Why are eating disorders so hard to treat? - Anees Bahji

翻译人员: Mariam Khaled 校对人员: Lexi Ding

Globally, about 10% of people

全球大约有10%的人，

will experience an eating disorder during their lifetime.

一生中都体会过饮食失调的滋味。

And yet, eating disorders are profoundly misunderstood.

但人们对饮食失调症的误解很深。

Misconceptions about everything from symptoms to treatment,

从症状到治疗的一系列误解，

make it difficult to navigate an eating disorder

让患者本人或是支持所爱之人

or support someone you love as they do so.

克服饮食失调变成了一件难事。

So let’s walk through what is— and isn’t— true about eating disorders.

让我们一起了解一下，关于饮食失调 哪些说法是真的，哪些是假的。

First, what is an eating disorder?

首先 ，什么是饮食失调？

Eating disorders are a range of psychiatric conditions

饮食失调属于精神类疾病，

characterized by these main patterns of behavior:

主要有以下几种行为特征：

restricting food intake, bingeing, or rapidly consuming large amounts of food,

严格控制食物摄入量、 暴饮暴食，即短时间大量摄入食物、

and purging or eliminating calories

以及通过催吐、吃泻药、过度运动等

through vomiting, laxatives, excessive exercise, and other harmful means.

其他有损健康的方式来清除卡路里。

An eating disorder can involve any one or any combination of these behaviors.

饮食失调患者可能会出现 上述某种或几种行为。

For example, people living with anorexia

例如，厌食症患者

usually restrict the amount of food they eat,

常常严格控制自己摄入食物的总量。

while bulimia nervosa is an eating disorder

但暴食症也属于饮食失调症的一种，

characterized by recurrent binges and purges.

其症状为反复地暴饮暴食和催吐。

Importantly, these behaviors determine whether someone has an eating disorder.

这些行为是判断一个人 是否患有饮食失调症的重要因素。

You can’t tell whether someone has an eating disorder

不能仅从体重的轻重来判断

from their weight alone.

一个人是否患有饮食失调。

People who weigh what medical professionals might consider

医生认为体重在健康值范围内的人，

a healthy range can have eating disorders,

也可能患有饮食失调。

including severe ones that damage their long-term health in invisible ways,

严重者可能会在无形中 慢慢损害自身健康。

including osteoporosis, anemia, heart damage, and kidney damage.

导致骨质疏松、贫血、 心脏受损以及肾脏受损。

Just as we can’t tell whether someone has an eating disorder

就像我们不能单凭体重来判断

based on their weight alone,

一个人是否患有饮食失调一样，

we can’t get rid of these disorders simply by eating differently.

我们也无法简单地 通过改变饮食习惯来治疗。

That’s because eating disorders are, at their core, psychiatric illnesses.

因为饮食失调本质上是精神疾病。

From what we understand,

据我们所知，

they involve a disruption to someone’s self-perception.

这种疾病会破坏人的自我认知。

Most people who experience them are severely critical of themselves

大部分患者会严厉批判自己，

and report many self-perceived flaws.

并说出许多自以为的缺陷。

They may use eating to try to regain some control

他们试图通过饮食

over an internal sense of chaos.

来缓解内心的混乱。

We still don’t know exactly what causes eating disorders.

我们仍然不知道 饮食失调的确切病因。

There likely isn’t a single cause, but a combination

病因可能并不是单一的，

of genetic and environmental risk factors that contribute.

而是基因和环境风险因素的结合。

Sometimes, other mental illnesses— like depression or anxiety—

有时，其他精神疾病—— 像是抑郁症和焦虑症——

can cause symptoms of eating disorders.

也会引发饮食失调。

In addition, certain psychological factors,

此外，某些心理因素，

such as perfectionism and body image dissatisfaction,

比如完美主义和身材焦虑，

are risk factors for eating disorders.

都是可能引起饮食失调的风险因素。

Several social factors contribute, too,

很多社会因素也会导致饮食失调。

including internalized weight stigma, exposure to bullying,

如内化的体重羞耻、遭受霸凌、

racial and ethnic assimilation, and limited social networks.

种族和民族的同化、以及缺乏社交。

Although there is a common misconception that only women

人们有一个普遍的错误认知，

experience eating disorders,

那就是女人才会出现饮食失调。

people of all genders can be affected.

但实际上所有性别的人群 都可能患饮食失调。

As these disorders intimately affect the development

由于饮食失调症会密切影响

of one’s identity and self-esteem,

一个人个性和自尊心的发育，

people are particularly vulnerable to developing them during adolescence.

所以青春期的孩子更易患饮食失调。

Although these are among the most challenging

虽然这种精神疾病

psychiatric disorders to treat,

很难治疗，

effective therapies and interventions exist,

但仍然存在一些 有效的疗法和干预手段。

and many people who receive treatment make a full recovery.

很多接受治疗的人们也完全康复了。

Treatment has a higher chance of success the earlier it starts

出现饮食失调行为后，

after someone develops disordered eating behaviors.

越早治疗，痊愈的几率越高。

But unfortunately, less than half of people with an eating disorder

但不幸地是，只有不到一半的患者，

will seek and receive treatment.

会寻求治疗，接受治疗。

Because of the complex effects of eating disorders

由于饮食失调对患者身心的影响

on both the body and the mind,

十分复杂，

treatment usually includes a combination of nutritional counseling and monitoring,

因此治疗手段通常包含 营养咨询与监测、

psychotherapy, and in some cases, medications.

心理疗法、某些情况下， 还需要药物治疗。

Evidence-based psychotherapies exist as treatments for most eating disorders,

循证心理疗法用以治疗 大多数饮食失调症，

including cognitive-behavioral therapy and family-based therapy.

它包括认知行为治疗和家庭治疗。

These are talk-therapies that help people gain the skills

这些谈话疗法可以 帮助人们获得一些技能，

to deal with underlying psychological problems

以应对引起饮食失调症状的

that drive eating disorder symptoms.

潜在心理问题。

Because not all patients will respond to these treatments,

但这些治疗手段 并非对所有患者都有用，

researchers are also investigating treatments outside of psychotherapy,

所以研究员们也在研究 除心理治疗以外的方法，

such as transcranial magnetic stimulation.

比如经颅磁刺激技术。

Proper treatment can reduce the chances of dying from a severe eating disorder.

恰当的治疗可以降低 重度饮食失调症的死亡几率。

Eating disorders can provoke a powerful sense of powerlessness,

饮食失调会引发强烈的无力感，

but education for individuals, families, and communities

但通过对个人、家庭和社会的教育，

helps erode the stigma and improve access to treatment.

有助于消除耻辱感， 进而有利于疾病治疗。