Nutritional priorities to support GLP ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society

作者：Dariush Mozaffarian, Monica Agarwal, Monica Aggarwal, Lydia Alexander, Caroline M. Apovian, Shagun Bindlish, Jonathan P. Bonnet, W. Scott Butsch, Sandra Christensen, Eugenia Gianos, Mahima Gulati, Alka Gupta, Debbie Horn, Ryan M. Kane, Jasdeep Saluja, Deepa Sannidhi, Fatima Cody Stanford, Emily A. Callahan · 发表于：Obesity · 年份：2025 · DOI：10.1002/oby.24336 · 被引用次数：106 · 研究领域：Diabetes Treatment and Management、Bariatric Surgery and Outcomes、Pharmacology and Obesity Treatment

BACKGROUND: Glucagon-like peptide 1 receptor agonists and combination medications (hereafter collectively referred to as GLP-1s) are shifting the treatment landscape for obesity. However, real-world challenges and limited clinician and public knowledge on nutritional and lifestyle interventions can limit GLP-1 efficacy, equitable results, and cost-effectiveness. OBJECTIVES: We aimed to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment of obesity for the practicing clinician. METHODS: An expert group comprising multiple clinical and research disciplines appraised the scientific literature, informed by expert knowledge and clinical experience, to identify and summarize relevant topics, priorities, and emerging directions. RESULTS: GLP-1s reduce body weight by 5% to 18% in trials, with modestly lower effects in real-world analyses, and multiple demonstrated clinical benefits. Challenges include side effects, especially gastrointestinal; nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence with subsequent weight regain; and high costs with resulting low cost-effectiveness. Numerous practice guidelines recommend multicomponent, evidence-based nutritional and behavioral therapy for adults with obesity, but use of such therapies with GLP-1s is not widespread. Priorities to address this include: (a) patient-centered initiation of GLP-1s, including goals for weight reduction and health;...