Very low-calorie ketogenic diet in the treatment of adaptive thermogenesis: A case report.

OBJECTIVES: The management of the phenomenon of adaptive thermogenesis poses a challenge to the successful treatment of overweight/obesity with a nutritional intervention that minimizes the loss of muscle mass, with little cognitive restraint use and disorganization of eating behavior. On the other hand, it creates a significant calorie deficit for the reduction of body fat. The aim of this case report was to discuss the effects of a very low-calorie ketogenic diet in a woman with obesity and low resting metabolic rate. CASE DESCRIPTION: A 36-y-old white woman with a history of obesity and bulimia nervosa who has had difficulty losing and maintaining weight despite numerous dietary and pharmacologic treatments. RESULTS: There was a loss of 12 kg in 115 d, reaching 13.4 kg, with 11.4 kg of fat mass (FM). The resting metabolic rate showed an increase of 79% in relation to the initial rate, reaching normal levels for the predictive equations and maintaining this level in the first-year follow-up. Additionally, improvement of metabolic laboratory parameters and eating behavior traits were described. CONCLUSIONS: In this specific case of bulimia nervosa resulting in hypometabolism (low resting metabolic rate/fat-free mass) and obesity, the very low-calorie ketogenic diet intervention has demonstrated a possibility of weight loss with little cognitive restraint use, thereby increasing resting metabolic rate in the short and medium terms, ultimately promoting a negative energy balance. In relation to the numeric results, it seems positive; however, more research is necessary to evaluate the effects on the overall relationship with food and its long-term repercussions.

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.

Insatisfação corporal, prática de dietas e comportamentos de risco para transtornos alimentares em mães residentes em Santos / Body dissatisfaction, dieting and risk behaviors for eating disorders among mothers living in Santos

OBJETIVO: Avaliar a insatisfação corporal, a prática de dietas e os comportamentos de risco para transtornos alimentares em uma amostra de mães residentes no município de Santos. MÉTODOS: Foi realizado um estudo transversal, de base populacional, com 453 mães de filhos com até 10 anos de idade. As mães responderam ao Teste de Atitudes Alimentares (EAT-26), à Escala de Figuras de Stunkard e a uma questão sobre a prática atual de dietas. RESULTADOS: Das mães, 29,9% apresentaram escore positivo para os comportamentos de risco para transtornos alimentares e 21,8% estavam fazendo dieta para emagrecer no momento da entrevista. No tocante à imagem corporal, 17,5% das mães estavam satisfeitas com o seu tamanho corporal, 71,5% gostariam de diminuir seu tamanho corporal e 11,0% gostariam de aumentá-lo. Os comportamentos de risco para transtornos alimentares foram mais frequentes nas mães insatisfeitas com seus tamanhos corporais (p < 0,0001). CONCLUSÃO: A maioria das mães investigadas estava insatisfeita com os seus tamanhos corporais. A frequência de mães que praticavam dietas ou tinham comportamentos de risco para transtornos alimentares foi similar ou superior aos demais estudos nacionais, conduzidos, em sua maioria, com populações consideradas de risco, como meninas adolescentes e jovens universitárias.

OBJECTIVE: To evaluate body dissatisfaction, dieting and risk behaviors for eating disorders among a sample of mothers living in the city of Santos. METHODS: It was conducted a cross-sectional population-based study with 453 mothers of children aged until 10 years old. The mothers answered to the Eating Attitudes Test (EAT-26), the Stunkard's Figure Scale and a question about being currently dieting. RESULTS: 29.9% presented a positive score for risk behaviors for eating disorders and 21.8% were currently dieting. Regarding body image, 17.5% of the mothers were satisfied with their current body size, 71.5% would like to decrease their body sizes and 11.0% would like to increase it. The risk behaviors for eating disorders were more frequent among the body-dissatisfied mothers (p < 0.0001). CONCLUSION: Most of the mothers were dissatisfied with their body sizes. The frequency of mothers who practiced diets or presented risk behaviors for eating disorders was similar or superior to the rest of the national studies, conducted, at large, with populations considered at risk, such as adolescent girls or young college women.