JAMA Pediatrics:体重担忧和节食在青少年中呈上升趋势,或导致抑郁症

2020-11-17 MedSci原创 MedSci原创

围绕肥胖的公共卫生运动应该考虑到对心理健康的不利影响,并确保避免对体重的歧视。

由于肥胖越来越普遍,社会上提倡“以瘦为美”的信息越来越广泛,通过节食来控制体重也变得越来越常见,尤其是那些BMI超标的青少年。这是值得关注的,因为有实验研究发现,节食对年轻人减轻体重无效,限制性饮食行为反而与不良心理健康结果相关,包括抑郁和饮食失调。

那么,在过去的30年里,青少年减肥和体重感知行为的流行程度以及它们与抑郁症状的关系有没有改变?近日,发表在JAMA Pediatrics上的新研究探讨了这个问题并发现,试图减肥的女孩比前几年更容易出现抑郁症状:2015年,42%的14岁女孩和男孩表示他们正在努力减肥,而2005年这一比例为30%。

这项研究使用了来自连续纵向出生队列研究的重复横断面数据。这些研究包括英国14至16岁青少年的一般人群样本,他们来自3个正在进行的出生队列:British Cohort Study 1970(1970年4月5日至11日出生的儿童;1986年收集的数据);the Avon Longitudinal Study of Parents and Children(1991年4月1日至1992年12月21日期间预产期的母亲;2005年收集的数据)和the Millennium Cohort Study(2000年9月1日至2002年1月11日出生的儿童;2015年收集的数据)。共有22503名青少年参与了这项研究,这些青少年至少有一个青春期体重控制或体重感知变量。数据分析时间为2019年8月1日至2020年1月15日。

主要结果及测量:自我报告的节食状态和运动减肥情况,当前对体重的期望(什么都不做,减肥,保持不变,体重增加),自觉体重(体重不足,体重适当,超重)根据体重指数进行调整。次要结果是抑郁症状。

研究发现,与2005年和1986年相比,2015年旨在实现减肥的行为的流行率有所上升,而这种变化并不能仅仅用已知的体重指数变化来解释。与2005年和1986年相比,2015年男孩的体重控制行为比女孩增加更多,但在后者中,这些行为与更严重的抑郁症状相关。

体重改变行为与抑郁症状之间的关系随年龄和性别的变化

认为自己体重不足和超重的青少年有更大的抑郁症状。有证据表明,只有在那些说自己超重的青少年中,认为自己超重的女孩比男孩报告更严重的抑郁症状。

按队列和性别划分的体重知觉与抑郁症状的相关性变化

这些结果表明,2015年的体重改变行为比2005年和1986年都有所增加。尽管在所有组群中,以减肥为目的的行为在女孩中更为常见,但在近年出生的组群中,这些行为在男孩中更为普遍。最近的证据表明,在过去的几十年里,媒体对男性美的标准已经发生了转变,肌肉发达的身材越来越被规范,这也可以解释这些发现。相比之下,要求女性保持苗条的压力在社会上存在的时间更长,自20世纪60年代和70年代可能就存在了。

研究的主要作者Solmi博士说:“媒体对苗条身材的描述、健身行业的兴起以及社交媒体的出现,或许可以部分解释我们的研究结果,而有关卡路里限制和锻炼的公共健康信息也可能会造成意想不到的伤害。”

“围绕肥胖的公共卫生运动应该考虑到对心理健康的不利影响,并确保避免对体重的歧视。通过促进健康和幸福,而不是关注‘健康体重’,它们可以对心理和身体健康产生积极影响。”

参考文献:Solmi F, Sharpe, PhD H, Gage SH, Maddock J, Lewis G, Patalay P. Changes in the Prevalence and Correlates of Weight-Control Behaviors and Weight Perception in Adolescents in the UK, 1986-2015. JAMA Pediatr. Published online November 16, 2020. doi:10.1001/jamapediatrics.2020.4746

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    2021-01-29 fengwu_chen

    学习了

    0

  2. 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    2020-12-30 ms1000002016287811

    感觉不是太过肥胖不用刻意减肥

    0

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createdName=lsndxfj, createdTime=Thu Nov 19 13:32:32 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900368, encodeId=d8a2900368a1, content=减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b4b4230603, createdName=13df4a40m17暂无昵称, createdTime=Thu Nov 19 08:51:27 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-12-28 ms6000000854809298

    学习了。#减肥#抑郁症

    0

  4. 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createdName=lsndxfj, createdTime=Thu Nov 19 13:32:32 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900368, encodeId=d8a2900368a1, content=减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b4b4230603, createdName=13df4a40m17暂无昵称, createdTime=Thu Nov 19 08:51:27 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2021-01-20 hbwxf
  5. 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    2021-03-15 feather89
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  7. 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createdName=lsndxfj, createdTime=Thu Nov 19 13:32:32 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900368, encodeId=d8a2900368a1, content=减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b4b4230603, createdName=13df4a40m17暂无昵称, createdTime=Thu Nov 19 08:51:27 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-27 种鱼的猫猫

    给体重减重更要为心理减重

    0

  8. 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createdName=lsndxfj, createdTime=Thu Nov 19 13:32:32 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900368, encodeId=d8a2900368a1, content=减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b4b4230603, createdName=13df4a40m17暂无昵称, createdTime=Thu Nov 19 08:51:27 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 BJying

    #减肥# #体重# 过度担忧体重的确会造成抑郁倾向。之前看过一个新闻评论,说现在社会女性被所谓的“网红” 信息包围,认为过度消瘦即美。一旦达不到“网红”那种程度的痩,便会焦虑不已,进而产生抑郁。实则我们需树立正确的审美观,保持良好作息习惯及饮食、生活习惯~~

    0

  9. 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createdName=lsndxfj, createdTime=Thu Nov 19 13:32:32 CST 2020, time=2020-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=900368, encodeId=d8a2900368a1, content=减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b4b4230603, createdName=13df4a40m17暂无昵称, createdTime=Thu Nov 19 08:51:27 CST 2020, time=2020-11-19, status=1, ipAttribution=)]
    2020-11-19 lsndxfj
  10. 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    2020-11-19 13df4a40m17暂无昵称

    减肥

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