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Objetivo: Analizar las conductas alimentarias de riesgo, en relación al estado nutricional y actividad física en jóvenes adultos durante la pandemia COVID-19 en las comunas de Chillán y Chillán Viejo. Método: Diseño observacional y transversal. Se obtuvo una muestra de 184 adultos jóvenes de ambos sexos, que residían en dos comunas de la región de Ñuble (Chile) durante el periodo de confinamiento por la pandemia COVID-19. Se les aplicó un cuestionario de antecedentes personales y la escala SCOFF que evalúa el riesgo de trastornos de la conducta alimentaria (TCA). Resultados: Se encontró un 37,16% de riesgo para TCA (IC 95%: 30,23 - 44,63%). El riesgo de trastornos de la conducta alimentaria tuvo relación con las variables: actividad física (p = 0,01 análisis bivariante) y estado nutricional (p = 0,03, análisis ajustado). Conclusión: Se logró identificar una proporción superior a la registrada en la literatura y los factores asociados a TCA eran los que se esperaban encontrar.
Objective: To analyze risky eating behaviors in relation to nutritional status and physical activity in young adults during the COVID-19 pandemic in the communes of Chillán and Chillán Viejo. Methods: Observational and cross-sectional design. A sample of 184 young adults of both sexes, who lived in two communes in the Ñuble region (Chile) during the period of confinement due to COVID-19 pandemic, was obtained. A personal history questionnaire and the SCOFF scale that assesses the risk of eating behavior disorders (EDs) were applied. Results: A 37.16% risk for ED was found (95% CI: 30.23 - 44.63%). The risk of eating behavior disorders was related to the variables: physical activity (p=0.01 bivariate analysis) and nutritional status (p=0.03, adjusted analysis). Conclusion: It was possible to identify a higher proportion than that recorded in the literature and the factors associated with eating disorders were those that were expected to be found.
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Introdução: Os jovens sofrem constantemente com pressões impostas pela sociedade, uma delas é o padrão corporal, reforçada diariamente pelas mídias e redes sociais. Isso acaba impactando diretamente na forma como esse jovem se vê, na sua aceitação corporal e nas escolhas alimentares, com potencial risco para o desenvolvimento de transtornos alimentares (TAs). Objetivo: Identificar a influência das redes sociais no comportamento alimentar e aceitação da imagem corporal, relacionado com o índice de massa corporal dos estudantes de um centro universitário particular de Foz do Iguaçu-PR. Materiais e Métodos: Tratou-se de um estudo transversal, de caráter observacional e natureza quantitativa. Para coleta de dados foram aplicados questionários sociodemográficos, EAT-26 e SATAQ-4 e realizadas análises estatísticas com o BioEstat 5.0. Participaram da pesquisa 211 acadêmicos, 64,24% do sexo feminino e 29,38% do sexo masculino. Resultados: Entre os principais resultados constatou-se que a pressão da mídia, sobre a percepção corporal desses universitários, é maior que a pressão da família e amigos (p. 0,0001); o maior impacto sobre o sexo feminino foi para o corpo magro (md= 15,15; ±5,59; p. 0,006) e o masculino para o corpo atlético (md= 16,98; ±5,07; p. 0,0004); o maior risco para o desenvolvimento de transtorno alimentar foi em mulheres (n= 44; 84,60%; p. 0,0025) dos cursos da área da saúde (n= 34; 65,40%; p. 0,0249). Quanto ao risco quantificado no teste de atitudes alimentares, a maior exposição foi de estudantes eutróficos (n= 30; 55,55%) na faixa etária de 18 a 25 anos (n= 38;70,37). Conclusão: O impacto causado pela mídia na percepção e aceitação corporal dos universitários se fez presente, evidenciando insatisfação corporal e influenciando escolhas alimentares. Mulheres foram as mais suscetíveis a essas pressões e, mesmo em sua maioria estando em eutrofia, apresentaram maior risco de desenvolver transtorno alimentar. Entre os homens, a pressão da mídia foi significativa na manutenção do corpo atlético.
Introduction: Young people constantly suffer from pressures imposed by society, one of which is the body pattern, reinforced daily by the media and social networks. This ends up directly impacting the way these young people see themselves, their body acceptance and food choices, influencing a greater risk of developing eating disorders (EDs).Objective: To identify the influence of social networks on eating behavior and acceptance of body image, related to the body mass index of students at a private university center in Foz do Iguaçu-PR. Materials and Methods: This was a cross-sectional, observational and quantitative study. For data collection, sociodemographic, EAT-26 and SATAQ-4 questionnaires were applied and statistical analyzes were performed with BioEstat 5.0. 211 academics participated in the research, 64.24% female and 29.38% male. Results: Among the main results, it was found that the pressure from the media, on the body perception of these university students, is greater than the pressure from family and friends (p. 0.0001); the greatest impact on the female sex was for the thin body (md= 15.15; ±5.59; p. 0.006) and the male for the athletic body (md= 16.98; ±5.07; p. 0 , 0004); the highest risk for developing an eating disorder was in women (n= 44; 84.60%; p. 0.0025) from courses in the health area (n= 34; 65.40%; p. 0.0249) . As for the quantified risk in the eating attitudes test, the highest exposure was for eutrophic students (n= 30; 55.55%) in the 18-25 age group (n= 38;70.37). Conclusion: The impact caused by the media on the acceptance and body acceptance of college students was present, showing body dissatisfaction and influencing food choices. Women were the most anxious about these crises and, even for the most part, were eutrophic, with a higher risk of developing an eating disorder. Among men, media pressure was significant in maintaining an athletic body.
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Body Image , Social Networking , Feeding and Eating Disorders , Body Mass Index , Feeding Behavior , Binge-Eating Disorder , Social Media , Body DissatisfactionABSTRACT
@#Introduction: The aim of the study was to estimate the occurrences of binge eating disorder (BED) and food addiction (FA) in Jordanian women with obesity and to explore their relationships with selected potential risk factors for obesity. Methods: A descriptive case series design that involved a total of 842 women with obesity was conducted. The occurrences of BED and FA were evaluated using the Questionnaire on Eating and Weight Patterns-5 (QEWP-5) and Yale Food Addiction Scale 2.0 (YFAS 2.0). Results: The overlapping of BED and FA (BED+FA) was the most frequent category constituting 53.7%. The second highest category was BED comprising 25.0%, followed by FA comprising 9.0%. Body mass index (BMI) and waist circumference (WC) were significantly higher in the BED+FA group as compared to all other groups. The FA group (41.3%) had significantly the lowest level of sleeping hours. BED (58.0%) and BED+FA (66.1%) groups were significantly higher in consuming more than three snacks per day. BED and/or FA-free group had significantly higher level of water intake of >5 cups/day. Conclusions: The frequencies of BED and FA were relatively high among obese Jordanian women. The study demonstrated an overlap between BED and FA, highlighting its associations with increased BMI and WC in a selected sample of obese women. The study suggested that BED, FA, and the overlapping of both conditions were associated with greater tendencies towards an unhealthy pattern of eating practices, fluid intake, and sleeping habits.
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ABSTRACT BACKGROUND: Although bariatric surgery is today's gold standard treatment for obesity, weight regain affects the success rate of the procedure. Recent studies have identified psychiatric and neurological factors as possible causes. AIMS: The aim of this study was to evaluate the influence of psychiatric diseases on the outcome and long-term success of bariatric surgeries and find a weight regain threshold that has an acceptable sensibility to mental health-related issues to be used in research and clinical studies. METHODS: This is a observational study of bariatric patients submitted to Roux-en-Y bypass or sleeve gastrectomy, with a postoperative time of 2-10 years to access weight regain, depression, and binge-eating disorder. RESULTS: Of 217 patients studied, 163 were women and 54 were men, with an average postoperative time of 5.2±2.6 years. Weight regain was experienced in 35% of the patients, binge-eating disorder in 24.9%, and depression in 24%. The greater weight before surgery, body mass index (BMI), percentage increase to maximum weight loss, and time postoperatively all have a significant positive correlation with weight regain (p=0.045, p=0.026, p<0.001, and p<0.001, respectively). A significant association between binge-eating disorder, depression, and anxiety with weight regain (p=0.004, p=0.008, and p=0.001, respectively) was found. CONCLUSIONS: The significant weight regain rates with significant impact on psychiatric disorders highlight the need for continuous postoperative monitoring focused on the psychiatric aspects of obesity to aid surgeries' long-term success.
RESUMO INTRODUÇÃO: Embora a cirurgia bariátrica atualmente é considerada o tratamento padrão ouro para a obesidade, o reganho de peso afeta a taxa de sucesso do procedimento. Estudos recentes identificaram fatores psiquiátricos e neurológicos como possíveis causas. OBJETIVOS: Avaliar a influência de transtornos psiquiátricos no resultado a longo prazo das cirurgias bariátricas; testar a sensibilidade e correlação das fórmulas de reganho de peso e de seus respectivos pontos de corte para questões relacionadas à saúde mental. MÉTODOS: Estudo observacional de pacientes pós bariátricos submetidos à by-pass em Y de Roux ou gastrectomia vertical com pós-operatório de 2 a10 anos avaliados quanto a reganho de peso, depressão e transtorno da compulsão alimentar. RESULTADOS: Foram avaliados 217 pacientes, 163 mulheres e 54 homens com pós-operatório de 5,2±2,6 anos. O reganho de peso foi registrado em 35% dos pacientes, o transtorno da compulsão alimentar (TCA) foi encontrado em 24,9% e depressão em 24%. O ganho de peso pré-operatório, o índice de massa corporea (IMC), o aumento percentual para perda máxima de peso e tempo de pós-operatório, apresentaram correlação positiva significativa com o reganho de peso (p=0,045), (p=0,026), (<0,001), (<0,001). Foi encontrada associação significativa entre TCA, depressão e ansiedade com reganho de peso (p=0,004), (p=0,008) e (p=0,001). CONCLUSÕES: As taxas significativas de reganho de peso associado ao impacto dos transtornos psiquiátricos reforçam a necessidade de acompanhamento pós-operatório contínuo focado nos aspectos psiquiátricos da obesidade, para sucesso do tratamento cirúrgico em longo prazo.
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ABSTRACT Objectives: to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic. Methods: a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence. Results: the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations. Final Considerations: the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.
RESUMEN Objetivos: analizar experiencias subjetivas relacionadas a la adaptación a la atención remota por usuarios con trastornos alimenticios durante la pandemia de COVID-19. Métodos: estudio descriptivo de abordaje cualitativo realizado con usuarios de un ambulatorio especializado en trastornos alimenticios. Fue aplicada una entrevista semiestructurada remota, utilizándose el aplicativo Google Meet. Los datos fueron sometidos al análisis lexical mediante software ALCESTE y discutidos a la luz de las evidencias científicas. Resultados: la consulta remota es una estrategia positiva, pero no substitutiva de la presencial. Ventajas como economía financiera, mayor contacto con los profesionales y flexibilización de horarios de atenciones fueron citadas. Dificultad de evaluación clínica en relación al peso, signos vitales y poco dominio de tecnología fueron apuntados como limitaciones. Consideraciones Finales: el estudio induce la discusión sobre sistematización de atenciones remotas, las cuales, durante la pandemia de COVID-19, fueron responsables por fornecer mayor sensación de soporte a personas con trastornos alimenticios.
RESUMO Objetivos: analisar as experiências subjetivas relacionadas à adaptação ao atendimento remoto por usuários com transtornos alimentares durante a pandemia de COVID-19. Métodos: estudo descritivo de abordagem qualitativa realizado com usuários de um ambulatório especializado em transtornos alimentares. Foi aplicada uma entrevista semiestruturada remota, utilizando-se o aplicativo Google Meet. Os dados foram submetidos à análise lexical por meio do software ALCESTE e discutidos à luz das evidências científicas. Resultados: a consulta remota é uma estratégia positiva, mas não substitutiva da modalidade presencial. Vantagens como economia financeira, maior contato com os profissionais e flexibilização de horários de atendimentos foram citadas. Dificuldade de avaliação clínica em relação ao peso, sinais vitais e pouco domínio da tecnologia foram apontados como limitações. Considerações Finais: o estudo induz a discussão sobre sistematização dos atendimentos remotos, os quais, durante a pandemia de COVID-19, foram responsáveis por fornecer maior sensação de suporte às pessoas com transtornos alimentares.
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ABSTRACT This study aimed to identify changes in physical activity, sitting time, and binge eating disorder in Brazilian women during the COVID-19 pandemic. A cross-sectional and retrospective study was conducted online on 150 Brazilian women adults. The prevalence of binge eating and physically inactive women increased during the COVID-19 pandemic (p = < 0.001 and p = 0.01, respectively). Binge eating was associated with insufficient physical activity before (p = 0.01) and during the pandemic (p = 0.05). The physical activity time and sitting time showed no differences after adjustment for possible confounders (p > 0.05). In conclusion, the pandemic affected Brazilian women's lifestyle and eating behavior.
RESUMO Este estudo teve como objetivo identificar mudanças na atividade física, tempo sentado e transtorno da compulsão alimentar periódica em mulheres brasileiras durante a pandemia de COVID-19. Foi realizado um estudo transversal e retrospectivo por meio de um formulário on-line em 150 mulheres adultas brasileiras. A prevalência de compulsão alimentar e de mulheres fisicamente inativas aumentou durante a pandemia de COVID-19 (p = < 0,001 e p = 0,01, respectivamente). A compulsão alimentar foi associada à atividade física insuficiente antes (p = 0,01) e durante a pandemia (p = 0,05). O tempo de atividade física e o tempo sentado não apresentaram diferenças após ajuste para possíveis fatores de confusão (p > 0,05). Em conclusão, a pandemia afetou o estilo de vida e o comportamento alimentar das mulheres brasileiras.
RESUMEN El objetivo del estudio fue identificar cambios los cambios en la actividad física, el tiempo sentado y el trastorno por atracón en mujeres brasileñas durante la pandemia de COVID-19. Es un estudio transversal y retrospectivo que evaluó, a través de un formulario en línea en 150 mujeres brasileñas adultas. La prevalencia de atracones y de mujeres físicamente inactivas aumentó durante la pandemia de COVID-19 (p = < 0,001 y p = 0,01, respectivamente). Los atracones se asociaron con actividad física insuficiente antes (p = 0,01) y durante la pandemia (p = 0,05). El tiempo de actividad física y el tiempo sentado no difirieron después del ajuste por posibles factores de confusión (p > 0,05). En conclusión, la pandemia afectó el estilo de vida y el comportamiento alimentario de las mujeres brasileñas.
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RESUMEN Introducción: Los trastornos de la conducta alimentaria (TCA) son afecciones complejas de origen multifactorial que tienen como principal característica la preocupación excesiva por el peso y la forma del cuerpo, que causa gran malestar y afectación física llevando a una disminución de la calidad de vida y alteraciones de la funcionalidad del paciente y su entorno social. El objetivo de este estudio es describir los síntomas de orden emocional y conductual de los adolescentes que consultan en la ciudad de Bogotá a un programa especializado en TCA. Métodos: Estudio observacional y descriptivo de corte transversal, para el que se reclutó a pacientes de 11-19 arios con diagnóstico de TCA. Resultados: Se incluyeron 40 pacientes con diagnóstico de TCA, el 92% mujeres. El promedio de edad de los pacientes fue 16,6 ± 1,9 años. El 57% de los pacientes viven en hogar biparental y el 30%, en hogar monoparental. El 72% de la población tenía un rendimiento académico excelente. El 50% de los pacientes estaban moderadamente enfermos. El 60% estaba en tratamiento farmacológico con ISRS. El 65% de los pacientes cumplían criterios clínicos de trastorno de ansiedad; el 30%, de trastorno depresivo; el 22,5%, de problemas de agresividad, y el 17,5%, de conducta delictiva. El 72,5% de la muestra muestra criterios clínicos de síntomas internalizantes y el 42,5%, de síntomas externalizantes, y la mayoría de ellos son pacientes con diagnóstico de bulimia nerviosa. Conclusiones: Los pacientes con bulimia nerviosa obtuvieron en los diferentes síntomas de orden emocional y conductual puntuaciones superiores que con los demás trastornos alimentarios. Esta entidad ofrece mayor psicopatología, la cual se debe examinar rigurosamente al momento de la atención clínica, buscando disminuir el impacto funcional que estos síntomas generan en el individuo.
ABSTRACT Introduction: Eating disorders (EDs) are complex conditions of multifactorial origin. Their main characteristic is excessive concern about body weight and shape, which causes great discomfort and physical problems and leads to a decrease in quality of life and alterations in the patient's functionality social environment. The objective of this study is to describe the emotional and behavioural symptoms of adolescents who consult a specialised ED programme in the city of Bogota. Methods: Observational, descriptive, cross-sectional study, for which patients between 11 and 19 years old with an ED diagnosis were recruited. Results: Forty patients with an ED diagnosis were included, of which 92% were female. The mean age of the patients was 16.6 ± 1.9 years; 57% of patients live in a two-parent home and 30% in a single-parent home; 72% of the sample had excellent academic performance; 50% were moderately ill; 60% received pharmacological management with SSRIs; 65% of patients met clinical criteria for anxiety disorder, 30% for depressive disorder; 22.5% had aggression problems; 17.5% criminal behaviour; 72.5% of the sample met clinical criteria for internalising symptoms and 42.5% for externalising symptoms, the majority being patients with a diagnosis of bulimia nervosa. Conclusions: Patients with bulimia nervosa obtained higher scores in the different emotional and behavioural symptoms than those with other eating disorders. This condition is associated with greater psychopathology, which must be examined rigorously at the time of clinical care, seeking to reduce the functional impact that these symptoms generate on the individual.
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O estudo analisou o papel preditor dos sintomas de dismorfia muscular na dependência de exercícios e na ortorexia em 158 praticantes de exercício brasileiros (corrida = 38, crossfit = 85, musculação = 35) de ambos os sexos (mulheres = 81, homens = 77), com idade média de 31,59 anos (± 7,99) e experiência de 4,5 anos (± 5,27). Utilizou-se a Escala de Dedicação ao Exercício, o Questionário para o Diagnóstico de Ortorexia e o Questionário Complexo em Adonis. A análise dos dados foi conduzida por meio da correlação de Pearson e de análise de regressão múltipla (p < 0,05). A dismorfia muscular prediz positivamente a dependência de exercícios (ß = ,51, p < ,001) e negativamente a ortorexia (ß = -,19, p < ,01), sendo importante discutir a temática com praticantes de exercícios físicos a fim de minimizar a prevalência e os efeitos deletérios associados a esse distúrbio psicológico
This study aimed to analyze the predictive role of muscle dysmorphia symptoms in exercise addiction and orthorexia in 158 Brazilian exercise practitioners (running = 38, crossfit = 85, bodybuilding = 35) of both sexes (women = 81, men = 77), with a mean age of 31.59 years (± 7.99) and experience of 4.5 years (± 5.27). The Dedication to Exercise Scale, the Questionnaire for the Diagnosis of Orthorexia, and the Complex in Adonis Questionnaire were used. Data analysis was conducted through Pearson's correlation and multiple regression analysis (p < .05). It was found that the muscle dysmorphia symptoms predicted positively exercise addiction (ß = .51, p < .001) and negatively orthorexia (ß = -.19, p < .01), and it is important to discuss the issue with physical exercise practitioners in order to minimize the prevalence and deleterious effects associated with this psychological disorder.
O estudo analisou o papel preditor dos sintomas de dismorfia muscular na dependência de exercícios e na ortorexia em 158 praticantes de exercício brasileiros (corrida = 38, crossfit = 85, musculação = 35) de ambos os sexos (mulheres = 81, homens = 77), com idade média de 31,59 anos (± 7,99) e experiência de 4,5 anos (± 5,27). Utilizou-se a Escala de Dedicação ao Exercício, o Questionário para o Diagnóstico de Ortorexia e o Questionário Complexo em Adonis. A análise dos dados foi conduzida por meio da correlação de Pearson e de análise de regressão múltipla (p < 0,05). A dismorfia muscular prediz positivamente a dependência de exercícios (ß = ,51, p < ,001) e negativamente a ortorexia (ß = -,19, p < ,01), sendo importante discutir a temática com praticantes de exercícios físicos a fim de minimizar a prevalência e os efeitos deletérios associados a esse distúrbio psicológico.
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Humans , Male , Female , Exercise , Body Dysmorphic Disorders , Orthorexia Nervosa , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Resistance Training , Binge-Eating Disorder , Data Analysis , Body DissatisfactionABSTRACT
Introdução: O Transtorno de Compulsão Alimentar Periódica é definido como episódios recorrentes e incontroláveis de compulsão alimentar, tendo como característica essencial para o diagnóstico a presença destes episódios, que devem ocorrer pelo menos uma vez por semana, durante um período de três meses. Os transtornos alimentares causam danos severos à vida psíquica dos portadores, como o desenvolvimento de patologias do humor. O objetivo geral do estudo foi avaliar a prevalência de Transtorno de Compulsão Alimentar Periódica em estudantes mulheres do curso de Medicina da Universidade do Sul de Santa Catarina, campus Tubarão/SC. Métodos: Os dados foram obtidos através de formulário aplicado online, contendo a Escala de Compulsão Alimentar Periódica e dados sociodemográficos e clínicos das participantes. A amostra final foi composta por 185 participantes. Resultados: A prevalência encontrada de Transtorno de Compulsão Alimentar Periódica entre as pesquisadas foi de 30,81%, sendo 24,86% classificado como moderado e 5,95% como grave. Houve correlação positiva entre o transtorno pesquisado e etnia, uso prévio ou atual de medicação antidepressiva ou ansiolítica, uso prévio ou atual de anorexígeno, diagnóstico prévio ou atual de transtorno alimentar e tratamento psiquiátrico prévio ou atual. Não ocorreu relação estatisticamente significante entre Transtorno de Compulsão Alimentar Periódica e idade. Entre os anorexígenos utilizados previamente, o mais citado foi a sibutramina. Conclusão: Foi encontrada uma elevada prevalência de Transtorno de Compulsão Alimentar Periódica, corroborando com a ideia de que universitários, principalmente de cursos da área da saúde, possuem uma prevalência maior de transtornos alimentares do que a população em geral.
Introduction: Periodic binge eating disorder is defined as recurrent and uncontrollable episodes of binge eating, having as an essential characteristic for the diagnosis the presence of these episodes, which must occur at least once a week for three months. Eating disorders cause severe damage to the psychic life of sufferers, such as the development of mood disorders. The study aimed to assess the prevalence of periodic binge eating disorder in female medical students at the University of Southern Santa Catarina (Universidade do Sul de Santa Catarina [UNISUL]), Tubarão/SC campus. Methods: Data were obtained through an online form containing the Periodic Eating Compulsion Scale (PCES) and participants' sociodemographic and clinical data. The final sample was composed of 185 participants. Results: The prevalence of Periodic Eating Compulsive Disorder among the surveyed women was 30.81%, with 24.86% classified as moderate and 5.95% as severe. There was a positive correlation between the disorder and ethnicity, previous or current use of antidepressant or anxiolytic medication, previous or current use of anorexics, previous or current diagnosis of eating disorders, and previous or current psychiatric treatment. There was no statistically significant relationship between binge eating disorder and age. Among the anorexics previously used, the most cited was sibutramine. Conclusion: A high prevalence of binge eating disorder was found, corroborating the idea that college students, especially in health courses, have a higher prevalence of eating disorders than the general population.
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Binge-Eating DisorderABSTRACT
ABSTRACT Objective: Binge eating disorder (BED) is the most prevalent eating disorder in individuals with obesity. Its association with factors that control hunger and satiety has not yet been elucidated. We evaluated whether levels of inflammatory markers, frequency of psychiatric comorbidities, and appetite-related hormones levels differ between individuals with obesity with and without BED. Materials and methods: The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 - Clinician Version (SCID-5-CV), Binge Eating Scale, and Hospital Anxiety and Depression Scale were evaluated in 39 individuals with obesity. Plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), leptin, ghrelin, and glucagon-like peptide-1 (GLP-1) were measured. Results: Individuals of the BED group exhibited significantly higher percentages of altered eating patterns (hyperphagia, bingeing, post-dinner eating, feeling "stuffed", and emotional eating), higher depressive symptom scores and levels of leptin, CRP, and TNF-α, compared to those from the non-BED group. Logistic regression showed that BED was independently associated with depressive symptoms and CRP levels. Conclusions: Individuals with obesity and BED showed greater psychiatric comorbidity, worse eating patterns and worse inflammatory profile than those without BED. BED should be assessed as an indicator of clinical severity in patients with obesity.
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El trastorno por atracón (TA) se caracteriza por el consumo de grandes cantidades de alimentos en corto tiempo acompañados de sensación de pérdida de control sobre la ingesta o la cantidad. Este trastorno alimentario se ha asociado con la obesidad constituyendo un factor de riesgo para futuras ganancias de peso corporal. El objetivo fue identificar la frecuencia del trastorno por atracón y determinar los factores asociados al mismo en adultos que cursan con obesidad que concurren al microcentro de la ciudad de San Lorenzo, en noviembre del 2018. Estudio transversal descriptivo, realizado en 92 sujetos con obesidad entre 20 y 59 años, que concurrieron al microcentro de la ciudad de San Lorenzo en noviembre del 2018. Se recolectaron datos sociodemográficos, clínicos, antropométricos y relacionados al estilo de vida mediante un instrumento al cual se anexó el cuestionario Binge Eating Scale (BES) traducido y validado al español para la evaluación del trastorno por atracón. El protocolo de investigación fue aprobado por el Comité de Ética de la Facultad de Ciencias Químicas de la Universidad Nacional de Asunción. La frecuencia del trastorno por atracón fue del 20,7% (n=19) de los cuales 17 personas presentaron TA moderado y 2 individuos TA severo y los factores que se encontraron asociados fueron: los antecedentes de obesidad, la realización de tratamientos previos para la pérdida de peso, y el consumo de alcohol (p<0,05). La muestra estudiada presentó una frecuencia de TA similar a la prevalencia de adultos con obesidad de Latinoamérica (16-51,6%).
Binge eating disorder (BED) is characterized by the consumption of large amounts of food in a short time accompanied by a feeling of loss of control over intake or quantity. This eating disorder has been associated with obesity constituting a risk factor for future body weight gains. The objective was to identify the frequency of binge eating disorder and determine the factors associated with it in adults who are obese and attend the microcenter of the city of San Lorenzo in November 2018. Descriptive cross-sectional study, conducted in 92 subjects with obesity between 20 and 59 years old, who attended the microcenter of the city of San Lorenzo in November, 2018. Sociodemographic, clinical, anthropometric and lifestyle-related data were collected using an instrument to which the Binge Eating Scale (BES) questionnaire translated and validated into Spanish for the evaluation of binge eating disorder was attached. The research protocol was approved by the Ethics Committee of the Faculty of Chemical Sciences of the National University of Asunción. The frequency of binge eating disorder was 20.7% (n=19), 17 people had moderate BED, 2 had severe BED and the factors associated were: history of obesity, prior treatments for weight loss, and alcohol consumption (p<0.05). The sample studied presented a frequency of BED similar to the prevalence of adults with obesity in Latin America (16-51.6%).
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Resumen: Objetivo: Evaluar la efectividad de una intervención multidisciplinar en línea (psicológica, médica y nutricional) en mujeres con trastornos por atracón (TpA). Método: participaron 5 mujeres diagnosticadas con TpA con una edad promedio de 43.2 años y un peso corporal inicial promedio de 90 kg. El tratamiento se realizó durante 24 sesiones, cada una de dos horas por semana; la primera hora era terapia grupal y la segunda individual. Se contó con cuatro momentos de evaluación: pre, post y dos seguimientos Resultados: Las comparaciones se realizaron a través de la prueba no paramétrica de Friedman, encontrando una disminución estadísticamente significativa de la sintomatología de atracón pre χ1= 30.30 al segundo seguimiento χ2=10.80 (x2=12.84; p=.005), sintomatología de ansiedad χ1= 28.80 χ2=12.40 (x2=10.83.96; p=.013) y depresión χ1= 19.80, χ2=4.0 (x2=10.18; p=.017). Se observó mejoría en la comprensión χ1= 21.00, χ2=30.20 (x2=9.63; p=.025) y regulación emocional χ1= 28.40 χ2=33.00, (x2=7.77; p=.050). Las pacientes redujeron su peso corporal, mejoraron hábitos alimentarios introduciendo fruta y verdura diariamente e incluyeron la actividad física en su rutina diaria, realizando de 20 a 30 minutos diarios. A partir del cambio clínico objetivo se observó un cambio positivo en las variables abordadas en tratamiento en todas las participantes. Conclusiones: Se puede observar que la intervención multidisciplinaria en línea fue efectiva en el tratamiento de TpA en mujeres.
Abstract: Objective: To evaluate the effectiveness of a multidisciplinary online intervention (psychological, medical, and nutritional) in women with binge eating disorder (BED). Method: 5 women diagnosed with BED with a mean age of 43.2 years and a mean initial body weight of 90 kg participated. The treatment was carried out during 24 sessions, each of two hours per week; the first hour was group therapy and the second individual. There were four moments of evaluation: pre, post and two follow-ups. Results: The comparisons were made through the non-parametric Friedman test, finding a statistically significant decrease in binge eating symptoms before χ1= 30.30 at the second follow-up χ2 =10.80 (x2=12.84; p=.005), symptoms of anxiety χ1= 28.80, χ2=12.40 (x2=10.83.96; p=.013) and depression χ1= 19.80, χ2=4.0 (x2= 10.18, p=.017). Improvement was observed in comprehension χ1= 21.00, χ2=30.20 (x2=9.63; p=.025) and emotional regulation χ1= 28.40 χ2=33.00, (x2=7.77; p=.050). The patients reduced their body weight, improved their eating habits by introducing fruit and vegetables daily and included physical activity in their daily routine, performing 20 to 30 minutes a day. From the objective clinical change, a positive change was observed in the variables addressed in treatment in all the participants. Conclusions: The online multidisciplinary intervention was effective in the treatment of BED in women.
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Humans , Female , Adult , Middle Aged , Patient Care Team , Binge-Eating Disorder/therapy , Internet-Based Intervention , Anxiety , Body Weight , Exercise , Follow-Up Studies , Treatment Outcome , Depression , Emotional Intelligence , Binge-Eating Disorder/diagnosis , Binge-Eating Disorder/psychologyABSTRACT
BACKGROUND: The use of probiotics as adjuvants in the treatment of eating disorders, known as psychobiotics, has already been investigated as a means of modulating the microbiota-gut-brain axis. AIM: This study aimed to assess the effect of probiotic supplementation on binge eating and food addiction in subjects after Roux-en-Y gastric bypass surgery. METHODS: This is a randomized, double-blind, placebo-controlled trial involving 101 patients who received probiotic (Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07) or placebo supplements for 90 days after bariatric surgery, starting on the seventh postoperative day. They were evaluated preoperatively (T0) and postoperatively at 90 days (T1) and 1 year (T2) after surgery. The Yale Food Addiction Scale (YFAS) and Binge Eating Scale (BES) were applied to assess food addiction and binge eating, respectively. RESULTS: Before surgery, one-third of the patients presented with a food addiction and binge eating diagnosis. The number of symptoms of YFAS and the BES score decreased significantly in both groups at T1 compared to T0. However, a significant effect of treatment with probiotics was observed 1 year after surgery (T2). Both the number of symptoms of food addiction and the binge eating score were lower in the probiotic group than in the placebo group (p=0.037 and p=0.030, respectively). CONCLUSION: The use of probiotic supplementation for 90 days in the immediate postoperative period may decrease food addiction symptoms and binge eating score up to 1 year after surgery compared to controls.
RESUMO - RACIONAL: O uso de probióticos como coadjuvantes no tratamento de distúrbios alimentares, conhecidos como psicobióticos, já foi investigado na modulação do eixo intestino-microbiota-cérebro. OBJETIVO: Analisar a influência da suplementação com probióticos no vício e compulsão alimentar em indivíduos submetidos à cirurgia de bypass gástrico em Y-de-Roux MÉTODOS: Trata-se de um estudo randomizado, duplo-cego, controlado por placebo, envolvendo 101 pacientes que receberam suplementação de probiótico (Lactobacillus acidophilus NCFM e Bifidobacterium lactis Bi-07) ou placebo, durante 90 dias após a cirurgia bariátrica, com início no sétimo dia de pós-operatório. Os indivíduos foram avaliados no pré-operatório (T0) e no pós-operatório aos 90 dias (T1) e 1 ano (T2) após a cirurgia. A Escala de Dependência Alimentar de Yale (YFAS) e a Escala de Compulsão Alimentar Periódica (ECAP) foram aplicadas para avaliar o vício e compulsão alimentar, respectivamente. RESULTADOS: Antes da cirurgia, um terço dos pacientes apresentou diagnóstico de dependência alimentar e compulsão alimentar. O número de sintomas da YFAS e a pontuação da ECAP diminuiu significativamente em ambos os grupos em T1 em comparação com T0. Entretanto, um ano após a cirurgia (T2), tanto o número de sintomas de vício alimentar como a pontuação de compulsão alimentar foram menores no grupo probiótico do que no grupo placebo (p = 0,037 e p = 0,030, respectivamente). CONCLUSÃO: A utilização de suplemento probiótico durante 90 dias após a cirurgia pode diminuir os sintomas de vício alimentar e a pontuação de compulsão alimentar um ano após a cirurgia em comparação com o grupo controle.
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Introdução: Este estudo tem como objeto avaliar as consequências geradas pelas medidas de isolamento social na saúde mental de pessoas com transtornos alimentares atendidas em um ambulatório especializados no município do Rio de Janeiro. Objetivos: descrever características sociodemográficas e clínicas de pessoas com transtornos alimentares em um ambulatório especializado; analisar as consequências da pandemia de COVID-19 na saúde mental de pessoas com transtornos alimentares em acompanhamento ambulatorial; discutir as ferramentas de acompanhamento em saúde mental no período de isolamento social em um ambulatório especializado em transtornos alimentares. Método: Pesquisa descritiva de caráter qualitativo com usuários de 18 a 60 anos diagnosticados com anorexia nervosa, bulimia nervosa ou transtorno de compulsão alimentar e suas formas subclínicas, em tratamento especializado durante a pandemia de COVID-19. O cenário foi o ambulatório do Grupo de Obesidade e Transtornos Alimentares (GOTA) de um Instituto de Psiquiatria universitário. Foram utilizados dados retrospectivos sobre características clínicas e demográficas dos usuários, coletados nos prontuários clínicos e de entrevistassemi-estruturadas aplicadas de forma remota. Os dados foram analisados através dos softwares ALCESTE e Microsoft Excel 2019 e discutidos a partir da literatura científica sobre o tema. As análises realizadas pelo ALCESTE evidenciaram 4 classes de palavras predominantes, sendo a de impactos socioeconômicos a mais relevante, seguida da classe referente ao suporte profissional em saúde mental recebido durante a pandemia, da classe referente aos impactos na autoestima e autopercepção dos participantes e por fim, da classe referente aos impactos na rotina de alimentação. Resultados: A amostra foi constituída de 16 mulheres com predomínio da cor branca, com faixa etária de 18 à 30 anos, sendo o diagnóstico de transtorno de compulsão alimentar o mais frequente. A pandemia resultou em sensação de perda de controle devido a modificações na rotina, tendo culminado em piora do comportamento alimentar e aumento de mecanismos compensatórios. Em alguns casos, o isolamento social foi considerado pelos participantes como ferramenta para reestruturação emocional. Os impactos socioeconômicos ocorreram de maneira indiferente a estrato social. A introdução do atendimento remoto no serviço foi considerado um fator protetor na manutenção do tratamento, com vantagens como economia financeira e maior flexibilidade de horário. Foram apontadas desvantagens como dificuldade de monitoramento de dados antropométricos e exame físico. Conclusão: Os desdobramentos do isolamento social refletiram em diferentes campos da vida dos participantes, tais como saúde física, mental, convivência intradomiciliar, impactos socioeconômicos e modificações no suporte profissional para o transtorno alimentar. O atendimento remoto foi apontado como uma estratégia promissora para prestação de assistência a esse público, necessitando melhor sistematização para o futuro, com potencial de permanência não somente em períodos pandêmicos. Para os profissionais de saúde, a pesquisa indica que os usuários com transtornos alimentares reconhecem o valor do atendimento no ambulatório, o que requer capacitação e maior participação da enfermagem na equipe interdisciplinar.
Introduction: This research has as aim to evaluate the consequences caused by social restriction measures in the mental health of clients with eating disorders attended in a specialized ambulatory in the city of Rio de Janeiro. Objectives: to describe sociodemographic and clinical characteristics of people with eating disorders in a specialized ambulatory; to analyse the consequences of the COVID-19 pandemic in the mental health of people with eating disorders; to discuss tools of mental health support during the social isolation in an ambulatory specialized on eating disorders. Methods: Descriptive study with qualitative design including clients between 18-60 years old diagnosed with anorexia nervosa, bulimia nervosa or binge eating disorders and its subclinical presentations in specialized treatment during the pandemic. The place of the study it was the Grupo de Obesidade e Transtornos Alimentares (GOTA) ambulatory of an academic psychiatric institute. It was used restropective data about clinical and demographical characteristics collected of the medical records and it was applied a semi-structured interview by remote mode. Data was analysed by the softwares ALCESTE and Microsoft Excel 2019, and discussed by the cientific literature about the subject. The analysis presented 4 classes of predominant words, within the socioeconomical impacts one being the most relevant, followed by the class referring to the professional mental health support during the pandemic, by the class referring to the impacts on self steem and self perception of the participants and finally, by the class referring to impacts on the food routine. Results: The sample was constituted by 16 women, with white skin color predominance, ages between 18 to 30 years old, with binge eating disorder being the most frequent diagnose. The pandemic resulted in a sense of loss of controle because of changes in the routine, resulting in worsening of food behaviour and increasing in compensatory behaviour. In some cases, social restriction was considered by participants as a tool for emotional reestructuration. The socioeconomical impacts existed regardless of social stratum. The introduction of the remote consultation was considered a protective factor on the treatment maintenance, including benefits such as financial economy and greater time flexibility. It were considered disadvantagens such as difficulty on monitoring anthropometric data and physical examination. Conclusion: The outspread of social restriction reflected in diverse life fields of the participants, such as physical health, mental health, household coexistency and changes on the professional support to eating disorders. The remote consultation was pointed as a promissory strategy to provide assistance to this public, and it needs better systematization to the future, within potential of implementation not only in pandemic periods. To healthcare professionals, the study indicates that users with eating disorders recognize the value of an ambulatory assistance, which requires training courses and a bigger participation of nursing on interdisciplinary teams.
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Humans , Female , Adult , Middle Aged , Social Isolation/psychology , Feeding and Eating Disorders/nursing , Mental Health , COVID-19/psychology , Feeding and Eating Disorders/diagnosis , Sleep Disorders, Circadian Rhythm/psychology , Qualitative Research , Mental Health AssistanceABSTRACT
ABSTRACT Food desires are defined as motivations that drive the search for and consumption of food. However, when domains of intensity and urgency are activated, these desires can become intense (i.e. food craving), being then characterized by episodes or cognitive events loaded with affectivity, in which food is associated with obtaining pleasure or relief, which is the only attentional focus. Specificity and urgency mark the differentiation between food desires and cravings. The process of elaboration with vivid images, the retention in working memory, the emergence of a negative affect state (awareness of the lack), and a committed attentional focus to seek food are characterized as stages of an episode of food craving. Individuals with eating disorders have the lowest levels of food craving when it comes to anorexia nervosa and the subsequent increase to bulimia nervosa and binge eating disorder. Some environmental and cultural triggers and internal factors of cognition and emotions play a crucial role in the emergence of food craving episodes. The external factors include positive/negative events, food environment, advertisements, cultural beliefs about food, specific locations, and food itself. The internal factors comprise dietary restriction, food reward, impulsivity/inflexibility, emotions, thoughts and feelings about food, hunger/satiety/appetite, and anxious/depressive symptoms. Treatment involves the association of flexibility, awareness, and questioning strategies about dietary practices based on three principles: unconditional permission to eat, eating more for physical than emotional reasons, and tuning in with the body's signs of hunger and satiety (intuitive eating).
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Resumen Objetivo: Examinar la efectividad, contenido, tipos de intervención y calidad de los tratamientos psicológicos de trastorno por atracón (TPA) en mujeres, que se han realizado en los últimos 20 años. Método: La revisión sistemática se realizó basada en la guía PRISMA y fue llevada acabo de Septiembre de 2018 a Junio de 2020 en las bases de datos: Medline, Scopus, Sciencedirect, Scielo, Redalyc y LILACS. Resultados: Se identificaron 206 artículos potencialmente relevantes, se seleccionó 15 que cumplían los criterios de inclusión. En el análisis de resultados se identificó que la mayoría de los estudios tuvo como objetivo probar la efectividad de las intervenciones. Los enfoques clínicos más utilizados fue la Terapia Cognitivo Conductual, la Terapia Dialéctica Conductual, la Terapia de Imagen Corporal y el Psicoanálisis. Los cuestionarios más utilizados para medir el TPA fueron el Eating Disorder Examination, la entrevista clínica basada en el DSM y la Escala de Atracón (BES). Discusión: Se observan retos en el trabajo multidisciplinario, además de resaltar la importancia del compromiso colaborativo con el paciente. Se plantea la necesidad de mayores estudios que consoliden y profundicen en la evaluación y tratamiento temprano del trastorno, así como ahondar en el enfoque emocional.
Abstract Objective: To examine the effectiveness, content, types of intervention and quality of psychological treatments for binge eating disorder (BED) in women, which have been carried out in the last 20 years. Method: The systematic review was carried out based on the PRISMA guide and was carried out from September 2018 to June 2020 in the databases: Medline, Scopus, ScienceDirect, Scielo, Redalyc and LILACS. Results: 206 potentially relevant articles were identified, 15 were selected that met the inclusion criteria. In the analysis of results, it was identified that the majority of the studies aimed to test the effectiveness of the interventions. The most widely used clinical approaches were Cognitive Behavioral Therapy, Dialectical Behavioral Therapy emphasizing the emotional component and interpersonal relationships, finally Body Image Therapy and Psychoanalysis. The most widely used questionnaires to measure BED were the Eating Disorder Examination, the DSM-based clinical interview and the Binge Eating Scale. Discussion: Challenges in multidisciplinary work are observed, in addition to highlighting the importance of collaborative commitment with the patient. There is a need for further studies that consolidate and deepen the early evaluation and treatment of the disorder, as well as delving into the emotional approach.
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Objective: To grade the evidence about risk factors for eating disorders (anorexia nervosa, bulimia nervosa, and binge eating disorder) with an umbrella review approach. Methods: This was a systematic review of observational studies on risk factors for eating disorders published in PubMed/PsycInfo/Embase until December 11th, 2019. We recalculated random-effect meta-analyses, heterogeneity, small-study effect, excess significance bias and 95% prediction intervals, grading significant evidence (p < 0.05) from convincing to weak according to established criteria. Quality was assessed with the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. Results: Of 2,197 meta-analyses, nine were included, providing evidence on 50 risk factors, 29,272 subjects with eating disorders, and 1,679,385 controls. Although no association was supported by convincing evidence, highly suggestive evidence supported the association between childhood sexual abuse and bulimia nervosa (k = 29, 1,103 cases with eating disorders, 8,496 controls, OR, 2.73, 95%CI 1.96-3.79, p = 2.1 x 10-9, AMSTAR-2 moderate quality) and between appearance-related teasing victimization and any eating disorder (k = 10, 1,341 cases with eating disorders, 3,295 controls, OR 2.91, 95%CI 2.05-4.12, p = 1.8x10-9, AMSTAR-2 moderate quality). Suggestive, weak, or no evidence supported 11, 29, and 8 associations, respectively. Conclusions: The most credible evidence indicates that early traumatic and stressful events are risk factors for eating disorders. Larger collaborative prospective cohort studies are needed to identify risk factors for eating disorders, particularly anorexia nervosa.
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Humans , Child , Anorexia Nervosa/epidemiology , Feeding and Eating Disorders/epidemiology , Bulimia Nervosa/epidemiology , Prospective Studies , Risk FactorsABSTRACT
Los trastornos de la conducta alimentaria afectan a mujeres en edad fértil, sin embargo, la intersección de éstos y el embarazo es aún pobremente comprendida, existiendo aún datos limitados en la literatura. Esta revisión narrativa resume la evidencia actual acerca de los trastornos alimentarios durante el embarazo: su prevalencia, curso, el impacto que éstos tienen en la salud materna, fetal y en su descendencia, así como posibles estrategias de intervención.
Eating disorders affect women of childbearing age, however, their intersection with pregnancy is still poorly understood, while there is still limited data in the literature. This narrative review summarizes the current evidence about eating disorders during pregnancy: their prevalence, course, the impact they have on maternal, fetal and offspring health, as well as possible intervention strategies.
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Humans , Female , Pregnancy , Pregnancy Complications/psychology , Feeding and Eating Disorders , Bulimia , Anorexia Nervosa , Depression, Postpartum , Binge-Eating DisorderABSTRACT
Eating disorder (ED) is a kind of chronic refractory mental disorder with high prevalence rate, high recurrence rate, high disability rate and heavy social burden.There is a close relationship between eating disorder and emotional regulation.More and more studies have shown that ED patients have abnormal emotional regulation.Emotional disorder is a feature of ED patients, and ED patients are easy to take abnormal eating ways to relieve their negative emotions.Studies have shown that the amygdala, ventral striatum (VS), nucleus accumbens (NAc), anterior cingulate cortex (ACC), prefrontal cortex (PFC) and subcallosal components (SCC) are crucial for emotion regulation and homeostasis.The structural and functional changes of these brain regions are closely related to emotional stimuli and impaired regulation in patients with ED.The purpose of this review is to summarize the neural mechanism of ED abnormal emotion regulation and discuss the future research direction.
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ABSTRACT Objective To evaluate whether the carbohydrate-restricted diet leads to higher levels of food cravings in individuals with binge eating. Methods A total of 146 individuals with binge eating participated in the Low-Carb Diet Group (n=48) and Control Group (n=98). The Binge Eating Scale, Hay's questionnaire, Food Cravings Questionnaire - Trait and State, Cognitive restraint subscale and its adapted version for the cognitive restraint toward carbohydrates, were used as measures. Parametric tests were used for comparison between groups (Student's t test), and Pearson's correlation test to verify correlations between variables of interest. Results No differences were found between groups with and without diet concerning the level of binge eating or food craving total score. The differences found were the higher levels of cognitive restraint (p=0.01), cognitive restraint for carbohydrates (p=0.01) and subscales of 'guilt about food craving' (p=0.04) in the Low-Carb Diet Group. Conclusion Individuals with binge eating and a history of low-carb diet have greater cognitive restraint toward carbohydrates and association with altered eating attitudes (guilt about food craving).
RESUMO Objetivo Avaliar se a dieta com restrição de carboidratos acarreta níveis elevados de desejos intenso por comida em indivíduos com compulsão alimentar. Métodos Participaram 146 indivíduos com compulsão alimentar divididos nos Grupos Dieta Low Carb (n=48) e Grupo Controle (n=98). Foram utilizados como medidas: Escala de Compulsão Alimentar Periódica, Questionário de Hay, Questionário de Desejos Intensos por Comida - Traço e Estado, Subescala de restrição cognitiva e sua versão adaptada para a restrição cognitiva direcionada aos carboidratos. Foram utilizados testes paramétricos para comparação entre grupos (teste t de Student) e o teste de correlação de Pearson para verificar correlações entre variáveis de interesse. Resultados Não foram encontradas diferenças entre grupos com e sem prática de dieta em relação ao nível de compulsão alimentar ou ao escore total para desejos intensos por comida. As diferenças encontradas foram os maiores níveis de restrição cognitiva (p=0,01), restrição cognitiva para carboidratos (p=0,01) e subescalas de 'culpa por causa dos desejos' (p=0,04) no Grupo Dieta Low Carb. Conclusão Indivíduos com compulsão alimentar e histórico de dieta com restrição de carboidratos (low carb) possuem maior restrição cognitiva direcionada aos carboidratos e associação com atitudes alimentares alteradas (culpa pelos desejos).