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别再简化了:“少吃多动”:我们在儿科超重治疗方面处于什么阶段?

Enough with simplifying: "eat less and move more": at what point are we with the treatment of excess weight in paediatrics?

机构信息

Pediatric Department, Ferrara, Italy.

, Via Fornace 17, Ferrara, 44123, Italy.

出版信息

Ital J Pediatr. 2024 May 23;50(1):105. doi: 10.1186/s13052-024-01676-z.

Abstract

BACKGROUND

For years politics and healthcare, faced with the progressive increase in the prevalence of overweight and obesity in childhood, have wondered how to stem it and reduce its consequences on health without finding a valid, effective and applicable solution. Many studies have been written initially on what to prescribe, then on why not to prescribe and how to approach people in a new and more effective way to improve their behaviors, considered the main cause of excess weight. Over the last twenty years it has been highlighted that no diet or physical exercise is truly effective and not even global changes in lifestyle guarantee the large weight reductions traditionally expected, despite offering significant health advantages. A new approach is necessary and we must begin by working on ourselves.

MAIN BODY

We examined literature on weight stigma and considered expert opinions, as well as feedback from parents/caregivers and patients. Literature on stigma has grown enormously in recent years, and finally considers the opinion of parents and patients. By interviewing patients with obesity, it was discovered that very often healthcare workers do not communicate the diagnosis and, if they do, they have a blaming attitude, holding patients responsible for their weight. Furthermore, when these people become aware of their obesity and seek treatment, they do not find adequate professionals and centers. Failure was mostly due to the enormous burden of obesity stigma and discrimination which, especially in children and young people, encourages internalization of the problem and takes away their self-efficacy, desire and ability to take care of themselves.

CONCLUSIONS

New actions are needed to change all this. We propose "Training, Networking and Contrasting Weight Stigma". Now that we've figured out where to start, we should get going. And yet, nothing is changing!

摘要

背景

多年来,政治和医疗保健部门一直在思考如何遏制儿童超重和肥胖问题的日益严重,并减少其对健康的影响,但一直未能找到有效、可行的解决方案。最初,许多研究都集中在应该开什么处方,然后是为什么不开处方,以及如何以新的、更有效的方式接近人们,以改善他们被认为是体重超标的主要行为。在过去的二十年中,人们已经认识到,没有哪种饮食或运动方案是真正有效的,即使是全球生活方式的改变也不能保证传统上所期望的大量体重减轻,尽管这会带来显著的健康益处。我们需要一种新的方法,必须从自我做起。

主要内容

我们研究了体重歧视方面的文献,并考虑了专家意见,以及来自家长/照顾者和患者的反馈。近年来,关于耻辱的文献大量增加,最终考虑了家长和患者的意见。通过采访肥胖患者,我们发现医护人员经常不传达诊断结果,即使传达了,也带有指责的态度,将患者的体重问题归咎于他们。此外,当这些人意识到自己肥胖并寻求治疗时,他们发现没有足够的专业人员和中心。失败主要是由于肥胖耻辱和歧视的巨大负担,这种耻辱和歧视尤其在儿童和年轻人中,会鼓励他们内化问题,并剥夺他们的自我效能、照顾自己的愿望和能力。

结论

需要采取新的行动来改变这一切。我们提出“培训、网络和对比体重歧视”。既然我们已经知道从哪里开始,我们就应该行动起来。然而,什么都没有改变!

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本文引用的文献

1
Weight stigma and bias: A guide for pediatric clinicians.
Obes Pillars. 2023 Mar 20;6:100058. doi: 10.1016/j.obpill.2023.100058. eCollection 2023 Jun.
2
Mechanisms of Stigmatization in Family-Based Prevention and Treatment of Childhood Overweight and Obesity.
Children (Basel). 2023 Sep 23;10(10):1590. doi: 10.3390/children10101590.
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Pediatr Obes. 2023 Jun;18(6):e13027. doi: 10.1111/ijpo.13027. Epub 2023 Apr 2.

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