Rachel Kramer, Catherine R Drury, Sarah Forsberg, Lindsey D Bruett, Erin E Reilly, Sasha Gorrell, Simar Singh, Lisa Hail, Kimberly Yu, Rachel M Radin, Jessica Keyser, Daniel Le Grange, Erin C Accurso, Kathryn M Huryk
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引用次数: 0
Abstract
Weight-centric health practices are based on the principle that excess weight predicts chronic disease, informing a growing sociopolitical movement to address an "obesity epidemic." This hyper-focus on preventing obesity may contribute to weight stigma (i.e., the devaluation and discrimination of individuals based on body size) and other iatrogenic outcomes for youth, including the development and maintenance of eating disorders (EDs). Current evidence-based treatments for EDs include language and practices that may reinforce fears of fatness, body shame, and unhealthy dietary restriction without guidance on addressing weight stigma. Here, we present case examples from three adolescent patients across ED presentations and body sizes to (1) elucidate the role of weight stigma in ED development, (2) highlight the ubiquity and harms of weight stigma within ED treatments, and (3) outline thoughtful protocol adaptations to avoid further harm and facilitate recovery. We conclude with a call for immediate action to advance research characterizing the harms of weight-centric approaches in existing ED interventions to reduce the risk of iatrogenic effects on youth with EDs and advance weight-inclusive approaches to ED treatment.
以体重为中心的健康实践所依据的原则是,体重过重会导致慢性疾病,这为日益壮大的应对 "肥胖流行病 "的社会政治运动提供了依据。这种对预防肥胖的过度关注可能会导致体重污名化(即基于体型对个人的贬低和歧视)和其他青少年人为后果,包括饮食失调(ED)的发展和维持。目前针对进食障碍的循证治疗方法包括一些语言和做法,这些语言和做法可能会强化对肥胖的恐惧、身体羞耻感和不健康的饮食限制,而没有解决体重污名化问题的指导。在此,我们列举了三位青少年患者的病例,这些患者有不同的 ED 表现和体型,目的是:(1)阐明体重鄙视在 ED 发展中的作用;(2)强调体重鄙视在 ED 治疗中的普遍性和危害;(3)概述周到的方案调整,以避免进一步伤害并促进康复。最后,我们呼吁立即行动起来,推进研究,确定现有 ED 干预措施中以体重为中心的方法的危害,以降低对患有 ED 的青少年造成先天性影响的风险,并推进 ED 治疗中的体重包容性方法。