[The syndrome of cognitive restraint: from the nutritional standard to eating disorders]. / Le syndrome de restriction cognitive: de la norme au désordre du comportement alimentaire.

It has been shown that behavioral and dietary treatments of obesity are ineffective in producing lasting weight loss and that dieting is associated with episodes of overeating. Dietary restraint leads to emotional and cognitive disturbances as well as to problems with eating. Treating dieting and encouraging natural eating may improve self-esteem, depression, eating pathology and life-style, and so far, weight and health risk factors.

Prevalence of binge eating disorder in different populations of French women.

OBJECTIVE: The aim of this study was to evaluate the prevalence of binge eating disorder (BED) in nonpatient women in the community and in weight control groups in France and to compare the characteristics of weight history of subjects with and without BED. METHODS: Eating patterns over the past six months were studied by questionnaires in self-report format. The prevalence of binge eating, BED, and bulimia was studied in 447 nonpatient women and in subjects seeking help for weight control either in private practice (PP, n = 292) or in a hospital department of nutrition (H, n = 85). RESULTS: BED was common (PP = 9%; H = 15%) among patients attending weight control clinics but very rare in the community (0.7%). The disorder was associated with a history of weight fluctuations. Many subjects with BED referred to regular use of diet pills (29%) or vomiting (39%) but the prevalence of these strategies of weight control fell short for the requirement for the diagnosis of bulimia. DISCUSSION: BED was common in subjects seeking help for weight control and extremely rare in the community nonpatients.

[Psychosocial determinants of massive obesity]. / Déterminants psycho-sociaux des obésités massives.

Subjected to the reversed relationship between corpulence and socio-cultural level, massive obesity is, in Western countries, more frequent in the lowest social classes, and particularly in women. The influence on bodyweight of restricted food intake, physical activity and relative proportion of fats in daily diet has been demonstrated, and these 3 interacting factors vary with the social class. Although they are unanimously blamed for their enormous weight, subjects with massive obesity do not have a higher psychopathological index than other obese subjects or people with normal weight. On the other hand, the search of these massively obese subjects for a hypernormal presentation to compensate for the "abnormality" of their physical appearance (partially dependent on genetic factors) leads them to deny a great deal of the emotional and nutritional reality. This denial, overlooked by health institutions, could have been full of consequences. By generating wrong evaluations it would have contributed to the inadequacy of therapeutic responses which in turn would have made the obesity worse. Taking into account this phenomenon should improve the adequacy of therapeutic strategies and hence the prognosis.