Enfrentamento do estigma relacionado ao peso corporal no cuidado em saúde: impactos de um curso educativo em profissionais de saúde / Tackling weight stigma in healthcare: impacts of an educational course on health care professionals

Introdução:O estigma relacionado ao peso corporal, presente entre profissionais e estudantes da área da saúde, prejudica a saúde e o cuidado de pessoas com sobrepeso e obesidade, e deve ser combatido. Objetivo:Este artigo visa relatar os resultados obtidos por meio da aplicação de um curso educativo sobre estigma relacionado ao peso corporal e o cuidado em saúde. Métodos:A aplicação ocorreu com 11 profissionais de saúde e teve desenho misto. No componente quantitativo, foi realizada análise estatística dos resultados iniciais e finais obtidos por meio da Escala de Atitudes Antiobesidade (AFAT), com realização de teste t pareado (nível de significância de p ≤ 0,05). No componente qualitativo, foi realizada análise de conteúdo temática de uma atividade final dissertativa sobre ideias que ficaram marcadas a partir do curso. Feedbacksestruturados a respeito da qualidade do material foram preenchidos. Resultados:As análises estatísticas não identificaram alterações entre os valores iniciais e finais da AFAT (p >0,05), com escore geral médio inicial de 0,418 e final de 0,419. Cinco temas emergiram da análise de conteúdo, os quais demonstram aprendizagem quanto à multifatorialidade da obesidade; reconhecimento de implicações interseccionais; compreensão dos impactos do estigma no cuidado em saúde; estímulo ao pensamento crítico; e considerações sobre o curso, no geral, bem avaliado de forma consistente. Conclusão:O instrumento quantitativo não indicou mudança; contudo, as análises qualitativas demonstram que o curso promoveu compreensão ampliada sobre os temas discutidos, bem como a reflexão e a autocrítica das/os profissionais.

Introduction:Weight stigma, present among health professionals and students, harms the health and healthcare of people with overweight and obesity and must be combated. Objective:This article aims to report the results obtained through a test application of an educational course on weight stigma and healthcare. Methods:The test was carried out with 11 healthcare professionals and had a mixed design. In the quantitative component, statistical analysis was carried out on the initial and final results obtained using theAntifat Attitudes Scale (AFAT), with a paired t test (significance level of p ≤ 0.05). In the qualitative component, a thematic content analysis was carried out with data produced in a final dissertation activity about ideas that were highlighted from thecourse. Structured feedback regarding the quality of the material was completed. Results:Statistical analyzes did not identify changes between initial and final AFAT values (p >0.05), with an initial overall average score of 0.418 and final of 0.419. Five themes emerged from the content analysis, which demonstrate learning regarding the multifactorial nature of obesity; recognition of intersectional implications; understanding of impacts of stigma on health care; stimulation of critical thinking; and considerations about the course, overall, consistently well evaluated. Conclusion: The quantitative instrument did not indicate change, however, qualitative analysis indicated that the course promoted expanded understanding of the topics discussed, as well as reflection and self-criticism by professionals.

"Narrativas de Peso": relato da experiência de construção de um curso educativo sobre estigma relacionado ao peso corporal e o cuidado em saúde / "Narraciones de Peso": relato de la experiencia de la construcción de un curso educativo sobre el estigma relacionado al peso corporal y el cuidado de la salud / "Narratives of Weight": experience report of the construction of an educational course about weight stigma and health care

O estigma relacionado ao peso corporal, definido como a desvalorização de indivíduos devido ao volume de seu corpo mais elevado, ocasiona prejuízos à saúde e está presente entre estudantes e profissionais da saúde. Abordar tal estigma em espaços de formação desses profissionais é crucial para combatê-lo. Este artigo relata a experiência de construção do curso educativo "Narrativas de peso: o estigma relacionado ao peso corporal e o cuidado em saúde", voltado para estudantes e profissionais da área da Saúde. Foram priorizadas a diversidade de materiais, a abrangência de perspectivas, a acessibilidade da linguagem e a presença de pessoas gordas. Considera-se que o processo de construção do curso possui elementos que podem orientar a elaboração de outros materiais e intervenções potentes e contextualizadas para o público-alvo.(AU)

El estigma relacionado al peso corporal se define como la desvalorización de individuos debido a su peso corporal más elevado, lleva a perjuicios para la salud y está presente entre estudiantes y profesionales de la salud. Abordar este estigma en espacios de formación de estos profesionales es crucial para combatirlo. Este artículo relata la experiencia de construcción del curso educativo "Narraciones de Peso: el estigma relacional al peso corporal y el cuidado de la salud", dirigido a estudiantes y profesionales del área de la salud. Se priorizaron la diversidad de materiales, el alcance de perspectiva, la accesibilidad del lenguaje y la presencia de personas gordas. Se considera que el proceso de construcción del curso cuenta con elementos que pueden orientar la elaboración de otros materiales e intervenciones potentes y contextualizadas para el público-objetivo.(AU)

Weight stigma is defined as the devaluation of people due to their higher body weight, causing harmful effects to health and is present among healthcare undergraduate students and professionals. Addressing weight stigma in training spaces is crucial to fight against it. This article reports the experience about the construction of the educational course "Narratives of Weight: weight stigma and health care", aimed at healthcare undergraduate students and professionals. Priority was given to the diversity of materials, range of perspectives, language accessibility and the presence of fat people. It is considered that the course's building process has elements that can guide the development of other powerful and contextualized materials and interventions for the target audience.(AU)

Alimentação da população em situação de rua no contexto da Covid-19 no Brasil: debate qualitativo a partir do jornal O Trecheiro / Food for the homeless people in the context of Covid-19 in Brazil: a qualitative debate based on the newspaper O Trecheiro

Introdução: A insegurança alimentar e nutricional da população em situação de rua perpassa a negação de direitos básicos, como moradia, e abrange a incerteza do que, quando, onde e como se alimentar. Assim, dar voz às vulnerabilidades e reivindicações dessa população é essencial. Objetivo: Descrever e discutir as principais questões que permearam a temática da alimentação e da comida nas matérias do jornal O Trecheiro, focado nas realidades sociais da população em situação de rua no Brasil, durante um período da pandemia de Covid-19 (março de 2020 a fevereiro de 2021). Métodos: Tratou-se de pesquisa qualitativa genérica com produção de dados a partir de análise documental; adotou-se o método de análise de conteúdo para categorizar o corpus documental e discutir os temas construídos a partir dos dados. Resultados: A "alimentação enquanto direito" surgiu como parte dos saberes e lutas da pessoa em situação de rua. Os temas e subtemas construídos abrangeram alimentação enquanto um direito não assegurado, vinculando-se à não garantia de outras necessidades (terra e trabalho); às saídas para a garantia do alimento e de outros insumos (solidariedade, luta popular); e aos sentidos e significados que a alimentação e os rituais em torno dela possuem para a pessoa em situação de rua. Conclusão: Pensar sobre o cuidado e a alimentação dessa população exige um olhar integral e multifatorial que considere a complexidade do grupo estudado, assim como os diversos aspectos que atravessam as vivências desses indivíduos, como questões estruturais, sociopolíticas e experiências individuais discutidas neste artigo.

Introduction: The food and nutritional insecurity of the homeless population goes beyond the denial of basic rights, such as housing, and encompasses the uncertainty of what, when, where and how to eat. It is therefore essential to give voice to the vulnerabilities and demands of this population. Objective: To describe and discuss the main issues that permeated the theme of food and eating in articles in the newspaper O Trecheiro, focused on the social realities of the homeless population in Brazil, during a period of the Covid-19 pandemic (March 2020 to February 2021). Methods: This was a generic qualitative research with data production from documentary analysis; the content analysis method was adopted to categorize the documentary corpus and discuss the themes constructed from the data. Results: "Food as a right" emerged as part of the knowledge and struggles of homeless people. The themes and sub-themes that emerged included food as a right that is not guaranteed, linked to the failure to guarantee other needs (land and work); ways of guaranteeing food and other inputs (solidarity, popular struggle); and the senses and meanings that food and the rituals surrounding it have for homeless people. Conclusion: Thinking about the care and feeding of this population requires a comprehensive and multifactorial approach that takes into account the complexity of the group studied, as well as the various aspects that permeate the experiences of these individuals, such as structural and socio-political issues and the individual experiences discussed in this article.

Health at Every Size®-Based Interventions May Improve Cardiometabolic Risk and Quality of Life Even in the Absence of Weight Loss: An Ancillary, Exploratory Analysis of the Health and Wellness in Obesity Study.

We examined whether weight loss following HAES®-based interventions associates with changes in cardiometabolic risk factors and quality of life of women with obesity. This was an exploratory, ancillary analysis of a 7-month, mixed-method, randomized controlled trial. Fifty-five women (age: 33.0 ± 7.2; BMI: 30-39.9 kg/m2) were included in this study. Body weight, cardiovascular risk factors, clustered cardiometabolic risk, and quality of life were assessed before (Pre) and after HAES®-based interventions (Post). Delta scores (Post-Pre) were calculated for each outcome and used in linear regression models. After adjusting by potential confounders, weight loss was associated with improvements in waist circumference (ß = 0.83, p <0.001), fasting glycemia (ß = 0.45, p = 0.036), total cholesterol (ß = 1.48, p = 0.024), LDL (ß = 1.33, p = 0.012), clustered cardiometabolic risk (ß = 0.18, p = 0.006), and quality of life (ß = -1.05, p = 0.007). All participants but one who reduced body weight (n = 11) improved clustered cardiometabolic risk and quality of life. Of relevance, 34% and 73% of the participants who maintained or gained weight improved clustered cardiometabolic risk and quality of life, respectively, although the magnitude of improvements was lower than that among those who lose weight. Improvements in cardiovascular risk factors and quality of life following HAES®-based interventions associated with weight loss as expected. However, most of the participants who maintained or even gained weight experienced benefits to some extent. This suggests that weight-neutral, lifestyle-modification interventions may improve wellness and health-related outcomes, even in the absence of weight loss.

"Macho food": Masculinities, food preferences, eating practices history and commensality among gay bears in São Paulo, Brazil.

This article describes and explore eating practices and food preferences among gay men who call themselves bears in São Paulo, Brazil, and their relation with their life history, masculinities representations, and sexuality. It is a qualitative and quantitative research within an ethnographic perspective. A purposive sample of thirty-five self-declared gay bears. The data were analyzed identifying the regular, expressive and meaningful significance units collected through the interviews. We identified that the self-declared bears in São Paulo, Brazil, build a solid relation between food preferences, eating practices, masculinity, and group belonging. From the bear's perspective, meat, especially bovine, is related to masculinity and extensively understood as a strong common bond within the community, leveraging their sexuality. For these persons, eating meat as well as drinking beer can build the ideal mannish and unfeminine body that is overvalue. Being gay and "eating like a man," as well as exposing a "macho" body while disdaining other body types constructions could represent a strategy to avoid discrimination, shame and humiliation. On the other way, this community does not just linearly imitate heterosexual men although their conducts can reproduce patriarchal representations and meanings through eating practices. These findings could be used to understand the complexity of alimentary practices, particularly food preferences as well as commensalities, among specific communities or membership groups.

It is over there, next to that fat lady: a qualitative study of fat womens own body perceptions and weight-related discriminations / É lá, perto da moça gorda: estudo qualitativo sobre as percepções de mulheres gordas acerca de seus corpos e discriminações relacionadas ao peso corporal

Abstract We investigated fat women's perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a fat body? These axes were composed of eight themes which had similar meaning or complemented each other. The results showed our participants had mechanisms to diminish the magnitude of their stigmatized bodies (e.g., attempting to lose weight and changing their current food choices). Participants also reported being fat had physical and psychological consequences for them. Most notably, their larger bodies influenced their self-evaluation, making them feel devalued, unlovable, incapable, and incomplete. They reported stigmatizing experiences in familiar situations, at the workplace and in public spaces, and reported being stigmatized by both close and unknown individuals, including healthcare professionals. These professionals were reported to treat patients disrespectfully, which urges attention to health care inequalities for obese people. Our results stress stigmatizing attitudes towards fat people and their own considerations about themselves have negative consequences in their physical and mental well-being.

Resumo Investigamos a percepção de mulheres gordas sobre seu próprio corpo e suas experiências com discriminações relacionadas ao peso e como essas situações afetavam seu bem-estar. Trinta e nove mulheres obesas foram entrevistadas, sendo identificados três eixos de análise: (1) repercussões de ser gorda, (2) vivendo com um corpo gordo, e (3) eu sou uma pessoa ou apenas um corpo gordo? Esses eixos eram compostos por oito temas que se complementavam ou tinham significado semelhante. Os resultados mostraram que nossas participantes utilizavam mecanismos para diminuir a magnitude de seus corpos estigmatizados (por exemplo, tentando perder peso e modificando suas escolhas alimentares atuais). As participantes também relataram que ser gorda teve consequências físicas e psicológicas para elas. É importante ressaltar que seus corpos maiores influenciaram sua autoavaliação, fazendo com que se sentissem desvalorizadas, incapazes, incompletas e sem possibilidade de se sentirem amadas. Elas relataram experiências estigmatizadoras em situações familiares, no local de trabalho e em espaços públicos, e relataram serem estigmatizadas por pessoas próximas e desconhecidas, bem como por profissionais de saúde. Foi relatado que esses profissionais tratam os pacientes com desrespeito, o que exige atenção quanto às desigualdades na assistência à saúde de pessoas obesas. Nossos resultados enfatizam que atitudes estigmatizadoras em relação às pessoas gordas e suas próprias considerações sobre si mesmas têm consequências negativas para seu bem-estar físico e mental.

Eating Pleasure in a Sample of Obese Brazilian Women: A Qualitative Report of an Interdisciplinary Intervention Based on the Health at Every Size Approach.

INTRODUCTION: Health at Every Size (HAES) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes and on enhancing pleasure derived from consuming food to achieve sustainable healthy eating outcomes. However, to the best of our knowledge, there are no studies in the literature assessing the effects of the HAES approach on perceptions of eating pleasure. OBJECTIVE: We qualitatively investigated the perceptions of obese women about eating pleasure before and after a new interdisciplinary, nonprescriptive intervention based on the HAES approach. DESIGN: The intervention was a randomized controlled clinical trial, designated as Health and Wellness in Obesity, conducted over 7 months at University of São Paulo (Brazil). We used a qualitative approach to data construction and analysis of perceptions about eating pleasure. Participants were randomized to either the intervention (I-HAES) group or the control (CTRL) group. The I-HAES group featured individual nutritional counseling, group practice of enjoyable physical activity, and philosophical workshops. The CTRL group was a traditional HAES intervention group (lecture-based model). Focus group discussions eliciting perceptions of pleasure around eating were conducted at baseline and post-study. Focus group transcripts were analyzed by exploratory content analysis. PARTICIPANTS: Forty-three women aged 25 to 50 years with body mass index (measured in kilograms per square meter) between 30 and 39. 9 completed the intervention and the focus groups, with 32 in the I-HAES group and 11 in the CTRL group. RESULTS: Lack of guilt about experiencing pleasure while eating and increased reflection on their own desires increased in participants of both groups after the study. The I-HAES group also displayed a greater sense of autonomy related to eating, increased pleasure in commensality, familiarity with the practice of cooking, and decreased automatic eating. CONCLUSION: HAES-based intervention featuring nutritional counseling, appreciation for physical activity, and philosophical engagement was shown to stimulate pleasure around eating without leading to indiscriminate eating.

Effects of a new intervention based on the Health at Every Size approach for the management of obesity: The "Health and Wellness in Obesity" study.

Health at Every Size® (HAES®) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes. This study examined multiple physiological, attitudinal, nutritional, and behavioral effects of a newly developed, intensive, interdisciplinary HAES®-based intervention in obese women. This was a prospective, seven-month, randomized (2:1), controlled, mixed-method clinical trial. The intervention group (I-HAES®; n = 39) took part in an intensified HAES®-based intervention comprising a physical activity program, nutrition counseling sessions, and philosophical workshops. The control group (CTRL; n = 19) underwent a traditional HAES®-based intervention. Before and after the interventions, participants were assessed for physiological, psychological, and behavioral parameters (quantitative data) and took part in focus groups (qualitative data). Body weight, body mass index, and waist and hip circumferences did not significantly differ within or between groups (P > 0.05). I-HAES® showed increased peak oxygen uptake and improved performance in the timed-stand test (P = 0.004 and P = 0.004, between-group comparisons). No significant within- or between-group differences were observed for objectively measured physical activity levels, even though the majority of the I-HAES® participants indicated that they were engaged in or had plans to include physical activity in their routines. I-HAES® resulted in improvements in eating attitudes and practices. The I-HAES® group showed significantly improved all Body Attitude Questionnaire subscale and all Figure Rating Scale scores (P ≤ 0.05 for all parameters, within-group comparisons), whereas the CTRL group showed slight or no changes. Both groups had significant improvements in health-related quality of life parameters, although the I-HAES® group had superior gains in the "physical health," "psychological health," and "overall perception of quality of life and health" (P = 0.05, 0.03, and 0.02, respectively, between-group comparisons) domains. Finally, most of the quantitative improvements were explained by qualitative data. Our results show that this new intensified HAES®-based intervention improved participants' eating attitudes and practices, perception of body image, physical capacity, and health-related quality of life despite the lack of changes in body weight and physical activity levels, showing that our novel approach was superior to a traditional HAES®-based program.

The design and rationale of an interdisciplinary, non-prescriptive, and Health at Every Size®-based clinical trial: The "Health and Wellness in Obesity" study.

BACKGROUND: This manuscript describes the design and rationale of a clinical trial that aims to investigate the multiple physiological, attitudinal, nutritional, and behavioral effects of a new interdisciplinary intervention based on the Health at Every Size® (HAES®) approach in obese women. METHODS: This will be a prospective, 7-month, randomized (2:1), mixed-method clinical trial. Obese women will be recruited and randomly allocated into two groups. The intervention group (I-HAES®; proposed n = 40) will undertake a novel HAES®-based intervention. Participants will take part in an exercise program, nutrition counseling sessions, and philosophical workshops, all aligned with the principles of the HAES® approach. The control group (CTRL; proposed n = 20) will participate in a program using a traditional HAES®-based group format, characterized by bimonthly lectures about the same topics offered to the experimental group, encouraging the adoption of a healthy lifestyle. The following multiple quantitative outcomes will be assessed pre and post intervention: health-related quality of life, cardiovascular risk factors, anthropometric assessments, physical activity level, physical capacity and function, and psychological and behavioral assessments. Qualitative analysis will be used to evaluate the experiences of the participants throughout the intervention, as assessed by focus groups and semi-structured interviews. CONCLUSIONS: The interdisciplinary research team leading this study has varied and complementary expertise. The knowledge arising from this study will help to guide new interdisciplinary interventions with the potential to holistically improve the health of obese individuals. This trial is registered at Clinicaltrials.gov (NCT02102061).

Os efeitos de uma intervenção interdisciplinar, não prescritiva e pautada na abordagem "Health at Every Size®" nas percepções de mulheres na condição de obesidade acerca do prazer alimentar / Effects of a non-prescriptive and interdisciplinary intervention based on Health at Every Size approach in obese women perceptions about pleasure of eating

Introdução: Novas condutas terapêuticas e de prevenção frente à obesidade tornam-se objetos de estudo, entre elas a abordagem Health at Every Size® (HAES®). A abordagem HAES® aponta para o prazer em comer como crucial para a promoção de saúde e sustentabilidade no tratamento. A condenação cultural do prazer em paralelo à negligência do prazer no tratamento da obesidade forma um cenário de crítica, em que a mulher obesa é alvo de múltiplas desvantagens, entre elas a culpabilização do comer. Assumimos, para este estudo, a importância de aprofundar-se nas relações entre novas perspectivas no cuidado à mulher obesa e o estímulo ao prazer em comer. Objetivos: Investigar as percepções de mulheres na condição de obesidade acerca do prazer em comer antes e após uma intervenção interdisciplinar, não prescritiva e pautada na abordagem do HAES®. Métodos: Estudo qualitativo a partir de um ensaio clínico randomizado controlado com seguimento de sete meses nos anos de 2015 e 2016. Incluiu 97 mulheres na condição de obesidade de 25 a 50 anos de idade, com índice de massa corporal entre 30 e 39,9Kg/m², sendo alocadas em dois grupos: Intervenção e Controle. Ao final do estudo, 39 mulheres concluíram no grupo Intervenção (62,90 por cento ) e 19 concluíram no Controle (54,28 por cento ). Para os dois grupos, as atividades tiveram como linha condutora a abordagem do HAES®. O grupo Intervenção trouxe uma proposta original, com oferta de atividade física 3 vezes na semana, acompanhamento nutricional individual e oferta de discussões no formato de cinco oficinas filosóficas. O grupo Controle baseou-se ao modelo tradicional de aplicação da abordagem HAES®, com palestras expositivas bimestrais. A construção dos dados ocorreu a partir de grupos focais. Para análise das transcrições dos grupos, foi realizado o método de Análise de Conteúdo, sendo construídos temas pela técnica de Cutting e Sorting, os quais fundamentaram a argumentação teórica neste estudo. Resultados: Vinte e três temas sobre as percepções do prazer em comer das mulheres estudadas foram construídos. Após a intervenção, foram construídos de maneira significativa para o grupo Intervenção temas sobre maior autocontrole e reflexão sobre os próprios desejos; sensação de empoderamento para escolher o que e quando comer; aumento do prazer em comer acompanhada; aumento do prazer em comer comidas feitas por si própria; aumento dos discursos sobre comer sem culpa; diminuição da sensação de não sentir prazer e ainda diminuição do comer por emoções como ansiedade. Conclusão: A nova intervenção proposta promoveu efeitos positivos na relação das mulheres com o prazer em comer, evidenciando a desculpabilização do prazer em comer e melhora de outros aspectos da prática alimentar, como a comensalidade. Percebemos que este efeito se deu sobretudo a partir do estímulo a um processo reflexivo sobre corpo, comida e saúde, ficando claro que o prazer em comer sem culpa é um desfecho necessário quando falamos da saúde

Introduction: New therapies and prevention practices directed to obesity become objects of study. The Health at Every Size® (HAES®) approach is one of them. The HAES® approach indicate the pleasure in eating as crucial for health promotion and sustainability of treatments. The cultural condemnation of pleasure and its disregard in the treatment of obesity created a critic scenario in which the obese woman is target of multiple disadvantages, such as blame for eating. We assume, for this study, the importance to deepen the relationship between new approaches to the care of obese woman and the encouragement of pleasure of eating. Objectives: To investigate obese women perceptions about the pleasure of eating, before and after an interdisciplinary, non-prescriptive and based on HAES® approach intervention. Methods: Qualitative study branch of a randomized controlled clinical trial, conducted over seven months in 2015 and 2016. It included 97 obese women, with 25 to 50 years old, with a body mass index between 30 and 39, 9 kg/m². The women were randomized to two groups: intervention and control. At the end, 39 women concluded in the Intervention Group (62.90 per cent ) and 19 in Control Group (54.28 per cent ). The two groups received activities based on HAES® approach. The Intervention Group, however, brought an original proposal, with physical activity 3 times a week, individual nutritional counseling and philosophical discussions in form of workshops. The Control Group received traditional model of HAES® approach application, with bimonthly expository lectures. The data construction occurred from Focus Groups. Analysis of the Focus Groups transcripts was conducted with Analysis of Content method, in which themes were built of Cutting and Sorting technique, and were used to theoretical arguments that substantiated this study. Results: Twenty-three themes about the perceptions of pleasure in eating of the studied women were built. After the intervention, more significantly for the Intervention Group, themes manifested greater self-control on the own desires; increased hunger and satiety response; sense of empowerment to choose what and when to eat; increase of the pleasure in eating accompanied; increase of the pleasure in eating food made by herself; increase of speeches about \"eat without guilt\"; decreased perception of not feeling pleasure and even decreased eating by emotions such as anxiety. Conclusion: The new proposed intervention promoted positive effects on women\'s relationship with pleasure in eating, showing decrease of guilt on pleasure in eating and improvements of other aspects of the eating practices, such as commensality. We realize that this effect occurred mainly due to stimulus to a reflection about body, food and health, becoming clear that the pleasure in eating without guilt is a necessary outcome when we talk about obese woman health

Eating practices and habitus in mothers. A Brazilian population-based survey.

A population-based cross-sectional study was conducted with mothers living in the city of Santos, Brazil, in order to investigate their eating practices, and the interface between those practices and the concept of habitus. From a cluster analysis of the scores for dietary pattern and for food preparation and consumption, the mothers were categorised into five clusters of eating practices: practical mothers (19.8%), symbiotic mothers (3.2%), health-conscious hedonists (17.3%), traditionalists (34.6%), and family cooks (25.1%). To access the habitus of the eating-practice clusters, the following variables were compared: location of residence, profession, socioeconomic status, weight-loss practices, risk behaviours for eating disorders, disordered eating attitudes, body dissatisfaction, and cultural and technological consumption. For all the groups, the observed eating practices were permeated by responsibility for the family's diet, but with different manifestations. For symbiotic mothers, practical mothers, and family cooks, the primary function of their relation with food was to nourish their families, with little expression of their own tastes and preferences. The traditionalists and the health-conscious hedonists, on the other hand, manifested their role as mothers by providing food considered 'nutritionally proper' to their family members. Furthermore, aspects of contemporary lifestyles, such as little time for food, individualisation of meals, and consumption of processed foods, were found to coexist with the valorisation and maintenance of the traditional meals within some groups. The variety of eating practices could not be understood as a linear association between economic and cultural capitals; however, eating practices seemed to interact with those capitals, composing a habitus.

Current and previous eating practices among women recovered from anorexia nervosa: a qualitative approach / Práticas alimentares atuais e pregressas em mulheres recuperadas da anorexia nervosa: uma abordagem qualitativa

OBJECTIVE: The aim of this study was to analyze qualitatively how women, who have recovered from anorexia nervosa, perceive and describe their current eating practices, as well as the ones developed during the eating disorder period. METHODS: Seven women were interviewed individually with the objective of investigating their eating practices, transition phases and all relevant aspects that somewhat contributed to the habit-forming; experiences, feelings and perceptions related to mealtime and the influence that food has had over the present subjects' life. The interviews were analyzed by the discourse of the collective subject method. RESULTS: The results brought up the following topics: a) control; b) concerns and feelings; c) deprivation d) beauty dictatorship; e) eating competence; f) importance of food; g) food cacophony. CONCLUSIONS: What stands out is a multiplicity of eating practices, which during the eating disorder were similar to and characterized by restriction; however, after recovery, part of the subjects seem to have developed a higher eating competence, whereas others show a practice similar to the one acquired during the anorexia nervosa, such as the difficulty in realizing when they are satisfied and a feeling of discomfort when facing social interactions.

OBJETIVO: Este artigo teve como objetivo analisar qualitativamente como mulheres que se recuperaram da anorexia nervosa percebem e relatam suas práticas alimentares atuais, bem como as práticas vigentes no período do transtorno. MÉTODOS: Foram feitas sete entrevistas individuais com mulheres que vivenciaram a anorexia nervosa. Estas abordaram: hábitos alimentares das entrevistadas; mudanças e fatores importantes para a formação destes; vivências, sentimentos e percepções associados ao momento da refeição; e a influência que a alimentação exerce na vida das participantes hoje. A análise dessas deu-se a partir da técnica do Discurso do Sujeito Coletivo. RESULTADOS: Os resultados trouxeram os seguintes temas: a) controle; b) preocupações e sensações; c) privação d) ditadura da beleza; e) competência alimentar; f) importância da alimentação; g) cacofonia alimentar. CONCLUSÕES: Destaca-se nesses a multiplicidade das práticas alimentares, que durante o transtorno se assemelham e se caracterizam pela restrição; no entanto, após a recuperação dos sujeitos, alguns parecem ter desenvolvido maior competência alimentar, enquanto outros apresentam práticas semelhantes às vigentes na anorexia nervosa, além de dificuldade de perceberem quando estão satisfeitos e sensação de desconforto em situações de interação social.