In light of the limited long-term success of obesity treatments, it is tempting to consider the elusive goal of ‘treatment matching’, in which characteristics of individuals are optimally matched to targeted treatments to improve success. Previous frameworks for treatment matching in obesity have primarily focused on basic physiological characteristics, such as initial degree of overweight, and on treatment intensity, such as stepped-care alternatives (self-help manuals, group support, medication and surgery). Few studies have empirically evaluated the success of these frameworks. Given recent advances in genomics, neuroscience and other fields, both the breadth of domains and combinations of individuals’ characteristics that could be used for treatment matching have increased markedly. Although the obesity field seems poised to build on these advances, a crucial challenge remains regarding the treatments themselves. Ultimately, the success of treatment matching will rely on identifying treatment intervention components with well-differentiated and empirically supported mediators, that is, clear insights into how intervention components work. Here we examine the scope of this challenge specifically for the design of efficacious psychosocial and behavioral intervention components, and identify areas for future research.

鉴于肥胖治疗的长期成功有限，人们很容易考虑“治疗匹配”这一难以捉摸的目标，其中个体的特征与靶向治疗进行最佳匹配以提高成功率。以前的肥胖治疗匹配框架主要侧重于基本生理特征，例如初始超重程度，以及治疗强度，例如阶梯式护理替代方案（自助手册、团体支持、药物和手术）。很少有研究从经验上评估这些框架的成功。鉴于基因组学、神经科学和其他领域的最新进展，可用于治疗匹配的领域的广度和个体特征的组合都显着增加。尽管肥胖领域似乎准备在这些进步的基础上发展，但治疗本身仍然存在一个关键挑战。最终，治疗匹配的成功将依赖于识别具有差异化和经验支持的介质的治疗干预组件，即对干预组件如何工作的清晰见解。在这里，我们检查了这一挑战的范围，专门用于设计有效的心理社会和行为干预组件，并确定未来研究的领域。