背景:在美国(U.S.),已经进行了一些不成功的尝试,以就饮食失调领域的基本问题达成跨学科共识。2020年1月,25位杰出的临床医生,院士,研究人员,有生活经验的人,和思想领袖在美国饮食失调社区聚集在希望的遗产峰会再试一次。本文阐述了他们达成共识的观点。它还:(1)概述了执行这些建议的战略;(2)确定执行这些建议的可能障碍;(3)规划成功导航和克服这些挑战的路线。
方法:在整个峰会和本手稿的开发过程中都采用了迭代和共识过程。
结果:首脑会议的结论最终达成了几个共识,包括:(1)通过实施专注于社会观念的创造性健康教育计划,可以改善饮食失调的结果和预防工作,早期发现,及时,有效干预;(2)此类举措应面向父母/监护人,家庭,其他看护人,和一线医疗保健提供者,以最大限度地发挥影响;(3)那些患有饮食失调的人,他们所爱的人,整个饮食失调社区将受益于更容易获得负担得起的食物,优质护理,以及医院内部更大的透明度和问责制,住宅,和门诊保健提供者的资格,方法论,和标准化的结果;(4)那些有饮食失调经历的人,他们所爱的人,卫生保健提供者,以及整个饮食失调社区,还将受益于治疗计划认证的建立和维护,专业认证,以及治疗类型和水平的护理指南;(5)建立和实施有效的,基于经验/证据的护理标准需要在不同范围的人群中进行研究,充足的私人和政府资金,以及所有致力于理解的人之间自由交流思想和信息,治疗,and,最终,显著减少饮食失调的负面影响。
结论:广泛采纳和实施这些建议有可能统一和推进饮食失调领域,并最终改善受影响者的生活。一个跨学科的饮食失调专家小组,思想领袖,和有生活经验的人聚集在一起,就与威胁生命和改变生命的疾病作斗争的根本问题达成共识,这些疾病是饮食谱系障碍。这些问题包括:(1)需要早期检测,干预,预防,和循证护理标准;(2)迫切需要使所有有需要的人更容易获得和负担得起专门护理;(3)基于证据的护理标准;(4)需要资金和进行饮食谱系障碍研究;(5)倡导不可或缺,教育,以及与这些疾病有关的立法。在协商一致的过程中,作者还提出了实施他们建议的策略,确定了实施这些措施的可能障碍,并为成功导航和克服这些挑战制定了路线。最重要的是,作者证明,在饮食谱系障碍领域达成共识是可能的和可实现的,在这样做的时候,点燃了希望的火炬,这肯定会照亮未来几年的前进道路。
BACKGROUND: Several unsuccessful attempts have been made to reach a cross-disciplinary
consensus on issues fundamental to the field of eating disorders in the United States (U.S.). In January 2020, 25 prominent clinicians, academicians, researchers, persons with lived experience, and thought leaders in the U.S. eating disorders community gathered at the Legacy of Hope Summit to try again. This paper articulates the points on which they reached a
consensus. It also: (1) outlines strategies for implementing those recommendations; (2) identifies likely obstacles to their implementation; and (3) charts a course for successfully navigating and overcoming those challenges.
METHODS: Iterative and consensual processes were employed throughout the Summit and the development of this manuscript.
RESULTS: The conclusion of the Summit culminated in several
consensus points, including: (1) Eating disorder outcomes and prevention efforts can be improved by implementing creative health education initiatives that focus on societal perceptions, early detection, and timely, effective intervention; (2) Such initiatives should be geared toward parents/guardians, families, other caretakers, and frontline healthcare providers in order to maximize impact; (3) Those afflicted with eating disorders, their loved ones, and the eating disorders community as a whole would benefit from greater accessibility to affordable, quality care, as well as greater transparency and accountability on the part of in-hospital, residential, and outpatient health care providers with respect to their qualifications, methodologies, and standardized outcomes; (4) Those with lived experience with eating disorders, their loved ones, health care providers, and the eating disorders community as a whole, also would benefit from the establishment and maintenance of treatment program accreditation, professional credentialing, and treatment type and levels of care
guidelines; and (5) The establishment and implementation of effective, empirically/evidence-based standards of care requires research across a diverse range of populations, adequate private and government funding, and the free exchange of ideas and information among all who share a commitment to understanding, treating, and, ultimately, markedly diminishing the negative impact of eating disorders.
CONCLUSIONS: Widespread uptake and implementation of these recommendations has the potential to unify and advance the eating disorders field and ultimately improve the lives of those affected. A cross-disciplinary group of eating disorder professionals, thought leaders, and persons with lived experience have come together and reached a consensus on issues that are fundamental to the battle against the life-threatening and life-altering illnesses that are eating spectrum disorders. Those issues include: (1) the need for early detection, intervention, prevention, and evidenced-based standards of care; (2) the critical need to make specialized care more accessible and affordable to all those in need; (3) the importance of developing uniform, evidenced-based standards of care; (4) the need for funding and conducting eating spectrum disorder research; and (5) the indispensability of
advocacy, education, and legislation where these illnesses are concerned. During the consensus process, the authors also arrived at strategies for implementing their recommendations, identified likely obstacles to their implementation, and charted a course for successfully navigating and overcoming those challenges. Above all else, the authors demonstrated that consensus in the field of eating spectrum disorders is possible and achievable and, in doing so, lit a torch of hope that is certain to light the path forward for years to come.