Name: 飲食失調莫輕忽！為什麼飲食失調如此難以治療？ (Why are eating disorders so hard to treat? - Anees Bahji)
Uploaded: 2022-06-18T21:01:20.000Z
Duration: 4 min 40 s

Globally, about 10% of people will experience an eating disorder during their lifetime.

全球大約有 10% 的人口一生當中會經歷一次飲食障礙。

And yet, eating disorders are profoundly misunderstood.

然而飲食障礙其實被徹底誤解了。

Misconceptions about everything from symptoms to treatment make it difficult to navigate an eating disorder or support someone you love as they do so.

對症狀以至治療方式的所有誤解，讓人難以理解飲食障礙的問題或是支持歷經飲食障礙的所愛之人。

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

那麼就讓我們來探討飲食障礙的是與非。

Eating disorders are a range of psychiatric conditions characterized by these main patterns of behavior:

飲食障礙是由下列主要行為模式定義的一系列精神症狀。

Restricting food intake, bingeing or rapidly consuming large amounts of food, and purging or eliminating calories through vomiting, laxatives, excessive exercise, and other harmful means.

限制食物攝取量、暴飲暴食或快速消耗大量食物以及透過嘔吐、瀉藥、過度運動或其它有害提途徑殲滅熱量。

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

飲食障礙可能是下列的任一行為或是這些行為的組合。

For example, people living with anorexia usually restrict the amount of food they eat, while bulimia nervosa is an eating disorder characterized by recurrent binges and purges.

舉例而言，厭食症患者通常會限制他們的食物量，而貪食症這種飲食障礙則以反覆的大吃與嘔吐為特徵。

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

重要的是，這些行為決定某人是否罹患飲食障礙。

You can't tell whether someone has an eating disorder from their weight alone.

你無法單靠一個人的體重判斷他是否有飲食障礙。

People who weigh what medical professionals might consider a "healthy range" can have eating disorders,

體重被專業醫護人員定義為「健康範圍」的人可能會有飲食障礙，

including severe ones that damage their long-term health in invisible ways, including osteoporosis, anemia, heart damage, and kidney damage.

包括嚴重到可能以隱形的方式損害他們長期健康狀態，導致骨質疏鬆、貧血、心臟疾病以及腎臟疾病。

Just as we can't tell whether someone has an eating disorder based on their weight alone, we can't get rid of these disorders simply by eating differently.

如果我們無法靠體重判斷一個人是否有飲食障礙，我們也不能僅依靠改變飲食方式來根除此一障礙。

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

那是因為飲食障礙根本上屬於精神疾病。

From what we understand, they involve a disruption to someone's self-perception.

根據我們的理解，它們涉及某人自我認知的破壞。

Most people who experience them are severely critical of themselves and report many self-perceived flaws.

多數經歷過這些的人對自己都特別嚴厲，並列舉許多自認為的缺陷。

They may use eating to try to regain some control over an internal sense of chaos.

他們可能會利用進食試圖重新獲得一些對於內心混亂感的控制。

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

我們仍然不知道飲食障礙的起因究竟是什麼。

There likely isn't a single cause, but a combination of genetic and environmental risk factors that contribute.

很可能沒有單一原因，而是基因以及環境危險因素的組合而產生。

Sometimes, other mental illnesses, like depression or anxiety, can cause symptoms of eating disorders.

有時候，像是憂鬱症或是焦慮症的精神疾病也可能引起飲食障礙的症狀。

In addition, certain psychological factors, such as perfectionism and body image dissatisfaction, are risk factors for eating disorders.

此外，像是完美主義以及身體意象不滿等心理因素也是飲食障礙的風險因子。

Several social factors contribute, too, including internalized weight stigma, exposure to bullying, racial and ethnic assimilation, and limited social networks.

有幾種社會現象也是因素，包括內化的肥胖羞辱、暴露於霸凌、種族與民族同化以及有限的社交網絡。

Although there is a common misconception that only women experience eating disorders, people of all genders can be affected.

只有女性才會經歷飲食障礙是個常見的誤解，但其實任何性別的人都可能被影響。

As these disorders intimately affect the development of one's identity and self-esteem, people are particularly vulnerable to developing them during adolescence.

由於這些障礙會密切地影響一個人身份與自尊的發展，人們在青少年時期特別容易罹患。

Although these are among the most challenging psychiatric disorders to treat, effective therapies and interventions exist, and many people who receive treatment make a full recovery.

雖然這些都屬於治療上最具挑戰性的精神疾病，有效的治療方法和干預措施還是存在的，而許多接受治療的人也都能完全康復。

Treatment has a higher chance of success the earlier it starts after someone develops disordered eating behaviors.

在一個人開始出現飲食習慣失常後，越早開始治療，成功的機會就越大。

But unfortunately, less than half of people with an eating disorder will seek and receive treatment.

但不幸的是，只有少於半數的飲食障礙患者會尋求並接受治療。

Because of the complex effects of eating disorders on both the body and the mind, treatment usually includes a combination of nutritional counseling and monitoring, psychotherapy, and in some cases, medications.

由於飲食障礙對身體和心靈的複雜影響，治療通常會結合營養諮詢與監測的結合、心理治療，並在某些情況下提供藥物治療。

Evidence-based psychotherapies exist as treatments for most eating disorders, including cognitive-behavioral therapy and family-based therapy.

以證據為基礎的心理治療是多數飲食障礙的治療方法，包括認知行為治療和家庭為主的治療。

These are talk therapies that help people gain the skills to deal with underlying psychological problems that drive eating disorder symptoms.

這些都是談話性治療，幫助人們取得應付引發飲食障礙症狀隱含心理問題的技巧。

Because not all patients will respond to these treatments, researchers are also investigating treatments outside of psychotherapy, such as transcranial magnetic stimulation.

因為不是所有病患都會對這些治療起反應，研究人員也在探討心理治療以外的療法，例如穿顱磁刺激儀。

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

適當的治療可以減少因嚴重飲食障礙而死亡的機率。

Eating disorders can provoke a powerful sense of powerlessness.

飲食障礙會激起一股強烈的無力感。

But education for individuals, families, and communities helps erode the stigma and improve access to treatment.

但教育個人、家庭和社區將有幫助消除恥辱感並提升獲得治療的機會。