要向儿童期肥胖宣战,需向责备宣战
The War on Childhood Obesity Needs a War on Blame
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2019-12-01 20:22
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火星译客

We need to communicate to kids that their health, not a number on the scale, is what’s important

我们需要向孩子们传达,天平上的数字不重要,健康才重要。

The War on Childhood Obesity Needs a War on Blame

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According to a new report recently released by the World Obesity Federation, obesity will affect more than 250 million kids by 2030. While media outlets and newsfeeds continuously remind us of the rising rates of childhood obesity—which have tripled in the past 20 years—far less attention has been paid to the complex solutions needed to address this problem.

世界肥胖联盟最近发布报道称,到2030年,肥胖问题将影响超过2.5亿儿童。当媒体和新闻不断地提醒我们儿童肥胖率在持续上升的时候——已达过去20年的3倍——却很少有人关注解决这一问题的复杂方案。

It seems the obvious answer to the rising prevalence of childhood obesity would be to reduce calorie intake and increase physical activity. If calories out exceed calories in then weight loss is inevitable, right? Unfortunately, it’s not that easy. And the hundreds of campaigns and interventions attempting to tackle childhood obesity are a testament of that. Take, for example, the large-scale WAVES study, which after a 12-month intervention across 54 schools, showed no differences between intervention and control schools in terms of improvements in students’ body mass index (BMI). School-based interventions may have little impact on obesity without broader societal and environmental efforts in place.

貌似解决越发流行的儿童期肥胖的答案显然是减少卡路里摄入和增加体育运动。要是卡路里入不敷出,体重一定就会降下来了,对吧?不幸的是,没那么简单。而且数以百计试图对付儿童期肥胖的运动和干预措施无不是这一点的明证。例如,拿妇女紧急志愿服务组织(WAVES)一项大规模的研究来说,遍及54所学校为期12个月的干预措施显示,学生在体质指数(BMI)的提高方面和(对照实验的)控制组学校相比并没有什么差别。没有更广泛的社会及环境的到位努力,单基于学校的干预可能对肥胖问题的效果很小。

Initiatives to address childhood obesity may be further compromised by a lack of consideration to the underlying messages they send to children and families. Many approaches targeting obesity are based on the assumption that body weight is within personal control and that individuals have the ability to change their weight. We assume that change won’t occur unless individuals believe they have the power to change. For example, in schools, promoting beliefs about the controllability of intelligence have been shown to increase academic effort. And in the case of emotions, controllability has been associated with more positive emotion regulation.

对他们向孩子们和各家庭传达的潜在信息欠缺考虑,也可能会导致人家解决儿童期肥胖问题的积极性进一步退化。很多针对肥胖问题的方法都基于这样的假定:体重处于人为控制之下,个体有能力改变其体重。我们假定,除非个体相信自己有能力改变,否则那一改变就不会发生。例如,在学校里,弘扬有关智力的可控性的信念已被用于提高学术成绩。在情绪方面,其可控性也已被与更积极的情绪调节关联了起来。

Body weight, however, is another story.

然而,体重却是另一回事。

Instead of encouraging a mindset motivated to change, messages that perpetuate beliefs that obesity is within personal control can instead increase societal stigma and self-blame. Beyond blatant fat-shaming and pervasive negative portrayals of individuals with larger bodies in the media, seemingly innocuous messages can produce potent stigma. The Late Late Show host, James Cordon, recently described the harmful effects of fat shaming, and how a judgmental gaze intended to restrain eating would be enough to evoke feelings of shame and self-loathing.

较之鼓舞人家积极去改变的心态,那些固化肥胖在人为控制之下的信念的信息反而会增加社会羞耻感和自责。在媒体公然羞辱肥胖和到处张贴肥胖个体的反面画像之后,貌似无伤大雅的信息都可以造成巨大的羞耻感。《深夜秀》的主持人詹姆斯·柯登最近描述了肥胖羞辱的有害后果,以及一个意图抑制你进食的审视是怎样足以唤起你的羞耻感和自我厌弃。

By emphasizing behavioral control as a method of weight loss, we are simultaneously (and at times unintentionally) placing blame on individuals who struggle to lose weight. This blame becomes internalized, surfacing as a cascade of emotional, physiological and behavioral problems that can undermine physical and psychological health.

在将行为性控制作为减肥的方法加以强调的同时(而且有时候也是无意的),我们也将责备施加给了那些努力减肥的个体。这些责备内化之后,表现出来的是一系列情绪上、生理上和行为上的问题,并危害人的身心健康。

This fact is particularly worrisome given that youth of all body shapes and sizes are vulnerable to weight stigma. Over and above BMI, weight stigma is linked with low self-esteembody dissatisfaction, sui/cide ideation, low physical activity levels and depressive symptoms among adolescents. When youth are stigmatized, shamed or teased about their weight, they are more likely to engage in unhealthy eating behaviors, such as binge eating or high calorie consumption, avoid physical activity and gain weight—contributing to a vicious cycle of psychological distress, social withdrawal, unhealthy behaviors and weight gain.

在那些体型和身体尺寸容易受到体重羞辱的攻击的青少年身上,这一事实尤其令人担忧。除了体质指数(BMI)之外,体重羞辱还关系到青少年群体的低自尊感、形体不满、自杀意念、低身体活动水平以及抑郁症状。当青少年因为体重被污蔑、羞辱和嘲笑的时候,他们很可能会陷于不健康的饮食行为,比如暴饮暴食或者高卡路里的消费,并逃避体育运动以至体重增加——导致心理压力、社交退缩、不健康行为和体重增加的恶性循环。

So, it’s time to take a step back and look carefully at the messages being communicated in interventions to address childhood obesity. Fundamentally, messages should emphasize health and health behaviors, rather than body weight. We need to communicate to children that their health, not a number on the scale, is important.

因此,是时候退一步仔细审视化解儿童期肥胖的干预措施所传达的信息了。根本上,其中的信息应该强调的是健康和健康的行为,而不是体重。我们需要向孩子们传达,天平上的数字不重要,健康才重要。

Reducing blame starts with raising awareness of the complex factors that contribute to body weight and the harmful consequences of weight stigma— in the media, the classroom, on the field, and at home. In addition to education, policies are needed to appropriately address weight-based mistreatment, such as school-based anti-bullying policies that adequately protect students in the face of weight-based bullying. And, finally, just as diversity surrounding other social stigmas, like those based on race/ethnicity or disability status, has proven effective in reducing stigma, increasing exposure to diverse bodies in positive ways will be critical to disrupting the harmful cycle of stigma.

减少责备从提高对导致体重的复杂因素和体重羞辱的有害后果的认识开始做起——在媒体上、在教室里、在操场上以及在家里。除了教育,也需要有政策到位地解决基于体重的虐待,比如学生面临出于体重的欺凌时,学校里要有能充分保护学生的反欺凌政策。最后,正如周遭其他各种各样的社会羞辱,比如基于种族划分或残疾状况的羞辱,都已经证明了减少羞辱是可以行之有效的。通过积极正面的方式提高各种形体的曝光率,对于瓦解有害的羞辱循环将是至关重要的。

While the issue of childhood obesity is complex public health priority, we must be certain that the messages we send serve to empower and support healthy behaviors among youth irrespective of body weight itself.

当儿童期肥胖问题成了一个复杂的公共健康优先事项时,我们必须确定,我们传递给青少年以授意和支持健康行为的信息无关体重本身。

The views expressed are those of the author(s) and are not necessarily those of Scientific American.

上述观点仅代表作者(们)本人,不代表《科学的美国人》的观点。

ABOUT THE AUTHOR(S)

关于作者(们)

Leah Lessard

莉娅·莱萨德

Leah Lessard, PhD, is a postdoctoral research fellow at the University of Connecticut Rudd Center for Food Policy and Obesity. Her work has called attention to the impact of weight stigma on emotional and physical health during middle and high school.

莉娅·莱萨德,博士学位,康涅狄格大学路德食品政策与肥胖中心的博士后研究员。她的工作已唤起人们对于体重羞辱对初中生和高中生的情绪健康及身体健康的影响的关注。

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