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政策进步的机遇:学校在最小化、减轻或延续基于体重的污名化方面的作用。

Opportunities for Policy Progress: The Role of Schools in Minimizing, Mitigating, or Perpetuating Weight-Based Stigma.

作者信息

Turner Samantha, D'Arpino Emma

机构信息

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA.

出版信息

J Sch Health. 2025 Jul;95(7):560-565. doi: 10.1111/josh.70034. Epub 2025 Jun 4.

DOI:10.1111/josh.70034
PMID:40468557
Abstract

Weight stigma profoundly impacts the mental, emotional, and physical well-being of children and adolescents in larger bodies. As pivotal social environments, schools may unintentionally reinforce weight stigma via policies and practices. This paper examines three key policy strategies to mitigate weight stigma in school settings: adopting weight-neutral approaches in nutrition and physical education, implementing equitable screening and referral for eating disorders, and de-implementing body mass index (BMI) screenings. A review of existing evidence highlights the potential of these strategies to reduce stigma, promote inclusive health practices, and improve student outcomes. Weight-neutral education can minimize biases in health curricula and foster healthier perceptions of body image. Universal screening for eating disorders addresses diagnostic disparities, particularly for youth in larger bodies, who are often overlooked despite significant health risks. Removal of BMI screenings emerges as the most impactful and feasible approach, given its association with increased body dissatisfaction and limited efficacy in improving health outcomes. By implementing these evidence-based practices, schools can foster an equitable and supportive environment for all students, emphasizing holistic health over weight-centric metrics. As trusted institutions, schools have the unique capacity to lead systemic efforts to combat weight stigma and promote inclusivity across broader societal contexts.

摘要

体重歧视对体型较大的儿童和青少年的心理、情感和身体健康有着深远影响。作为关键的社会环境,学校可能会通过政策和做法无意中强化体重歧视。本文探讨了减轻学校环境中体重歧视的三项关键政策策略:在营养和体育教育中采用体重中立的方法、对饮食失调进行公平的筛查和转诊,以及取消体重指数(BMI)筛查。对现有证据的回顾凸显了这些策略在减少歧视、促进包容性健康做法以及改善学生成果方面的潜力。体重中立的教育可以最大限度地减少健康课程中的偏见,并培养对身体形象更健康的认知。对饮食失调进行普遍筛查可以解决诊断差异问题,尤其是对于体型较大的青少年,尽管他们面临重大健康风险,但往往被忽视。鉴于BMI筛查与身体不满情绪增加以及改善健康结果的效果有限相关,取消BMI筛查成为最具影响力和可行性的方法。通过实施这些基于证据的做法,学校可以为所有学生营造一个公平且支持性的环境,强调整体健康而非以体重为中心的指标。作为受信任的机构,学校有独特的能力引领系统性努力,以对抗体重歧视并在更广泛的社会背景下促进包容性。

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