group 1: Research Findings - A recent study published in Nature Medicine indicates that consuming UPF can hinder weight loss efforts, even when adhering to national dietary guidelines. In contrast, a diet based on minimally processed foods (MPF) may facilitate weight loss [3][6]. - The study involved 55 adults following UK dietary guidelines, where participants consumed UPF for 8 weeks and MPF for another 8 weeks. Results showed an average weight loss of 0.88 kg during the UPF phase compared to 1.84 kg during the MPF phase [11][12]. - The research found that while both diets led to weight loss, the MPF diet resulted in significant improvements in cardiovascular health indicators, such as total fat, body fat percentage, visceral fat, and triglycerides, which were not observed during the UPF diet [11][12]. Group 2: Implications of Food Processing - The study suggests that the degree of food processing affects weight management and cardiometabolic health, indicating that even healthy dietary guidelines may not mitigate the negative impacts of UPF [12][14]. - The mechanisms behind the weight changes between UPF and MPF diets remain unclear, but factors such as texture, structure, and the presence of additives in UPF may lead to increased calorie intake and delayed satiety [14]. - The research underscores the importance of considering food processing as a unique dimension of dietary quality, suggesting that policies focusing solely on reformulating processed foods to meet nutritional standards may overlook the behavioral and physiological impacts of food processing methods [14][15].

Core Viewpoint - The article emphasizes the importance of meal timing in weight loss, suggesting that a higher caloric intake at breakfast may lead to better appetite control and easier adherence to weight loss plans, despite similar weight loss results compared to a higher caloric intake at dinner [6][11][12]. Summary by Sections - **Study Overview**: A recent study published in *Cell Metabolism* involved 30 overweight or obese volunteers who followed two different meal timing plans for four weeks: one with a higher caloric intake at breakfast and the other with a higher intake at dinner [6][7]. - **Weight Loss Results**: Both dietary approaches resulted in an average weight loss of approximately 3.3 kg, indicating that the timing of caloric intake did not significantly affect weight loss outcomes [11]. - **Appetite Control**: Participants who consumed more calories at breakfast reported lower daily hunger levels and better appetite control, suggesting that a substantial breakfast may help mitigate feelings of hunger throughout the day [11][12]. - **Physiological Mechanisms**: A larger breakfast may slow gastric emptying and increase the secretion of satiety hormones while decreasing hunger hormone levels, which can help in appetite regulation [13][14]. - **Biological Clock Alignment**: The article notes that aligning meal timing with the body's biological clock may enhance weight loss effectiveness, as humans are naturally inclined to consume more energy during the day [15].

Core Viewpoint - The long-term study of Wegovy (semaglutide) demonstrates its effectiveness in weight management and cardiovascular benefits for overweight or obese patients with cardiovascular diseases, showing an average weight loss of approximately 10% over four years with sustained results for 65 weeks without rebound [2][6][13]. Study Design - The SELECT trial, the longest clinical trial to date, involved 17,604 participants from 41 countries, assessing the impact of Wegovy versus placebo over four years [5][9]. - The primary endpoint was the time to the first occurrence of major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke [10]. Efficacy of Wegovy - Results indicated that 67.8% of participants in the Wegovy group lost 5% or more of their body weight, compared to 21.3% in the placebo group. The percentages for losing 10%, 15%, 20%, and 25% were 44.2%, 22.9%, 11%, and 4.9% respectively, versus 6.9%, 1.7%, 0.6%, and 0.1% in the placebo group [11]. - After 104 weeks, approximately 52.4% of Wegovy patients showed improvement in BMI, while only 15.7% in the placebo group did [11]. Weight Loss and Measurements - The average weight loss in the Wegovy group was 10.2%, with a waist circumference reduction of 7.7 cm, compared to a 1.5% weight loss and 1.3 cm reduction in the placebo group [13]. - The waist-to-height ratio decreased by 6.9% in the Wegovy group, while the placebo group saw a decrease of 1.0% [13]. Side Effects - 16.6% of patients in the Wegovy group discontinued due to adverse events, compared to 8.2% in the placebo group. Serious adverse events were reported by approximately 33.4% in the Wegovy group and 36.4% in the placebo group [14]. - The study found a lower association of serious adverse events with Wegovy, particularly those related to cardiovascular diseases or infections [14]. Future Research - The SELECT Life trial will follow participants from the SELECT trial to gather long-term data on the effects of Wegovy [16].

Core Viewpoint - Weight loss is often confused with fat loss, but they are fundamentally different. Weight loss refers to the overall decrease in body weight, including fat, muscle, and water, while fat loss focuses specifically on reducing fat content and lowering body fat percentage, which is a more scientific and healthier approach to weight management [2][4]. Group 1: Understanding Body Composition - Body composition can be divided into "lean body mass" and "total fat mass." Standard scales only show total weight changes and do not reflect fat loss. Generally, male body fat percentage should be maintained between 15%-18%, while for females, it should be between 25%-28% [4]. - For individuals with a higher initial weight, the priority should be weight loss, while those with a lower initial weight should focus on fat loss [4]. Group 2: Scientific Weight Loss Strategies - Effective fat loss requires a comprehensive lifestyle intervention, including a balanced diet, appropriate exercise, sufficient sleep, and a positive mindset. The "20 Guidelines for Weight Management" from the Chinese residents' health initiative emphasizes the importance of lifestyle changes [4]. - The "2024 Adult Obesity Dietary Guidelines" from the National Health Commission provides detailed dietary guidance, highlighting the importance of controlling total energy intake and optimizing dietary structure [4]. Group 3: Dietary Recommendations - Avoiding extreme dieting is crucial, as it may lead to muscle loss rather than fat loss. Muscle is essential for maintaining metabolic rate, and its reduction can hinder fat metabolism [6]. - The recommended daily caloric intake for men is between 1750-1950 kcal, but should not fall below 1200 kcal. A "small meals frequently" approach is suggested to prevent binge eating due to hunger [6]. - A balanced diet should primarily consist of grains, vegetables, fruits, and lean proteins while reducing oil, salt, and sugar intake. The Mediterranean diet is highlighted as beneficial for health and weight management [8][10]. Group 4: Specific Dietary Patterns - The Jiangnan diet, representative of the health dietary pattern in China, emphasizes a variety of ingredients, high vegetable and fruit intake, and lower consumption of red meat, which may help control weight and reduce chronic disease risk [10]. - Dairy products are recommended for their high-quality protein and calcium content, with a daily intake of 300-500g of liquid milk or equivalent dairy products suggested [11]. Group 5: Short-term Weight Loss Techniques - Adjusting the macronutrient ratio (low carb, low fat, high protein) can lead to short-term weight loss, but long-term effects are not well-supported. Intermittent fasting shows some weight loss benefits but lacks long-term evidence [12][14]. - The ketogenic diet, characterized by very low carbohydrate intake, can improve weight management but should be followed under professional guidance due to safety concerns [13]. Group 6: Behavioral Changes - Eating speed is linked to obesity, and reducing eating speed can help with weight loss by decreasing caloric intake and increasing satiety hormones. It is recommended that adults take more than 20 minutes per meal [15]. - Skipping breakfast and late-night eating are associated with increased obesity risk. Eating breakfast helps maintain stable blood sugar levels and reduces hunger later in the day [14]. Group 7: GLP-1 Medications - The approval of semaglutide (Nuoheying) for long-term weight management in China marks a significant development. This GLP-1 receptor agonist can achieve an average weight reduction of 17% (approximately 16.8 kg) and offers multiple health benefits beyond weight loss [17][18].