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暴食障碍是一个社会公正问题:一项关于暴食障碍专家意见的横断面混合方法研究。

Binge Eating Disorder Is a Social Justice Issue: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts' Opinions.

机构信息

Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA.

Wilder Research Division, Amherst H. Wilder Foundation, Saint Paul, MN 55104, USA.

出版信息

Int J Environ Res Public Health. 2022 May 20;19(10):6243. doi: 10.3390/ijerph19106243.

Abstract

BACKGROUND

Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology.

METHODS

Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification.

RESULTS

Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%).

CONCLUSIONS

Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it.

摘要

背景

暴食障碍是 DSM-V 中的一种自主诊断,其特征为在没有补偿的情况下,频繁、迅速地摄入大量客观食物,同时伴有失控感和苦恼。促成暴食障碍的环境因素仍在不断演变。本混合方法横断面研究评估了该领域的专家是否就影响成人暴食障碍病理的环境因素达成共识。

方法

根据联邦资助、PubMed 索引出版物、该领域的活跃实践、相关学会的领导地位以及/或临床和大众媒体的区分,在国际上确定了 14 名暴食障碍专家研究人员、临床医生和医疗保健管理人员。半结构式访谈以匿名方式记录,并由≥2 名调查员使用反思性主题分析和量化进行分析。

结果

确定的主题包括:(1)系统性问题和压迫制度(100%);(2)边缘化和代表性不足的人群(100%);(3)经济不稳定和食物/营养不安全/匮乏(93%);(4)污名化及其心理影响(93%);(5)创伤和逆境(79%);(6)人际因素(64%);(7)社会信息和社交媒体(50%);(8)掠夺性食品行业做法(29%);(9)研究/临床差距和指示(100%)。

结论

总体而言,专家呼吁围绕助长暴食的系统性因素进行政策改革,并加强公众对谁可能患有暴食障碍的教育。专家还呼吁考虑到有暴食障碍患者的叙述和生活经历,以更好地了解我们目前对诊断的理解以及影响其发展的环境因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/021d/9141064/41f82656fd7a/ijerph-19-06243-g001.jpg

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