Andrea Bombak is with the University of Manitoba, Winnipeg.
Am J Public Health. 2014 Feb;104(2):e60-7. doi: 10.2105/AJPH.2013.301486. Epub 2013 Dec 12.
Obesity is associated with chronic diseases that may negatively affect individuals' health and the sustainability of the health care system. Despite increasing emphasis on obesity as a major health care issue, little progress has been made in its treatment or prevention. Individual approaches to obesity treatment, largely composed of weight-loss dieting, have not proven effective. Little direct evidence supports the notion of reforms to the "obesogenic environment." Both these individualistic and environmental approaches to obesity have important limitations and ethical implications. The low levels of success associated with these approaches may necessitate a new non-weight-centric public health strategy. Evidence is accumulating that a weight-neutral, nutrition- and physical activity-based, Health at Every Size (HAES) approach may be a promising chronic disease-prevention strategy.
肥胖与慢性病有关，可能会对个人健康和医疗保健系统的可持续性产生负面影响。尽管人们越来越重视肥胖是一个主要的健康问题，但在治疗或预防方面几乎没有取得进展。以减肥饮食为主的个体肥胖治疗方法并没有被证明是有效的。很少有直接的证据支持对“肥胖环境”进行改革的观点。这些针对肥胖的个体主义和环境方法都有重要的局限性和伦理影响。这些方法成功率低，可能需要制定一种新的非体重为中心的公共卫生策略。越来越多的证据表明，一种无体重偏见、基于营养和身体活动的健康体型（Health at Every Size，HAES）方法可能是一种有前途的慢性病预防策略。
