Is binge eating associated with poor weight loss outcomes in people with a high body weight? A systematic review with meta-analyses.

OBJECTIVES: This systematic review aimed to compare the weight change in people with or without binge eating who underwent various weight loss treatments. METHODS: We searched for studies in PubMed, American Psychological Association, and Embase from inception to January 2022. The studies selected included assessment of binge eating and body weight before and after weight loss treatment in people of any age. The meta-analyses were conducted using Comprehensive Meta-Analysis (CMA). We used Egger's regression test, the funnel plot, and the Trim and Fill test to assess the risk of publication bias. RESULTS: Thirty-four studies were included in the systematic review, with a total of 10.184 participants. The included studies were divided into three categories according to types of weight loss treatments, namely, (1) bariatric surgery; (2) pharmacotherapy isolated or combined with behavioral interventions; and (3) behavioral and/or nutritional interventions. The meta-analyses showed no significant difference in weight loss between people with or without binge eating engaged in weight loss treatments, with an overall effect size of - 0.117 (95% CI - 0.405 to 0.171; P = 0.426). CONCLUSIONS: Our findings showed no difference in weight loss in people with or without pre-treatment binge eating who received various weight loss treatments. Weight loss treatments should not be withheld on the basis that they will not be effective in people with pre-treatment binge eating, albeit their safety and longer term impacts are unclear. LEVEL OF EVIDENCE: Level I, at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.

Effect of a Nutritional Behavioral Intervention on Intuitive Eating in Overweight Women With Chronic Kidney Disease.

OBJECTIVES: This study aimed to evaluate the impact of a nutritional behavioral intervention on intuitive eating (IE) scores of overweight non-dialysis-dependent women with chronic kidney disease and to investigate the relationship of IE scores with demographic, nutritional, and quality of life parameters in this group. DESIGN AND METHODS: This is a prospective noncontrolled clinical trial of a behavioral multisession group intervention for dietary management. Each group comprised five to eight participants in 14 weekly or biweekly sessions lasting about 90 minutes each. The IE principles were discussed during the meetings. The IE scale 2, translated and adapted to the study population, with a four-factor model was applied to assess IE attitudes. The 36-Item Short-Form Health Survey questionnaire was applied to assess health-related quality of life. RESULTS: Of the 33 patients who began participation in the study, 23 patients (median [interquartile range]: age = 62.0 years [58.0-68.0]; 52.2% with diabetes; body mass index = 32.6 kg/m2 [30.2-39.3]; estimated glomerular filtration rate = 28.0 mL/min/1.73 m2 [22.0-31.0]) completed the intervention. Except for the IE subscale Body-Food Choice Congruence, the IE total score and all its subscales (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) improved after the intervention. In a cross-sectional analysis, more intuitive eaters were older and had better scores for health-related quality of life. CONCLUSIONS: The nutritional behavioral intervention embracing IE principles was effective to improve IE attitudes for this group of chronic kidney disease patients. These results are promising and may contribute to a paradigm change in the strategies to enhance motivation and adherence to dietary recommendations in this population.

Effects of participation level and physical activity on eating behavior and disordered eating symptoms in the Brazilian version of the New Moves intervention: data from a cluster randomized controlled trial

ABSTRACT BACKGROUND: Childhood and adolescent obesity is a worldwide public health concern. The New Moves program aims to change eating behavior (EB) and physical activity (PA). OBJECTIVE: To evaluate the effectiveness of an intervention and predictors of better outcomes relating to EB and PA levels. DESIGN AND SETTING: Secondary data from a cluster randomized controlled trial in 10 public schools in São Paulo, Brazil. METHODS: 270 female adolescents, aged 12 to 14 years, were analyzed. Participation levels were categorized as presence in 1 to 9 sessions or 10 to 17 sessions, or control. Effectiveness was evaluated through improvement in disordered EB (DEB) and EB. Predictors of better outcomes relating to PA levels were evaluated through clustering of individual characteristics that affected changes in PA scores. RESULTS: Participation level was not significantly associated with changes in DEB or EB. Girls with higher body mass index percentile (BMI-P) percentile tended to have increases in sedentary lifestyles through the program. Girls with less body image dissatisfaction presented higher increases in daily PA. Girls with higher BMI-P percentile and higher self-esteem showed reductions in sedentary lifestyles. The program seemed to have more effect on daily PA among older girls than among younger girls. CONCLUSIONS: This program could be used as a structured action plan in schools, with the aims of improving eating behaviors and physical activity, in addition to promoting self-acceptance. The results indicate the importance of evaluating determinants of adherence, as these metrics might influence the effectiveness and future design of lifestyle programs.

Effects of participation level and physical activity on eating behavior and disordered eating symptoms in the Brazilian version of the New Moves intervention: data from a cluster randomized controlled trial.

BACKGROUND: Childhood and adolescent obesity is a worldwide public health concern. The New Moves program aims to change eating behavior (EB) and physical activity (PA). OBJECTIVE: To evaluate the effectiveness of an intervention and predictors of better outcomes relating to EB and PA levels. DESIGN AND SETTING: Secondary data from a cluster randomized controlled trial in 10 public schools in São Paulo, Brazil. METHODS: 270 female adolescents, aged 12 to 14 years, were analyzed. Participation levels were categorized as presence in 1 to 9 sessions or 10 to 17 sessions, or control. Effectiveness was evaluated through improvement in disordered EB (DEB) and EB. Predictors of better outcomes relating to PA levels were evaluated through clustering of individual characteristics that affected changes in PA scores. RESULTS: Participation level was not significantly associated with changes in DEB or EB. Girls with higher body mass index percentile (BMI-P) percentile tended to have increases in sedentary lifestyles through the program. Girls with less body image dissatisfaction presented higher increases in daily PA. Girls with higher BMI-P percentile and higher self-esteem showed reductions in sedentary lifestyles. The program seemed to have more effect on daily PA among older girls than among younger girls. CONCLUSIONS: This program could be used as a structured action plan in schools, with the aims of improving eating behaviors and physical activity, in addition to promoting self-acceptance. The results indicate the importance of evaluating determinants of adherence, as these metrics might influence the effectiveness and future design of lifestyle programs.

Insatisfação corporal, nível de atividade física e comportamento sedentário em adolescentes do sexo feminino / Body dissatisfaction, physical activity, and sedentary behavior in female adolescents

RESUMO Objetivo: Avaliar a associação da imagem corporal com o nível de atividade física, composição corporal e o comportamento sedentário de adolescentes do sexo feminino. Métodos: Estudo transversal e exploratório com 120 adolescentes do sexo feminino, de 14 a 19 anos, de Viçosa, MG. A imagem corporal foi avaliada por uma Escala de Silhuetas e pelo Body Shape Questionnaire (BSQ). O peso, a estatura e o perímetro da cintura foram aferidos, avaliando-se a relação cintura estatura e o percentual de gordura corporal. O nível de atividade física (NAF) foi avaliado pelo Recordatório de Atividade Física de 24h (R24h) e o comportamento sedentário, pelo tempo em frente à tela de uma TV, jogando videogame, ao computador e usando tablets e, separadamente, o tempo de tela ao celular. Resultados: A média de idade foi 16,5±1,5 anos, sendo a maioria das participantes eutróficas (77,6%), sedentárias/baixo NAF (84,2%), com tempo de tela (85,2%) e tempo de celular (58,7%) elevados. A insatisfação corporal manifestou-se em 40,6% pelo BSQ e em 45,8% pela Escala de Silhuetas. A distorção corporal manifestou-se em 52,9% das participantes. As medidas de composição corporal, juntamente com o tempo ao celular e o NAF, mostraram associação com a insatisfação corporal, sendo as adolescentes mais ativas as mais insatisfeitas. Conclusões: O estudo mostrou que as adolescentes com maior tempo ao celular tinham maior insatisfação corporal, assim como as fisicamente mais ativas. Todas as medidas de avaliação da composição corporal mostraram-se associadas ao nível de insatisfação, principalmente o índice de massa corporal, perímetro da cintura e relação cintura-estatura.

ABSTRACT Objective: To evaluate the association of body image with physical activity level, body composition, and sedentary behavior (SB) of female adolescents. Methods: Exploratory cross-sectional study conducted with 120 female adolescents aged between 14-19 years, from the city of Viçosa, Minas Gerais, Southeast Brazil. Body image was evaluated with a Body Silhouette Scale (BSS) and a Body Shape Questionnaire (BSQ). Weight, height, and waist circumference values were analyzed, as well as the waist-to-height ratio and body fat percentage. The physical activity level (PAL) was assessed by 24-hour Physical Activity Recall and SB by screen time, that is, time spent in front of a TV, playing video game, on the computer and using tablets, and, separately, the cell phone time. Results: Mean age was 16.5±1.5 years, and most adolescents were eutrophic (77.6%), sedentary/low PAL (84.2%), with high screen time (85.2%) and cell phone time (58.7%). Body dissatisfaction was stated in 40.6% of BSQ and 45.8% of BSS evaluations. Body distortion was identified in 52.9% of participants. All body composition measures, along with cell phone time and PAL, were associated with body dissatisfaction, the more active adolescents presenting higher levels of dissatisfaction. Conclusions: This study concluded that female adolescents with higher cell phone time also present higher body dissatisfaction, as well as the most physically active ones. All body composition measurements were associated with body dissatisfaction, mainly body mass index, waist circumference, and waist-to-height ratio.

BODY DISSATISFACTION, PHYSICAL ACTIVITY, AND SEDENTARY BEHAVIOR IN FEMALE ADOLESCENTS. / INSATISFAÇÃO CORPORAL, NÍVEL DE ATIVIDADE FÍSICA E COMPORTAMENTO SEDENTÁRIO EM ADOLESCENTES DO SEXO FEMININO.

OBJECTIVE: To evaluate the association of body image with physical activity level, body composition, and sedentary behavior (SB) of female adolescents. METHODS: Exploratory cross-sectional study conducted with 120 female adolescents aged between 14-19 years, from the city of Viçosa, Minas Gerais, Southeast Brazil. Body image was evaluated with a Body Silhouette Scale (BSS) and a Body Shape Questionnaire (BSQ). Weight, height, and waist circumference values were analyzed, as well as the waist-to-height ratio and body fat percentage. The physical activity level (PAL) was assessed by 24-hour Physical Activity Recall and SB by screen time, that is, time spent in front of a TV, playing video game, on the computer and using tablets, and, separately, the cell phone time. RESULTS: Mean age was 16.5±1.5 years, and most adolescents were eutrophic (77.6%), sedentary/low PAL (84.2%), with high screen time (85.2%) and cell phone time (58.7%). Body dissatisfaction was stated in 40.6% of BSQ and 45.8% of BSS evaluations. Body distortion was identified in 52.9% of participants. All body composition measures, along with cell phone time and PAL, were associated with body dissatisfaction, the more active adolescents presenting higher levels of dissatisfaction. CONCLUSIONS: This study concluded that female adolescents with higher cell phone time also present higher body dissatisfaction, as well as the most physically active ones. All body composition measurements were associated with body dissatisfaction, mainly body mass index, waist circumference, and waist-to-height ratio.

OBJETIVO: Avaliar a associação da imagem corporal com o nível de atividade física, composição corporal e o comportamento sedentário de adolescentes do sexo feminino. MÉTODOS: Estudo transversal e exploratório com 120 adolescentes do sexo feminino, de 14 a 19 anos, de Viçosa, MG. A imagem corporal foi avaliada por uma Escala de Silhuetas e pelo Body Shape Questionnaire (BSQ). O peso, a estatura e o perímetro da cintura foram aferidos, avaliando-se a relação cintura estatura e o percentual de gordura corporal. O nível de atividade física (NAF) foi avaliado pelo Recordatório de Atividade Física de 24h (R24h) e o comportamento sedentário, pelo tempo em frente à tela de uma TV, jogando videogame, ao computador e usando tablets e, separadamente, o tempo de tela ao celular. RESULTADOS: A média de idade foi 16,5±1,5 anos, sendo a maioria das participantes eutróficas (77,6%), sedentárias/baixo NAF (84,2%), com tempo de tela (85,2%) e tempo de celular (58,7%) elevados. A insatisfação corporal manifestou-se em 40,6% pelo BSQ e em 45,8% pela Escala de Silhuetas. A distorção corporal manifestou-se em 52,9% das participantes. As medidas de composição corporal, juntamente com o tempo ao celular e o NAF, mostraram associação com a insatisfação corporal, sendo as adolescentes mais ativas as mais insatisfeitas. CONCLUSÕES: O estudo mostrou que as adolescentes com maior tempo ao celular tinham maior insatisfação corporal, assim como as fisicamente mais ativas. Todas as medidas de avaliação da composição corporal mostraram-se associadas ao nível de insatisfação, principalmente o índice de massa corporal, perímetro da cintura e relação cintura-estatura.

Stunkard Figure Rating Scale for Brazilian men.

PURPOSE: To evaluate psychometric assessment of Stunkard Figure Rating Scale (FRS) for Brazilian male population. METHODS: The sample was composed of a control group (94 students) and a clinical group (20 eating disordered patients). Two questionnaires were applied: the FRS and the Eating Attitudes Questionnaire-26. Weight, height, and body mass index (BMI) were collected in the control group (self-reported) and clinical group (measured). Body dissatisfaction (BD) was calculated by subtraction of ideal body (IB) from the current body (CB) score. The concurrent validity was assessed through the analysis of the correlation between the CB and BD scores and the BMI and the body weight. The discriminant validity was achieved by measurements of association between the groups studied and the scales CB, IB and BD. Reliability was assessed by the comparison of the score averages at two moments and by the intraclass coefficient correlation. RESULTS: The questionnaire had a correlation higher than 0.67 for the measures of weight and BMI. Regarding the CB, IB and BD scores, a significant difference was not observed between the clinical and the control group. There was no difference between the scores for BD at the two moments analyzed. CONCLUSIONS: The FRS is stable and capable of correlating with anthropometric measures. Nevertheless, for this population the questionnaire was unable to distinguish between the two groups analyzed.

[Conceptual, semantic, and instrumental equivalences: preliminary analysis of the Brazilian Portuguese version of the Male Body Dissatisfaction Scale (MBDS)]. / Equivalências conceitual, semântica e instrumental: análises preliminares da versão em português (Brasil) da Male Body Dissatisfaction Scale (MBDS).

This study aimed to describe the translation into Brazilian Portuguese and the analysis of conceptual, semantic, and instrumental equivalences and assessment of internal consistency of the Male Body Dissatisfaction Scale (MBDS). The study included the steps of (1) translation; (2) synthesis of translation; (3) back-translation; (4) review by experts - judges - analysis of the semantic and instrumental equivalences; (5) pre-test - assessment of verbal understanding of the instrument by specialists and male students; (6) analysis of the internal consistency by Cronbach's α coefficient. The MBDS was translated and adapted into Brazilian Portuguese maintaining its original 25 items, showed good verbal comprehension, and had an internal consistency coefficient of 0.92. The scale was translated and adapted with satisfactory results, thus confirming its initial psychometric qualities. The instrument requires further analysis of internal and external validity, and reproducibility.

Anorexia e bulimia – corpo perfeito versus morte / Anorexia and bulimia – perfect body versus death

A anorexia nervosa e a bulimia nervosa são transtornos alimentares (TA) de difícil tratamento e de alta morbidade. OPrograma de Transtornos Alimentares (AMBULIM) do IPq-FMUSP caracteriza-se como o primeiro centro brasileiro multidisciplinarpara o tratamento, ensino e pesquisa da área. O atendimento embasa-se em ações multidisciplinares envolvendo,essencialmente, o acompanhamento médico, nutricional e psicológico. A atividade física merece atenção, poishá evidências da associação da dependência ao exercício com os TA. Observamos um processo lento e gradativo, como comprometimento da saúde física, emocional e social desse paciente, com uma recusa mórbida em ganhar peso. Suascrenças pessoais, muitas vezes, embasam-se no fato de que “ser magro(a)”, “estar magro(a)” é a chave para o seu sucessopessoal, afetivo e social. A expectativa de corpo difundida na sociedade contemporânea, caracterizada por uma noção deperfeição ligada à magreza, acaba por influenciar a imagem corporal, elemento essencial na etiologia dos TA. A mídia,por sua vez, oferece instruções explícitas sobre como atingir o ideal de beleza, promovendo a crença de que as pessoaspodem, e de fato devem, controlar sua forma e peso corporais. O trabalho desenvolvido pelo profissional da saúde com opaciente que desenvolve TA é intenso e repleto de desafios, devendo ir além da intervenção assistencial. É esperado quepossa compartilhar seus conhecimentos com a população e informá-la acerca dos riscos e formas de cuidados, evitando,assim, que o TA seja um dos caminhos trilhado por muitos jovens.(AU)

Nervous anorexia and nervous bulimia are food disturbances (FD) of difficult treatment and of rise morbidity. The Programof Food Disturbances (Ambulim) of IPq-FMUSP is the first multidisciplinary Brazilian center for the treatment, teachingand research of the area. The service is based on multidisciplinary actions integrating essentially medical, nutritional andpsychological assistance. Physical activity is considered, since there are evidences of the association of dependence toexercise with FD. We observe a slow and gradual process leading to physical, emotional and social health worsening of apatient, with a morbid refusal to gaining weight. Her personal beliefs very often are based on the fact that “to be thin”, “staythin” is the key for her personal, affective and social success. The expectation about the body spread in the contemporarysociety, characterized by a notion of perfection connected to slimness, influences the physical image, essential element theetiology of FD. The media, by their turn, offer explicit instructions about how to reach the ideal of beauty, promoting thebelief that persons can, and in fact have to, to control his physical condition and weight. The work developed by a healthprofessional with a patient who develops FD is intense and full with challenges, and must go beyond health care. It is expectedthat professionals could share their knowledge with the population, warning it about the risks and care modalitiesin order to prevent FDs to be a life style choice for young people.(AU)

Anorexia e bulimia – corpo perfeito versus morte / Anorexia and bulimia – perfect body versus death

A anorexia nervosa e a bulimia nervosa são transtornos alimentares (TA) de difícil tratamento e de alta morbidade. OPrograma de Transtornos Alimentares (AMBULIM) do IPq-FMUSP caracteriza-se como o primeiro centro brasileiro multidisciplinarpara o tratamento, ensino e pesquisa da área. O atendimento embasa-se em ações multidisciplinares envolvendo,essencialmente, o acompanhamento médico, nutricional e psicológico. A atividade física merece atenção, poishá evidências da associação da dependência ao exercício com os TA. Observamos um processo lento e gradativo, como comprometimento da saúde física, emocional e social desse paciente, com uma recusa mórbida em ganhar peso. Suascrenças pessoais, muitas vezes, embasam-se no fato de que “ser magro(a)”, “estar magro(a)” é a chave para o seu sucessopessoal, afetivo e social. A expectativa de corpo difundida na sociedade contemporânea, caracterizada por uma noção deperfeição ligada à magreza, acaba por influenciar a imagem corporal, elemento essencial na etiologia dos TA. A mídia,por sua vez, oferece instruções explícitas sobre como atingir o ideal de beleza, promovendo a crença de que as pessoaspodem, e de fato devem, controlar sua forma e peso corporais. O trabalho desenvolvido pelo profissional da saúde com opaciente que desenvolve TA é intenso e repleto de desafios, devendo ir além da intervenção assistencial. É esperado quepossa compartilhar seus conhecimentos com a população e informá-la acerca dos riscos e formas de cuidados, evitando,assim, que o TA seja um dos caminhos trilhado por muitos jovens.

Nervous anorexia and nervous bulimia are food disturbances (FD) of difficult treatment and of rise morbidity. The Programof Food Disturbances (Ambulim) of IPq-FMUSP is the first multidisciplinary Brazilian center for the treatment, teachingand research of the area. The service is based on multidisciplinary actions integrating essentially medical, nutritional andpsychological assistance. Physical activity is considered, since there are evidences of the association of dependence toexercise with FD. We observe a slow and gradual process leading to physical, emotional and social health worsening of apatient, with a morbid refusal to gaining weight. Her personal beliefs very often are based on the fact that “to be thin”, “staythin” is the key for her personal, affective and social success. The expectation about the body spread in the contemporarysociety, characterized by a notion of perfection connected to slimness, influences the physical image, essential element theetiology of FD. The media, by their turn, offer explicit instructions about how to reach the ideal of beauty, promoting thebelief that persons can, and in fact have to, to control his physical condition and weight. The work developed by a healthprofessional with a patient who develops FD is intense and full with challenges, and must go beyond health care. It is expectedthat professionals could share their knowledge with the population, warning it about the risks and care modalitiesin order to prevent FDs to be a life style choice for young people.

Insatisfação corporal em universitários de diferentes áreas de conhecimento / Body dissatisfaction in college students of different study areas

OBJETIVOS: Verificar a prevalência de insatisfação corporal em universitários de diferentes áreas de conhecimento, bem como a relação com sexo e com estado nutricional. MÉTODOS: A amostra foi composta por universitários da Universidade Federal de Juiz de Fora (UFJF) de diferentes áreas de conhecimento. O Body Shape Questionnaire (BSQ) e a Escala de Silhuetas para adultos avaliaram a insatisfação corporal. Massa corporal e estatura autorreferidas foram utilizadas para o cálculo do índice de massa corporal (IMC). Para as análises estatísticas, foram realizados testes de associação, comparação e regressão logística. RESULTADOS: Dos 535 estudantes, com média de idade de 20,82 ± 3,03 anos, 245 eram do sexo masculino. A média do BSQ foi de 68,00 ± 28,74, sendo 88,9% livres de insatisfação. Porém, pela escala de silhuetas, 76,6% foram considerados insatisfeitos. Os estudantes da área de saúde e humanas foram, sem significância, mais insatisfeitos que alunos de exatas. As mulheres em relação aos homens (p < 0,05) e aqueles com sobrepeso/obesidade (OR: 3,174; p = 0,000) tiveram a maior frequência na classificação de insatisfação corporal. CONCLUSÃO: A maioria dos jovens mostrou-se livre de insatisfação corporal, não havendo relação com a área de estudo, porém as universitárias com IMC mais elevado apresentaram-se mais insatisfeitas com sua imagem corporal.

OBJECTIVES: To check the prevalence of body dissatisfaction in college students of different majors, as well as the relationship with gender and nutritional status. METHODS: The sample was composed of college students from the Federal University of Juiz de Fora (UFJF) of several different majors. The Body Shape Questionnaire (BSQ) and the Silhouette Scale for Adults assessed body dissatisfaction. Self-referred body mass and height were used to calculate the body mass index (BMI). For the statistical analysis, association, comparison, and logistic regression tests were performed. RESULTS: Among the 535 students, with average age of 20.82 ± 3.03 years old, 245 were male. The BSQ average score was 68.00 ± 28.74, being 88.9% of the subjects free from dissatisfaction. Nevertheless, according to the silhouette scale, 76.6% were found to be dissatisfied. The students of Life Sciences and Humanities were, insignificantly, more dissatisfied than the Exact Sciences students. Women, when compared to men (p < 0.05) and those overweight/obese (OR: 3.174; p = 0.000) had the highest score in the body dissatisfaction rating. CONCLUSION: Most young people were found to be free from body dissatisfaction, and no correlation to their area of studies was found. However, the college girls with the highest BMIs were found to be the most dissatisfied with their body image.

Adaptação transcultural preliminar do Children's Eating Attitude Test (Cheat) para o idioma português / The preliminary transcultural adaptation of the Children's Eating Attitude Test (Cheat) for portuguese

OBJETIVOS: traduzir e adaptar o instrumento Children's Eating Attitude Test (Cheat) para o idioma português, avaliar a equivalência semântica e a compreensão verbal. MÉTODOS: envolveu quatro etapas: (1) tradução, (2) retradução, (3) revisão técnica e avaliação semântica, (4) pré-teste - avaliação da compreensão verbal por especialistas em transtorno alimentar. RESULTADOS: as 26 questões foram traduzidas e adaptadas para o idioma português. A versão final constou dos mesmos 26 itens apresentando-se de forma clara e de fácil compreensão (valores médios superior a 4,5 - máximo 5,0). CONCLUSÕES: o instrumento encontra-se traduzido e adaptado para o idioma português demonstrando bons resultados no processo de adaptação transcultural. São necessárias análises de validade externa, equivalência de mensuração e reprodutibilidade.

OBJECTIVES: to translate and adapt the Children's Eating Attitude Test (Cheat) to Portuguese and evaluate the semantic equivalence and verbal comprehension. METHODS: the process involved four stages: (1) translation, (2) back-translation, (3) technical review and semantic evaluation, (4) pre-test - evaluation of verbal comprehension by specialists in eating disorders. RESULTS: the 26 questions were translated and adapted for Portuguese. The final version contained the same 26 items presented in a clear and easy-tounderstand format (average score higher than 4.5 - maximum 5.0). CONCLUSIONS: the tool has been translated and adapted for Portuguese and the transcultural adaptation process was a success. There is still a need for analyses of external validity, measurement equivalence and reproducibility.

Adaptação transcultural: tradução e validação de conteúdo da versão brasileira do Commitment Exercise Scale / Transcultural adaptation: translation and content validation of the Commitment Exercise Scale to the Brazilian language

CONTEXTO: O Commitment Exercise Scale (CES) avalia o comprometimento, o comportamento e a atitude de pacientes com transtornos alimentares em relação ao exercício físico. OBJETIVO: Tradução e adaptação transcultural do CES para o idioma português (BRA), validação de conteúdo e análise da consistência interna. MÉTODOS: Envolveu cinco etapas: (1) tradução; (2) retradução; (3) revisão técnica e avaliação semântica; (4) validação de conteúdo por profissionais da área - juízes; (5) avaliação do instrumento por uma amostra de estudantes, por meio da avaliação do grau de compreensão e análise da consistência interna do instrumento pelo coeficiente a de Cronbach. RESULTADOS: A escala foi traduzida e adaptada, sendo considerada de fácil compreensão (grau de compreensão de 4,3 a 4,9), e demonstrou valores do coeficiente aceitáveis (a de Cronbach: 0,60 a 0,79). CONCLUSÃO: A partir do processo de adaptação transcultural, os resultados satisfatórios possibilitam a recomendação da versão brasileira do CES. São necessárias análises de validação de construto, fatorial e de reprodutibilidade.

BACKGROUND: The Exercise Commitment Scale (CES) evaluates commitment, attitude and behavior regarding exercise in eating disorders patients. OBJECTIVE: Translation and cultural adaptation of the CES for Portuguese (BRA), content validation and analysis of internal consistency. METHODS: This study involved five steps: (1) translation, (2) re-translation, (3) technical review and evaluation semantics, (4) content validation by professionals - judges, (5) assessment of the instrument in a sample of students, by assessing the degree of understanding and analysis of internal consistency by Cronbach's a coefficient. RESULTS: The scale was translated and adapted. It was considered easy to understand (degree of understanding from 4.3 to 4.9) and showed acceptable consistency coefficients (Cronbach's a: 0.60 to 0.79). DISCUSSION: Satisfactory results of this adaptation process allow the recommendation of the CES Brazilian version. Analysis is needed of construct and factorial validation, and of reproducibility.

A prática de exercícios físicos em pacientes com transtornos alimentares: [revisão] / Physical exercises in patients with eating disorders: [review]

CONTEXTO: Diferentes estudos discutem a relação da prática excessiva de exercícios físicos com transtornos alimentares como estratégia para perda de peso. OBJETIVO: Revisar a literatura sobre a prática de exercícios físicos em pacientes com transtornos alimentares, discutindo definições, critérios diagnósticos e propostas terapêuticas. MÉTODOS: Levantamento bibliográfico foi realizado por meio de MedLine, LiLacs e Cochrane Library, com os termos "transtornos alimentares", "anorexia", "bulimia", "exercício físico excessivo", "atividade física", "exercício obrigatório", "exercício compulsivo" e "exercício excessivo". RESULTADOS: Dos 80 artigos encontrados, foram selecionados 12 que incluíam a investigação de um padrão de atividade física considerado excessivo em indivíduos acima dos 18 anos e uso de algum instrumento de avaliação para essa finalidade. A prática de exercícios físicos em pacientes com transtornos do comportamento alimentar é revisada. CONCLUSÃO: Não há consenso sobre critérios diagnósticos e instrumentos para considerar o exercício físico como inadequado ou excessivo e seu uso como recurso para perder peso. Por outro lado, a prática de exercícios físicos durante o tratamento de pacientes com transtornos alimentares pode ser benéfica desde que orientada e supervisionada.

BACKGROUND: Several studies discuss the relationship between excessive physical exercises and eating disorder patient as a strategy to lose weight. OBJECTIVE: Review the literature concerning physical exercises in eating disorder patients including definitions, diagnostic criteria and therapeutic proposals. METHODS: A literature review was done through MedLine, LILACS and Cochrane databases using the terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "physical activity", "obligatory exercise", "compulsive exercise" and "excessive exercise". RESULTS: 12 articles in a sampling of 80 were selected. These articles include the investigation of a physical pattern that was considered excessive in adults over 18 and the use of evaluation instruments. The practice of physical exercises in patients with disturbed eating behaviors is revised. DISCUSSION: There is no consensus in literature about diagnostic criteria and instruments to consider the physical exercise as inadequate or excessive and its use as a way to lose weight. On the other hand the practice of physical exercises along the treatment of eating disorder patients could be beneficial if oriented and supervised.

Auto-estima e imagem corporal de gestantes de acordo com o nível de atividade física / Self-esteem and body image in pregnant women according to physical activity level

Objetivo: comparar a auto-estima e a imagem corporal de gestantes ativas e irregularmente ativas em duas comunidades. Métodos: participaram da amostra 20 gestantes alunas de academias e 11 gestantes pacientes de programa de pré-natal não envolvidas com atividade física estruturada, com faixa etária de 22 a 42 anos com 27,2 ± 1,5 semanas de gestação. A amostra foi dividida de acordo com a classifi cação do Questionário Internacional de Nível de Atividade Física (IPAQ). A auto-estima foi avaliada com a Escala Janis-Field de inadequação dos sentimentos para avaliação da auto-estima e a imagem corporal com o questionário de imagem corporal (BSQ). As comparações foram feitas por meio de análise de variância paramétrica e não-paramétrica. O nível de signifi cância adotado foi de p<0,05. Resultados: houve diferença signifi cativa apenas entre as gestantes inseridas no programa de atividade física das academias: em uma escala de 0 a 100, as classifi cadas em ativas apresentaram uma auto-estima signifi cativamente alta (77,1) em relação às irregularmente ativas (68,0). Quanto à imagem corporal não houve diferença estatística signifi cativa. Conclusão: as gestantes consideradas ativas possuem uma auto-estima melhor em relação as gestantes irregularmente ativas quando participantes de um programa de atividade física estruturado, sendo que esta associação não foi encontrada em gestantes não envolvidas nesse tipo de programa. A imagem corporal não teve associação com o nível de atividade física.

Purpose: to compare self-esteem and body image of active and insuffi ciently active pregnant women (PW) in two communities. Methods: sample consisted of 20 PW participants of physical activity program of fi tness centers and 11 PW not involved in structured physical activity. They were 29.8 ± 4.54 years old, and 27.2 ± 1.5 weeks of gestation. The sample was divided according to physical activity level using the International Physical Activity Questionnaire (IPAQ). The participants had answered Janis-Field scale feelings for evaluation of self-esteem and to the Body Shape Questionnaire to analyze body perception. Statistical analyze used was analysis of variance parametric and no parametric. Signifi cance level was p<.05. Results: we found signifi cant difference in PW from fi tness centers: in a scale from 0 to 100, the PW classifi ed in active had presented self-esteem signifi cantly high (77.1) in relation to the irregularly active (68.0). There is no statistic difference in body image. Conclusion: the PW considered active have better self-esteem in relation irregularly active when participant of a physical activity program. In fact, this association was not found in PW who were not involved in this type of physical activity program.

Relação do tempo de TV e aptidão física de escolares de uma região de baixo nível sócio-econômico / Association between time of TV and fitness variables in low income students

Objetivo: verificar a relação entre o tempo utilizado assistindo TV, o nível deatividade física e a aptidão física de escolares de ambos os sexos de uma região de baixo nível sócio-econômico. Métodos: o estudo faz parte do Projeto Longitudinal de Crescimento e Desenvolvimento e Aptidão Física de Ilhabela. Foram avaliados 233 escolares de uma escola municipal com faixa etária de 9 a 15 anos, sendo 119 meninos (10,8 ± 1,8 anos) e 114 meninas (10,7 ± 1.8 anos). Para avaliar o nível de atividade física foi utilizado o questionário “Youth RiskBehavior Surveillance System” (YRBSS). A comparação dos grupos classificados de acordo com o tempo de TV foi feita por meio de ANOVA “One Way” e post-hoc Scheffé, e a associação entre o tempo de TV e a aptidão física por correlação de Pearson. O nível de significância adotado foi de p<0,01. Resultados: de acordo com o gasto energético estimado em METs, 12,9% da amostra foi classificada como sedentária, 36,1% insuficientemente ativa, 35,2% ativa e 15,9% como muito ativa. Não foram encontradas diferenças significativas entre o gasto energético e os gêneros, nos quatro níveis de atividade física. O tempo médio de TV foi de 3,7 ± 2,4 horas, sendo que no sexo masculino foi de 3,6 ± 2,3 horas e no feminino 3,8 ± 2,5 horas. As associações entre tempo de TV e as variáveis da aptidão física foram consideradas baixas e não apresentou diferenças significativas. Conclusão: não houve relação entre o tempo de TV e as variáveis da aptidão física de escolares de uma região de baixo nível sócio-econômico.

Purpose: to verify the association between TV watching time, physical activity level and physical fitness in low income students from both genders. Methods: this study is part of the Longitudinal Project of Growth and Development and Physical Fitness in Ilhabela. 233 students from a municipal school, between 9 and 15 years old were evaluated, being 119 boys (10.8 ±1.8 years) and 114 girls (10.7 ± 1.8 years). The physical activity level was assessed by “Youth Risk Behavior Surveillance System” (YRBSS). The comparison of the classified groups in accordance with the TV time was analyzed by ANOVA “One Way” post-hoc Scheffé, and the association between time of TV and fitness variables by Pearson. The significance level adopted was p<.01.Results: according to energy expenditure estimated in METs, the sample was classified in 12.9%as sedentary, 36.1% irregularly active, 35.2% active, and 15.9% very active. There were no significant differences between energy expenditure and genders. The average time of TV was 3.7± 2.4 hours. Boys watched 3.6 ± 2.3 hours and girls 3.8 ± 2.5 hours. The associations between time of TV and fitness variables were low, and there were no significant differences. Conclusion: there was no association between time of TV and the fitness variable in low income students.