Lister Natalie B, Baur Louise A, Paxton Susan J, Jebeile Hiba
Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia.
Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.
Curr Obes Rep. 2021 Sep;10(3):322-331. doi: 10.1007/s13679-021-00440-2. Epub 2021 May 10.
Eating disorders are complex mental health conditions that share risk factors with obesity. This review outlines the context for concerns that paediatric obesity treatment presents a risk for eating disorder development.
Most children and adolescents undergoing professionally supervised obesity treatment will have improvements or no change to eating disorder risk profiles. However, some may subsequently develop a clinical eating disorder, and this is proposed to relate to weight-focussed dietary interventions that are standard in paediatric obesity treatment. Nevertheless, dietary restraint may not be a strong predictor of eating disorder risk in the context of paediatric obesity treatment. Most international guidelines recommend weight maintenance or weight loss as a treatment goal, and weight loss is related to improvements in cardiometabolic health but not eating disorder risk in the short term. The risk of inducing or exacerbating an eating disorder during paediatric weight management is likely to be low; however, the serious consequences combined with increasing scale of obesity treatment, and lack of empirical evidence, are of concern. There is a need for further research to identify long-term predictors of eating disorder development for children and adolescents who seek treatment for their obesity.
饮食失调是复杂的心理健康状况，与肥胖症有共同的风险因素。本综述概述了对儿童肥胖治疗存在饮食失调发展风险这一担忧的背景。
大多数接受专业监督的肥胖治疗的儿童和青少年，其饮食失调风险状况会有所改善或无变化。然而，一些人随后可能会发展为临床饮食失调，这被认为与儿童肥胖治疗中标准的以体重为重点的饮食干预有关。尽管如此，在儿童肥胖治疗背景下，饮食限制可能并不是饮食失调风险的有力预测指标。大多数国际指南建议将维持体重或减轻体重作为治疗目标，短期内体重减轻与心脏代谢健康改善有关，但与饮食失调风险无关。在儿童体重管理期间诱发或加重饮食失调的风险可能较低；然而，其严重后果、肥胖治疗规模的扩大以及缺乏实证证据令人担忧。需要进一步研究，以确定寻求肥胖治疗的儿童和青少年饮食失调发展的长期预测因素。
