小结
定义
病史和体格检查
关键诊断因素
- 身高
- 体重
其他诊断因素
- 腰围
- 合并症
危险因素
- 甲状腺功能减退
- 皮质醇增多症
- 年龄≥40岁
- 围绝经期
- 妊娠前
- 已婚
- 睡眠减少
- 吸烟史
- 缺少正规教育
- 宫内营养不良
- 低等社会经济状况
- 久坐不动的生活方式
- 每日超过2-3小时看电视和玩电子游戏
- 高糖饮食、高胆固醇、高脂饮食和快餐
- 过量饮酒(>2杯/天)
- 暴食症
- 夜食综合征
- 瘦素缺乏
- 皮质类固醇疗法
- 抗抑郁药物治疗
- 抗精神病治疗
- Beta受体阻滞剂治疗
- 乳腺癌的辅助治疗
- 诊断精神病
诊断性检查
首要检查
- 临床检查
需考虑的检查
- 全血细胞计数 (FBC)
- 血清氨基转移酶
- 甲状腺功能检测
- 心电图 (ECG)
- 腹部超声扫描
- 多导睡眠监测
治疗流程
BMI ≥30 kg/m²;或 BMI ≥27 kg/m² 合并肥胖相关合并症
对于 BMI ≥40 kg/m²;或 BMI ≥ 35kg/m² 伴有严重合并症,通过饮食控制减重无效
撰稿人
作者
Constantine T. Frantzides, MD, PhD, FACS

Director, Chicago Institute of Minimally Invasive Surgery (CIMIS)
Director, Laparoscopic and Bariatric Fellowship Program
Clinical Professor of Surgery, University of Illinois
Chicago
IL
利益声明
CTF declares that he has no competing interests.
Mark A. Carlson, MD, FACS

Professor, Department of Surgery
Professor, Department of Genetics, Cell Biology and Anatomy (courtesy)
Director, Center for Advanced Surgical Technology (CAST)
University of Nebraska Medical Center
Staff Physician, Surgery Department
Omaha VA Medical Center
Omaha
NE
利益声明
MAC declares that he has no competing interests.
Kelsey R. Tieken, MD

General Surgery Resident
University of Nebraska Medical Center
Omaha
NE
利益声明
KRT declares that she has no competing interests.
鸣谢
Dr Constantine T. Frantzides, Dr Mark A. Carlson, and Dr Kelsey R. Tieken would like to gratefully acknowledge Dr Minh B. Luu and Dr Scott N. Welle, previous contributors to this topic.
利益声明
MBL and SNW declare that they have no competing interests.
同行评议者
Carel Le Roux, MRCP, PhD, FRCPath
Consultant in Metabolic Medicine
Imperial College London
Charing Cross Hospital
London
UK
利益声明
CLR declares that he has no competing interests.
Arya M. Sharma, MD, PhD, FRCPC
Professor of Medicine
Chair for Obesity Research & Management
University of Alberta
Royal Alexandra Hospital
Edmonton
Canada
利益声明
AMS declares that he has no competing interests.
Edward H. Livingston, MD, FACS
Chair in Surgery
Division of Gastrointestinal and Endocrine Surgery
University of Texas
Southwestern Medical Center
Dallas
TX
利益声明
EHL declares that he has no competing interests.
鉴别诊断
- 甲状腺功能减退,原发性
- 甲状腺机能减退,中枢性
- 库欣综合征
更多 鉴别诊断指南
- ASMBS 关于在代谢和减重手术前后实施上消化道内镜检查理由的立场声明
- AGA 关于使用胃内球囊术治疗肥胖的临床实践指南
更多 指南患者教育信息
肥胖 - 饮食和运动
肥胖 - 药物和手术
更多 患者教育信息医学计算器
体重指数(BMI,又称克托莱指数)
更多 医学计算器登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
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