Birch Edwin, Downs James, Ayton Agnes
Oxford Health NHS Foundation Trust, Oxford, OX4 4XN, UK.
Expert by Experience and Independent Researcher, Oxford, UK.
J Eat Disord. 2024 Sep 12;12(1):140. doi: 10.1186/s40337-024-01063-3.
Questions remain about the best approaches to treatment for the subset of patients with severe and long-standing Anorexia Nervosa, commonly described in the literature as "Severe and Enduring Anorexia Nervosa." When discussing the optimal strategies and goals for treating this group, there is uncertainty over whether to focus on refining current treatment methods or exploring alternative approaches. One such alternative is "harm reduction," which has generated a wave of positive interest from patients and clinicians alike because of its emphasis on individual autonomy, personal goals and quality of life. While harm reduction can provide an attractive alternative to seemingly endless cycles of ineffective treatment, this narrative review builds on previous work to highlight the inadequate terminology and possible dangers of considering harm reduction as the endpoint of treatment. In conjunction with perspectives from a lived experience author, we consider wider contextual and ethical issues in the field of eating disorders, which should inform the role of harm-reduction approaches in this patient group.
对于患有严重且长期神经性厌食症的患者亚组（在文献中通常被描述为“严重且持久的神经性厌食症”），最佳治疗方法仍存在疑问。在讨论治疗该群体的最佳策略和目标时，对于是专注于改进现有治疗方法还是探索替代方法存在不确定性。一种这样的替代方法是“减少伤害”，由于其强调个人自主性、个人目标和生活质量，它在患者和临床医生中都引起了一波积极关注。虽然减少伤害可以为看似无休止的无效治疗循环提供一个有吸引力的替代方案，但这篇叙述性综述基于先前的工作，强调了将减少伤害视为治疗终点时术语的不足和可能的危险。结合一位有实际经历的作者的观点，我们考虑了饮食失调领域更广泛的背景和伦理问题，这些问题应该为减少伤害方法在该患者群体中的作用提供参考。
