We propose a weight-neutral strategy for obesity treatment on the following grounds: (1) the mortality risk associated with obesity is largely attenuated or eliminated by moderate-to-high levels of cardiorespiratory fitness (CRF) or physical activity (PA), (2) most cardiometabolic risk markers associated with obesity can be improved with exercise training independent of weight loss and by a magnitude similar to that observed with weight-loss programs, (3) weight loss, even if intentional, is not consistently associated with lower mortality risk, (4) increases in CRF or PA are consistently associated with greater reductions in mortality risk than is intentional weight loss, and (5) weight cycling is associated with numerous adverse health outcomes including increased mortality. Adherence to PA may improve if health care professionals consider PA and CRF as essential vital signs and consistently emphasize to their patients the myriad benefits of PA and CRF in the absence of weight loss.

我们基于以下理由提出体重中性的肥胖治疗策略：（1）与肥胖相关的死亡风险可以通过中到高水平的心肺健康（CRF）或体力活动（PA）在很大程度上减弱或消除，（ 2) 大多数与肥胖相关的心脏代谢风险标志物都可以通过独立于体重减轻的运动训练得到改善，其程度与减肥计划中观察到的相似，(3) 体重减轻，即使是有意的，也并不总是与较低的死亡率相关风险，(4) CRF 或 PA 的增加始终与比有意减肥更大的死亡风险降低相关，(5) 体重循环与许多不良健康结果相关，包括死亡率增加。如果医疗保健专业人员将 PA 和 CRF 视为重要的生命体征，并持续向患者强调 PA 和 CRF 在体重不减轻的情况下的诸多益处，那么 PA 的依从性可能会提高。