Yale School of Medicine, New Haven, Connecticut.
Yale School of Medicine, New Haven, Connecticut.
J Am Acad Child Adolesc Psychiatry. 2023 Sep;62(9):957-962. doi: 10.1016/j.jaac.2023.03.008. Epub 2023 Mar 20.
Adolescence is a critical developmental period when youth are vulnerable to messages that promote unrealistic body shapes and a culture of weight-based stigma. Adolescents' vulnerability is reflected in high prevalence of body dissatisfaction among adolescents of all genders, which can lead to negative mental health consequences including disordered eating and depression. Importantly, body concerns are compounded among adolescents with higher weights who are more likely to experience weight-based victimization and internalize weight-based stigma compared with adolescents with lower weights. Health care providers have an opportunity to advocate for well-being of adolescent patients by providing nonstigmatizing messages regarding body image, eating, and weight. While body image prevention programs emphasize the need to promote positive body image and awareness of weight-based victimization, clinical guidelines instead focus on preventing or treating conditions (ie, obesity or eating disorders). Yet, adolescents' well-being would benefit from weight-inclusive, positive body image messages. Providers can model the importance of prioritizing positive body image messages by spending time discussing body image through a positive rather than problem-focused lens. We propose an advocacy framework for health care providers to support adolescents' body image and to reduce the impact of weight bias across 4 settings: the clinic, social media, adolescents' homes, and school.
青春期是一个关键的发育阶段,年轻人容易受到宣扬不切实际的体型和体重歧视文化的信息的影响。所有性别的青少年都普遍存在身体不满,这反映了青少年的脆弱性,这可能导致不良的心理健康后果,包括饮食失调和抑郁。重要的是,体重较高的青少年的身体担忧更为复杂,与体重较低的青少年相比,他们更有可能经历基于体重的受害和内化体重歧视。医疗保健提供者有机会通过提供非歧视性的关于身体形象、饮食和体重的信息来倡导青少年患者的健康。虽然身体形象预防计划强调需要促进积极的身体形象和对基于体重的受害的认识,但临床指南则侧重于预防或治疗疾病(即肥胖或饮食失调)。然而,青少年的健康将受益于包含体重的、积极的身体形象信息。提供者可以通过积极而不是以问题为中心的视角来讨论身体形象,从而为青少年树立重视积极身体形象信息的榜样。我们提出了一个医疗保健提供者的倡导框架,以支持青少年的身体形象,并减少体重偏见在 4 个环境中的影响:诊所、社交媒体、青少年的家庭和学校。