Navegando por Palavras-chave "Binge Eating"

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    Associação entre a ocorrência de compulsâo alimentar, recuperação de peso e incidência de alcoolismo em longo prazo após cirurgia bariátrica através do Bypass gástrico em Y de roux
    (Universidade Federal de São Paulo (UNIFESP), 2019-09-26) Freire, Cristina Cardoso [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Weight regain (WR) after bariatric surgery (BS) is frequent. The aim of this study was to evaluate whether the occurrence of psychiatric disorders would be associated with shortand long-term WR after BS. Ninety-six patients (77.6% female, age 40.2 ± 10.1 years, BMI of 50 ± 8.2 kg/m2 ) from the Obesity and Bariatric Surgery Outpatient Clinic of the Universidade Federal São Paulo completed the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R), the Beck Depression Inventory (BDI) and an anxiety inventory to assess the occurrence of binge eating, depressive symptoms (DS) and anxious symptoms (AS) before and after short-term and long-term BS. After 24 months of BS, the prevalence of binge eating, depression and anxiety decreased from 100% to 13%, 100% to 15% and 43% to 4%, respectively. The mean WR of 35.2 ± 17.3% of weight loss occurred in nine patients after 24 months and was associated with binge eating (p = 0.002) but not with DS or AS. At long-term follow-up (12 ± 1.5 years), 67% had a mean WR of 50.3 ± 24.9%. The prevalence of binge eating, DS and AS were 48%, 46% and 63%, respectively, in this group, and significant associations were observed between WR and binge eating (p = 0.001), DS (p = 0.029) and AS (p = 0.001). Furthermore, the number of psychiatric disorders was inversely associated with the percentage of weight loss (p < 0,05) and positively associated with WR (p < 0,05). In conclusion, WR was associated with the occurrence of binge eating in the short and long term after BS, whereas the occurrence of depressive and anxious symptoms was associated with WR only in the long term.
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    Comparação entre os efeitos de três diferentes formas de tratamento não medicamentoso em mulheres obesas com e sem sinais de compulsão alimentar
    (Universidade Federal de São Paulo, 2019-03-18) Affonso, Luiz Henrique Lima [UNIFESP]; Gomes, Ricardo José [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Signals of binge eating (SBE) are symptoms associated with binge eating disorder (BED), but might not present a full diagnosis of BED, but it might there is also no binge eating episode. These SBE have a high prevalence in obese women, which makes it difficult to reduce and maintain body mass (BM), therefore is necessary know the different forms of effective treatment for obese women with and without BE. Objective: Evaluation of 28 weeks of combined physical exercise (EXE), interdisciplinary therapy (INT) or health education (HE) on SBE in obese women; to investigate the prevalence of BE in obese women; compare effects of therapies on brain-derived neurotropic factor (BDNF), leptin (LEP), glycaemia, insulin and insulin resistance (IR). Methods: 81 obese women were randomized into three groups who performed 28 weeks of different non-drug interventions INT, EXE and HE. These women performed the following evaluations: anthropometric (BM, body mass index - BMI and waist circumference - WC); serum biochemical and hormones (BDNF, LEP, insulin, triacylglycerol and glycaemia, as well as the calculation of IR by HOMA-IR and TyG); and also evaluation of SBE through the binge eating scale (BES). The data were analyses by the SPSS Statistics version 22 software and express on descriptive form with mean and standard deviation, were also checked for normality and performed tests of variance (ANOVA) of repeated measures, considering a level of significance of p < 0,05. Results: 50% of the women in the sample had BE. After 28 weeks of therapy there was a significant reduction in the BE of the volunteers who participated in the INT group (reduction of 100% of cases of BE) and EXE group (reduction of 50% of cases of BE), which did not occur for the HE group. Furthermore, only INT therapy was able to make a significant BM, BMI and WC, in contrast glycaemia was improved in almost all groups. When do analysis together people with and without BE, LEP was less only in volunteers with BE, whereas BDNF was less only in women without SBE. Conclusion: There is a high prevalence of BE in obese women, and only more structured and intensive treatment (INT and EXE) were able to improve SBE. Someway, BDNF appears to modulate SCA in obese women, however future studies should investigate more deeply the role of BDNF, insulin, LEP and glycaemia in SCA in obese women, under different types of intervention.
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    Intervenções psicológicas e comportamentais nos transtornos alimentares caracterizados por compulsão alimentar recorrente associados a sobrepeso ou obesidade
    (Universidade Federal de São Paulo (UNIFESP), 2019-08-16) Palavras, Marly Amorim [UNIFESP]; Claudino, Angelica De Medeiros [UNIFESP]; Hay, Phillipa; http://lattes.cnpq.br/4532343545365473; Universidade Federal de São Paulo (UNIFESP)
    Background: This thesis is structured in three articles involving the association between Bulimia Nervosa (BN) or Binge Eating Disorder (BED) and overweight/obesity. Current treatments to these clinical conditions usually focus either on improvement of eating disorder symptoms or in weight loss. In this project, we tested a psychological intervention, called HAPIFED, which targets simultaneously binge eating associated to overweight/obesity comparing to the intervention with the best evidence of efficacy, the Cognitive Behavioural Therapy, in its enhanced form (CBT-E). Objectives: Study 1 - presents a systematic review of the literature and meta-analysis evaluating the effects of psychological approaches in the remission or reduction of binge eating and weight loss in obese people with BN or BED. Studies 2 and 3 - describe the protocol of a randomized controlled trial (RCT) which tested the efficacy and safety of HAPIFED compared to CBT-E in reducing symptoms of eating disorders and introducing the healthy management of weight loss in the treatment of obese people with BN or BED. Methods: Study 1 – Articles selected in databases (up to March 2016) consisted of RCTs testing psychological approaches for binge eating remission or reduction and weight loss, in adult population with overweight/obesity and diagnosis of BN or BED. Methodological quality of trials was evaluated and meta-analysis of results of studies comparing CBT with Behaviour Weight Loss Therapy (BWLT) was performed. Studies 2 and 3 - A single blind RCT selected adults of both genders with BN or BED (DSM-5 or ICD-11) and BMI ≥ 27 to < 40 kg/m². Ninety-eight participants were randomized, 50 were included in HAPIFED and 48 in CBT-E. Compared interventions provided 30 group sessions over 6 months. The primary outcome was weight reduction and secondary outcomes included reduction of symptoms of eating disorder. Results: Study 1 - Nineteen articles were included in this review. No study with BN was identified. CBT was the most tested intervention. For binge eating remission, CBT was superior to waiting list, not superior to other interventions and inferior to CBT combined with exercise. For weight loss, CBT was not superior to waiting list or other interventions and was inferior to CBT plus exercise. In meta-analysis comparing CBT with BWLT, CBT promoted greater binge eating frequency reduction at the end of treatment (MD 2.04 95% CI, 0.35 to 3.73; n=4). Meta-analyses performed for binge eating frequency at 12-month follow-up, as well as for weight loss at the end of treatment and 12-month follow-up did not show difference between treatments. Studies 2 and 3 – There was no difference between groups throughout treatment for weight loss (x²(3)=0.19, p=0.979), nor for the secondary outcomes, except for reduction of purging behaviours, favoring HAPIFED (x²(3)=10.35, p=0.016). There was a reduction of eating disorders’ psychopathology in both treatments. Conclusions: Study 1 – Evidence supports better results for CBT with regards to short-term binge eating remission compared to BWLT. Insufficient evidence was found for superiority of BWLT efficacy compared to CBT considering binge eating remission, reduction of binge eating frequency and weight loss in short term. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight/obesity, including trials evaluating binge eating remission and weight loss in the long-term. Studies 2 and 3 - HAPIFED was not superior to CBT-E in promoting clinically significant weight loss and was not significantly different in reducing most eating disorder symptoms. No harm was observed with HAPIFED, in that no worsening of eating disorder symptoms was observed.