Recently, the National Health and Wellness Commission issued the Guidelines for the Diagnosis and Treatment of Obesity (2024 Edition) (hereinafter referred to as the Guidelines). The Guide emphasizes evidence-based medicine and multidisciplinary cooperation, and gives detailed guidance and norms in the fields of obesity clinical nutrition, drug treatment, surgical treatment, behavioral psychological intervention, exercise intervention, etc., and sorts out and standardizes the multidisciplinary diagnosis and treatment plan and path of obesity.
The Guide points out that obesity has become a major public health problem in China. The prevalence rate of obesity in adults is 16.4%. Among children and adolescents aged 6 to 17, the overweight rate and obesity rate are 11.1% and 7.9% respectively. The prevalence of overweight and obesity in children under 6 years old was 6.8% and 3.6% respectively. The global disease burden study in 2019 showed that the proportion of deaths caused by overweight and obesity among all-cause deaths increased from 2.8% in 1990 to 7.2% in 2019.
The Guide clarifies that the diagnostic criteria for obesity include four categories: body mass index, body shape characteristics, body fat ratio and obesity diagnostic criteria for children and adolescents. Among them, in China’s adult population, obesity is defined as BMI reaching or exceeding 28kg/㎡ (weight divided by the square of height). The weight loss goal of obesity should be set in layers, and the degree of obesity and the risk of obesity-related diseases should be considered comprehensively. For most patients with overweight and mild obesity, it can be set to reduce their weight by at least 5% to 15% within 3 to 6 months and maintain it; Higher weight loss goals can be set for moderate and severe obesity patients.
At the same time, the experts of the Guide Committee stressed that most overweight and obesity are caused by unhealthy lifestyles, and the fundamental solution is to adhere to a healthy lifestyle, including keeping weight within a healthy range through reasonable diet and appropriate exercise. No matter what method is adopted in the clinical treatment of obesity, the treatment basis is the change of patients’ behavior, and the prevention and treatment effect will be maximized by actively exerting their subjective initiative.
Active exercise is an important measure of exercise intervention for obesity. For obese patients, the exercise intervention program should be based on the principle of paying attention to patients’ safety. On the basis of exercise risk assessment (including mechanical injury risk and exercise-induced disease risk), individualized exercise prescriptions should be formulated according to patients’ BMI, physical fitness, basic diseases and obesity-related diseases, including exercise frequency, intensity, mode, time, total amount and exercise progress during weight loss. Follow-up exercise implementation and dynamic evaluation should be carried out, and the total amount of exercise should be gradually increased according to the improvement of cardiopulmonary function and health status. Strength training and self-weight resistance training are recommended to enhance physical stability, ensure the safety of various dynamic training and reduce the risk of injury. During weight loss, adults should do aerobic endurance exercise for 150 to 420 minutes every week; In the weight maintenance stage, aerobic endurance exercise should be carried out for 200 to 300 minutes every week, while static and dynamic stretching should be carried out to enhance the flexibility of the body. (From November 6th, China Sports Daily, 06 edition)
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