A literatura aponta que casos de transtornos alimentares em homens têm uma menor incidência do que em mulheres e que, até os anos 80, questões relacionadas à imagem corporal eram vistas como uma preocupação feminina, porém estudos recentes demonstram que os homens também estão sofrendo com preocupações relativas à corporeidade e isso se reflete no comportamento alimentar, na prática de exercícios físicos e na adesão às dietas. Apesar disso, quadros clínicos de homens com anorexia e/ou bulimia nervosas ainda são pouco conhecidos e apresentam uma enorme complexidade diagnóstica. O objetivo deste estudo foi investigar o modo singular como portadores de anorexia e/ou bulimia nervosas vivenciam o corpo e a imagem corporal e como os acompanhantes/familiares e os profissionais de saúde percebem a problemática desses rapazes em relação à corporeidade, visando compreender essa singularidade e qual a sua influência na evolução desses transtornos alimentares e no tratamento. Trata-se de uma pesquisa com abordagem qualitativa, priorizando um enfoque exploratório, conduzida segundo o método de estudo de caso. O estudo compreende três casos e a população do universo de cada caso é composta por: paciente, seus respectivos acompanhantes/familiares (que o acompanharam durante tratamento) e profissionais de saúde responsáveis diretos pela assistência em cada caso (psicólogo, nutricionista, médico nutrólogo e psiquiatra). O contexto da investigação é de um serviço especializado na assistência em transtornos alimentares. Para a coleta de dados a pesquisadora utilizou três fontes: (1) consulta aos prontuários dos participantes (pacientes), visando obter informações clínicas que complementarão as informações obtidas com os profissionais; (2) entrevistas individuais semi-estruturadas com os participantes (pacientes, acompanhantes e profissionais de saúde) e (3) diário de campo. Primeiramente foi realizada análise de cada caso separadamente, as entrevistas foram submetidas à análise de conteúdo na modalidade temática, o que proporcionou conhecer como profissionais de saúde e familiares percebem a forma com que o paciente vivencia sua corporeidade, bem como a ótica do próprio paciente. Em seguida, o material coligido a partir das entrevistas, prontuário e diário de campo foi triangulado e submetido à interpretação, seguindo as proposições da teoria psicanalítica, inspirando-se principalmente no trabalho de Winnicott. Os resultados da análise dos casos sugeriram que estes rapazes não foram capazes de lidar com emoções primitivas e consequentemente, não foram capazes de desenvolver a capacidade de pensá-las e elaborá-las, expandindo essas emoções impensáveis para o corpo. Dessa forma, conclui-se que esses rapazes usam o corpo como uma fortaleza que os protege da vivência de sentimentos tão angustiantes, como invasão, desamparo e solidão. (FAPESP). / Literature shows that cases of males with eating disorders are in less incidence than females and that until the eighties issues related to body and body image were seen as a female concern. However, current studies present that males are also suffering due to worries regarding corporeity and it reflects on the eating habits, on the practice of physical exercises and on diet habits. In spite of it, clinical cases of males who develop anorexia and/or bulimia nervosa still are scarcely known and have an enormous diagnostic complexity. The aim of this study was to investigate the singular way of how males with eating disorders (anorexia nervosa, bulimia nervosa) experience body and body image and how family and health professionals perceive the troubles of these males with regards to their corporeity, intending to understand this singularity and its influence in the development of an eating disorder and in the treatment. It is a qualitative, exploratory research, carried out according to the case study methodology. This study comprehends 3 cases and the population of each case is composed by: patient and his respective family (who have followed the patient throughout the illness and treatment) and health professionals (responsible for the assistance to the patient: nutritionist, psychologist, psychiatrist, nutrologist). It was carried out in the eating disorders service of the Hospital das Clínicas da FMRP-USP (Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo - USP). The data was collected from 3 sources: (1) consultation to the medical reports of the patients, in order to obtain clinical and socio - demographic information, (2) individual interview with the participants (patients, family and professionals), (3) diary (where I wrote feelings and impressions I had throughout the research process and interviews). Firstly each case was analyzed separately; the interviews were transcribed literarily and submitted for theme-based content analysis. After that, the data collected from the interviews, medical reports and diary were interpreted mainly according to the psychoanalytic approach of Winnicott. The results of the analysis of the cases suggested that these males were not able to deal with primitive emotions inside themselves and consequently, not able to develop the skill to think about them and elaborate these emotions, expanding these unthinkable feelings to their body. In this manner these males use their body as a fort to protect them from overwhelming feelings such as invasion, abandonment and solitude. (FAPESP).

Made available in DSpace on 2016-08-19T17:47:10Z (GMT). No. of bitstreams: 1 Paula Virginia Lisboa da Silva.pdf: 243172 bytes, checksum: 82862c6d4daf4b78d92d43011fc92f20 (MD5) Previous issue date: 2008-10-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This is a cross-sectional study whose objectives are to investigate the occurrence of possible eating disorders, anorexia and/or bulimia in adolescents of both sexes, and to identify the epidemiologic profile of both. To identify eating disorders, 500 adolescents from a private school in São Luís, Maranhão, Brazil, completed self-report questionnaires, the BITE (Bulimic Investigatory Test Edinburgh) and the EAT-26 (Eating Attitudes Test summarized). The findings indicate that 70 (14%) adolescents possibly present with diagnoses of anorexia, 4 (0,8%) of bulimia, and 11(2,2%) with anorexia and bulimia combined. It was observed that 78 (15,6%) adolescents presented with non-usual eating habits, placing them at risk for the development of eating disorders. This investigation shows that there is a high occurrence of possible eating disorders in the sample studied and a heterogeneous epidemiologic profile, occurring in both sexes and within diverse ethnic groups and social-economic classes. The dissatisfaction with their own bodies and the wish to modify them are feelings present in adolescents who probably exhibit eating disorders (p<0.001). / Este é um estudo transversal que tem como objetivos investigar a ocorrência de possíveis transtornos alimentares, anorexia e/ou bulimia, em adolescentes de ambos os sexos e identificar o perfil epidemiológico dos mesmos. Para o rastreamento dos transtornos alimentares foram aplicados os questionários autopreenchíveis BITE (Teste de Investigação Bulímica de Edinburg) e EAT-26 (Teste de Atitudes Alimentares resumido) em 500 adolescentes de uma escola particular na cidade de São Luís, Maranhão, Brasil. Os achados mostraram que 70(14%) adolescentes possivelmente apresentam o diagnóstico de anorexia, 4(0,8%), bulimia e 11(2,2%), anorexia combinada com bulimia. Verificou-se que 78(15,6%) adolescentes apresentam uma conduta alimentar não usual, comportamento de risco para o desenvolvimento de transtornos alimentares. Este trabalho mostra uma alta ocorrência de possíveis transtornos alimentares na amostra estudada e um perfil epidemiológico heterogêneo, ocorrendo, em ambos os sexos, em diversas etnias e camadas sócio-econômicas. A insatisfação com o próprio corpo e o desejo de modificá-lo são sentimentos presentes nos adolescentes que provavelmente têm transtorno alimentar (p<0,001).

Made available in DSpace on 2016-04-28T20:38:50Z (GMT). No. of bitstreams: 1 Caroline Wajss Zylberkan.pdf: 2254771 bytes, checksum: a14c7ebac62788f157bfaaf15dba62f4 (MD5) Previous issue date: 2014-02-21 / The main objective of this project was to understand the implications of family therapy in the treatment of a patient cared for in the program for eating disorders of the Hospital das Clínicas, at the Instituto de Psiquiatria de São Paulo (IPq HC-FMUSP). This objective was drafted from the possibility of creating a space for dialogue among those participating in this research project, by way of semi-structured interviews which could increase the understanding and the reach of family therapy in this context. An effort was made specifically to extend knowledge of treatment of eating disorders beyond family therapy, with a view to perceive and analyze the context of the relationships and life both within the family organization of the patient being treated, as well as within the professional system involved in the treatment. For this end, interviews were held with three of the professionals who were part of the multidisciplinary team which took care of the chosen case during the last five years, being one a psychiatrist, one a nutritionist and one an individual psychologist, apart from the patient herself and members of her family. For data analysis information was gleaned from the interviews of each participant, according to the importance of their content and the objective of this research project. Thus some themes were identified which could didactically outline some specific points relevant to the discussion. Taking into consideration the collaborative approach proposed by Harlene Anderson (2011), we understand the different voices offered by our participants as possible interpretations capable of communicating amongst themselves. From this material it was possible to identify some of the expectations of the multidisciplinary team in relation to the effects of family therapy in the treatment of eating disorders in a hospital setting, and also the relevance of this care both to the patient as well as her family. It became evident that family therapy was valued by all those involved in the research project as a necessary support for the patient and her family, insofar that from the specific point of view of each one it contributed to greater adhesion to the treatment. However this valuing implies in fitting the family therapy into a format of behavior which is aimed at the symptom, and this research project endeavored to reflect on the use of this space for the inter-relational process in which the symptom arises, and on the possible reach of this care for a long term process which would look at the dynamics of the relationships and also beyond the symptom / O objetivo principal deste trabalho foi compreender os significados da terapia familiar no tratamento de uma paciente atendida no programa para transtorno alimentar do Hospital das Clínicas, no Instituto de Psiquiatria de São Paulo (IPq HC-FMUSP). Esse objetivo foi delineado a partir da possibilidade de criar um espaço de diálogo entre os participantes desta pesquisa, por meio de entrevistas semiestruturadas que pudessem ampliar o entendimento e o alcance da terapia familiar nesse contexto. De maneira específica, buscou-se estender o conhecimento sobre o tratamento dos transtornos alimentares para além da terapia familiar, com vistas a perceber e analisar os contextos das relações e da vivência tanto na organização familiar da paciente em tratamento, quanto na organização do sistema profissional envolvido no tratamento. Para isso, foram entrevistados três profissionais que participaram da equipe multidisciplinar que tratou do caso escolhido durante os últimos cinco anos, sendo um psiquiatra, uma nutricionista e um psicólogo individual, além da própria paciente e de seus familiares. Para a análise dos dados foram feitos recortes das entrevistas de cada participante, a partir da importância do conteúdo relatado e do objetivo desta pesquisa. Assim, levantaram-se alguns temas que pudessem delinear de forma didática alguns pontos específicos e relevantes para discussão. Levando em consideração a abordagem colaborativa proposta por Harlene Anderson (2011), compreendemos as diferentes vozes oferecidas por nossos participantes como possibilidades de entendimentos capazes de dialogar entre si. Diante desse material, foi possível verificar algumas expectativas da equipe multidisciplinar em relação à atuação da terapia familiar no tratamento dos transtornos alimentares no contexto hospitalar, bem como a relevância desse atendimento tanto para a paciente quanto para os seus familiares. Ficou evidente que a terapia familiar foi valorizada por todos os envolvidos na pesquisa como um suporte necessário à paciente e seus familiares, na medida em que, do ponto de vista específico de cada um contribuiu para maior adesão ao tratamento. No entanto, essa valorização implica em colocar a terapia familiar dentro de um formato de conduta voltada para o sintoma, e esta pesquisa buscou refletir sobre a utilização desse espaço para a compreensão do processo inter relacional no qual se produz o sintoma e nas possibilidades de alcance desse atendimento para um trabalho a longo prazo que olhe para as dinâmicas da relação e para além do sintoma

Forskning visar att ungdomar med typ 1 diabetes (T1D) har dubbelt så stor risk att drabbas av en ätstörning jämfört med ungdomar utan T1D. Dessutom ökar även mortalitet och morbiditet avsevärt hos ungdomarna med denna kombination. Syftet med litteraturstudien var att beskriva vad ungdomars upplevelser är i samband med ätstörningar och T1D. Dataanalysen genomfördes med inspiration från metoden innehållsanalys. Litteraturstudiens resultat visar kunskap från sju vetenskapliga artiklar. Efter tolkningen av resultaten i de vetenskapliga artiklarna formulerades fem teman: Social dimension, Fysisk dimension, Emotionell dimension, Triggerfaktorer och Coping. Resultatet gestaltade att stöd från familj och vänner upplevdes underlättande för ungdomarna, men även som ett ofullständigt stöd. Stödet från sjukvårdspersonalen upplevdes betydelsefullt. En del av ungdomarna upplevde negativa kroppsbilder, vilket föranledde till underdosering av insulin. Ätstörningarna kunde förorsaka depressiva känslor och samtidigt upplevd kroppskontroll. Stressade livssituationer kunde trigga igång ätstörningen. Upplevda copingstrategier som gav stöd i återhämtningen från ätstörningen var att dela sina erfarenheter med ungdomar i samma situation. Litteraturstudien visar att sjuksköterskan kan vara stödjande för ungdomar med T1D och ätstörningar genom att visa ett förhållningssätt i former av att vara lyssnande, icke dömande och visa tilltro. Litteraturstudien visar behov av ytterligare forskning för ett mer evidensbaserat kliniskt vårdande. / Research shows that adolescents with T1D runs a double risk of eating disorders compared to adolescents without T1D. Additionally, morbidity and mortality increases considerably at the combination. The aim of this literature study was to describe adolescents' experiences of living with T1D and eating disorders. The results in this literature study shows knowledge from seven scientific articles. Data analysis was inspired by content analysis. The results in this literature study shows knowledge from seven scientific articles. The interpretation resulted in five formulated themes: Social dimension, Physical dimension, Emotional dimension, Triggers and Coping. Results indicate that support originating from family, friends and healthcare professionals was experienced as facilitating, but also as an uncomplete support. Some adolescents experienced negative body images, which conduced to insulin omission. The eating disorders provided depressive feelings and simultaneously experienced body control. Stressed life situations could trigger eating disorders. Coping strategies which aided the recovery of eating disorders was sharing experiences with peers. This literature study indicate that nurses can be supportive for adolescents with T1D and eating disorders through approaching in forms of being listening, non-judging and trustful. This literature study display requirements of supplementary research for a more evidence based clinical caring.

Os transtornos alimentares (TA) são doenças graves de etiologia multifatorial, que cursam com alterações importantes no comportamento alimentar e complicações clínicas como desnutrição e distúrbios hidroeletrolíticos, além de comorbidades psiquiátricas. A hospitalização integral é uma modalidade terapêutica indicada quando o seguimento ambulatorial não atinge resultados satisfatórios associados à piora dos sintomas. O objetivo deste estudo foi descrever as características e resultados da hospitalização dos pacientes com TA atendidos pelo Grupo de Assistência em Transtornos Alimentares do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. Dados antropométricos, bioquímicos e clínicos foram coletados a partir da revisão de prontuários dos pacientes internados durante o período de 1982 a 2011. Como resultado, observou-se que das 186 pessoas que receberam atendimento pelo serviço, 44,6% deles (n=83) necessitaram de no mínimo, uma internação durante o tratamento. A predominância foi do sexo feminino (95,2%), da raça branca (94%), solteira (76%) e sem filhos (78,3%). Cursavam o ensino médio (50,6%) com idade de 23,3±10,8 anos. O diagnóstico era de anorexia do tipo restritivo (AN-R) para 54,2% (n=45) deles, 31,3% (n=.26) apresentavam anorexia do subtipo compulsão periódica/purgativo (AN-CP) e 14,5% (n=12) tinham bulimia nervosa (BN). A média de internações foi de 1,9±3,9 vezes sendo que 73,5% (n=61) dos pacientes foram internados apenas uma vez, por 41,2±37,6 dias. Para aqueles que precisaram dessa modalidade de tratamento por mais de uma vez, a duração da hospitalização, considerando todas as internações, foi de 70,6±115,9 dias com extensa variação (3 a 804 dias). Não foi observada associação entre o número de internações com o Índice de Massa Corporal (IMC) e com o tempo de sintomas antes do diagnóstico. O IMC dos pacientes mudou significativamente (p<0,05) durante a internação (para o grupo com AN-R: de 13,5kg/m2 para 14,8kg/m2 ; para os com AN-CP: de 15,7kg/m2 para 16,9kg/m2 ; naqueles com BN: de 22,0kg/m2 para 21,0kg/m2 ). A amenorréia esteve presente em 69% (n=45) das mulheres, sendo mais frequente naquelas com AN-R (65,1%). Dos 23 pacientes (27,7%) que realizaram o exame de densitometria óssea, 44,4% (n=10) apresentam osteopenia e 29,7% (n=7) osteoporose. Os valores médios da maioria dos parâmetros bioquímicos avaliados estavam dentro da normalidade, com exceção do beta-caroteno, que encontrava-se elevado, tanto no início quanto no final da internação. A Nutrologia foi a enfermaria na qual a maioria das internações ocorreu (79,5%) e a necessidade de terapia nutricional foi a indicação mais frequente (62,3%). A via de administração de nutrientes preferencialmente utilizada foi a via oral (67,5%), apesar de ter sido observado aumento de 2,3 vezes na escolha da terapia nutricional enteral exclusiva nos pacientes que foram internados mais de uma vez. O acompanhamento multidisciplinar foi evidenciado, pois além do médico, houve a participação maciça de nutricionistas (87,9%) e psiquiatras (72,3%). Como conclusão, a hospitalização integral é uma modalidade bastante indicada no tratamento de pacientes com TA, mas sua duração é prolongada e requer a assistência de diversos profissionais. No entanto, quando indicada a partir de critérios bem estabelecidos proporciona melhora no estado nutricional. Futuros estudos são necessários para ampliar e aprofundar os resultados encontrados possibilitando o aprimoramento de condutas terapêuticas. / Eating disorders (ED) are serious diseases with multiple etiologies that course with major changes in eating behavior and clinical complications such as malnutrition and electrolyte disturbances, and also psychiatric comorbidities. Inpatient treatment is a modality of treatment used when the outpatient follow-up did not reach satisfactory results associated with worsening of clinical status. The aim of this study was to describe the characteristics and outcomes of the hospitalization in patients with ED who were treated by Assistance Group on Eating Disorders from the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP. Anthropometric, biochemical and clinical data were collected from the medical records of patients admitted between 1982 and 2011. It was observed that among 186 patients attended by the service, 44.6% (n = 83) required at least one inpatient treatment. Most patients were female (95.2%) and white (94%). The majority was single (76%), with no children 78.3%) and were high school students (50.6%). The mean age was 23.3± 10.8 years old. According to the diagnosis, 54.2% of patients had anorexia nervosa, restricting subtype (AN-R), 31.3% had anorexia nervosa binge-eating/purging subtype (AN-CP) and 14.5% had bulimia nervosa (BN). The mean age at admission was 23.3 ± 10.8 years (range 8-58 years), 73.5% of patients were hospitalized only once. The mean number of admissions was 1.9 ± 3.9 times and 73.5% (n=61) were hospitalized only once, during 41.2 ± 37.6 days. For those who needed this type of treatment more than once, the length of stay, considering all admissions, was 70.6 ± 115.9 days with extensive variation (3-804 days). No associations were observed between the number of hospitalizations and Body Mass Index (BMI) and duration of symptoms before diagnosis. The BMI of the patients changed significantly (p <0.05) during hospitalization (for the group with AN-R, from 13.5 kg/m2 to 14.8 kg/m2 ; for AN-CP: 15.7 kg/m2 to 16.9 kg/m2 , those with BN: from 22.0 kg/m2 to 21.0 kg/m2 ). Amenorrhea was present in 69% (n = 45) women, most frequently in those with AN-R (65.1%). According to exam of bone densitometry of 23 patients (27.7%), 44.4% (n=10) had osteopenia and 29.7% (n=7) had osteoporosis. The mean values of most biochemical parameters were within normal limits, except for beta- carotene, which was above the normal range, both in admission and discharge. The Nutrology was the infirmary where the majority of hospitalizations occurred (79.5%), nutritional support was the most frequent indication for hospitalization (62.3%). The route of administration of nutrients preferably used was oral (67.5%), although it has been observed an increase at 2.3 times on exclusively enteral feeding in patients admitted more than once. The multidisciplinary team reveals, besides the doctor, the massive presence of dietitians (87.9%) and extensive involvement of psychiatrists (72.3%). It is concluded that inpatient treatment is needed in patients with ED, often shows prolonged duration and requires the assistance of various professionals. However, when indicated based on criteria well established can provide improvement in nutritional status. Future studies are needed to broaden the results enabling the improvement of therapeutic approaches.

Nas últimas décadas, a investigação sobre o corpo e a imagem corporal tem adquirido uma importância crescente. Contudo, ainda são poucas as pesquisas internacionais e não se encontram nas investigações nacionais, trabalhos específicos sobre imagem corporal (IC) e estudos sobre a inter-relação da IC com sintomas alimentares nas mães de pacientes adolescentes com transtornos alimentares (TAs). Objetivo: Avaliar a presença de insatisfação corporal e sintomas de transtorno alimentar nas mães de pacientes adolescentes com TA e comparar a insatisfação corporal, e sintomas de TA entre as mães de adolescentes com TA e mães de adolescentes sem esses transtornos (grupo-controle). Método: Foram estudadas 35 mães de pacientes adolescentes do sexo feminino (entre 10 e 17 anos) com TAs, no inicio do tratamento no Projeto Interdisciplinar de Atendimento, Ensino, e Pesquisa em Transtornos Alimentares na Infância e Adolescência (PROTAD) do Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da USP. Para coleta de dados utilizou-se um Questionário Sociodemográfico padronizado; para definir a classe econômica foi utilizado o Questionário Socioeconômico (ANEP); para rastreamento de atitudes alimentares foi empregado o Teste de Atitudes Alimentares (EAT-26); e para avaliação de insatisfação corporal foram utilizados o Questionário de Imagem Corporal (BSQ) e Escala de Silhuetas de Stunkard. Os resultados foram comparados com um grupo controle, constituído de 35 mães de adolescentes do sexo feminino (entre 10 e 17 anos) estudantes de um colégio particular da cidade de São Paulo. Resultados: Nos 2 grupos não foram encontradas diferenças estatisticamente significantes na insatisfação da IC nem na sintomatologia alimentar. Apresentaram significância as correlações entre o Índice de Massa Corporal (IMC) e insatisfação corporal e entre o IMC e sintomatologia alimentar. Conclusões: Mães com filhas com TAs não apresentaram níveis de insatisfação corporal diferente das encontradas em mães de filhas adolescentes sem TAs. Sugere-se a complementação de escalas que permitam integrar os aspectos perceptivos e subjetivos que fazem parte da estruturação da imagem corporal. Fazer entrevistas individuais com as mães dos pacientes para incluir as mães no tratamento das filhas de forma mais eficaz / Research on body and body image has gained wider relevance in recent decades. There are few studies in the literature and no Brazilian study on body image targeting the interrelationship between body image and eating symptoms in mothers of eating disorder (ED) adolescent patients. Objective: To assess body image dissatisfaction and eating symptoms in mothers of ED female adolescents (case group) and to compare this data with a group of mothers of non-ED adolescents (control group). Methods: There were studied 35 mothers of female adolescents (aged 10 to 17 years) diagnosed with eating disorders who attended the Interdisciplinary Project for Care, Teaching and Research on Eating Disorders in Childhood and Adolescence (PROTAD) at Clínicas Hospital Institute of Psychiatry of Universidade de São Paulo Medical School. Socio-demographic data was collected using a PROTAD standard questionnaire. Socioeconomic condition was assessed following the Brazilian Criteria for Economic Classification (ANEP); eating symptoms were assessed using the Eating Attitudes Test (EAT-26); and body image dissatisfaction was assessed through Body Shape Questionnaire (BSQ) and Stunkard Figure Rating Scale (FRS). The results were compared against a control group comprising 35 mothers of female adolescents (aged 10 to 17 years) who attended a private school in the city of São Paulo. Results: There were no statistically significant differences of body dissatisfaction and eating symptoms in both groups. Significant correlations were found between body mass index (BMI) and body dissatisfaction, and BMI and eating symptoms. Conclusions: Mothers of ED adolescents had the same intensity of body dissatisfaction compared to mother of non-ED adolescents. It is suggested the addition of complementary scales that would enable to integrate perceptive and subjective aspects and components that are involved in body image construction. It is crucial to conduct individual interviews with mothers of patients to more effectively involve them in their daughter’s treatment

INTRODUÇÃO: Pacientes com transtornos alimentares (TAs) costumam checar o corpo repetidamente com atitudes tais como: pesar-se constantemente, estudar a si mesmo no espelho, experimentar roupas para avaliar se estão adequadas ou não, beliscar o corpo, comparar seu corpo com o de outras pessoas, entre outras práticas. Esses comportamentos podem prolongar-se por muito tempo, várias vezes ao dia. Por outro lado, alguns pacientes têm atitude oposta e evitam ao máximo checar seus corpos. Os referidos comportamentos estão associados ao constructo central da doença: superavaliação do corpo, do peso e da alimentação. OBJETIVOS: Comparar comportamentos de checagem corporal em pacientes com anorexia nervosa (AN), bulimia nervosa (BN) e controles. MÉTODO: Aplicação de escalas padronizadas que avaliam checagem corporal, sintomas de AN e BN, imagem corporal, sintomas de depressão e transtorno obsessivo-compulsivo. A pesquisa foi realizada no Programa de Transtornos Alimentares (AMBULIM) do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IPq - HC-FMUSP) (grupo AN, n= 44 e grupo BN, n=41) e Ambulatório de Ginecologia do HC-FMUSP (grupo controle, n= 40). RESULTADOS: O grupo BN relatou checar mais o corpo (média = 57,83) do que os outros grupos (média AN = 46,05 e média controle = 22,80; p valor <0,001) e também evitar mais a checagem corporal do que os outros dois grupos (media AN= 1,91; média BN = 4,05; média controle = 0,80; p valor <0,001). O método mais comum para a checagem corporal foi a visualização no espelho, e a área corporal mais checada foi a barriga. Pacientes com AN indicam buscar, na checagem corporal, a verificação objetiva e o controle da dieta e ganho de peso, enquanto pacientes com BN indicam buscar segurança e garantia a respeito do corpo, além de antecipar as consequências de não checar. Já o grupo controle possui baixa motivação para se checar. A checagem corporal se relacionou com o peso desejado (þ = -340; p valor <0,001), com a restrição alimentar (þ = 0,501; p valor <0,001), com a gravidade de sintomas bulímicos no grupo BN (média = 67,08; p valor = 0,021), com a insatisfação corporal no grupo AN (média = 46,05; p valor = 0,001) e BN (média = 57,83; p valor = 0,022), com distorção da imagem corporal no grupo BN (média = 57,83; p valor = 0,030), com sintomas depressivos (þ = 0,509; p valor <0,001) e com alguns sintomas obsessivo-compulsivos, especialmente em pacientes com AN (média obsessões somáticas = 57,38; p valor = 0,004; média compulsão por rituais para comer = 58,33; p valor = 0,043). CONCLUSÕES: Os resultados indicam existir diferenças nos comportamentos de checagem corporal e nas cognições relacionadas a esses comportamentos, nos três grupos estudados. O grupo BN relatou checar mais o corpo e também evitar mais a checagem corporal do que os outros dois grupos. O grupo que se preocupou menos com a checagem do corpo foi o grupo controle. As motivações para a checagem foram diferentes entre os grupos, sendo que o grupo controle teve baixa motivação para esse comportamento. / INTRODUCTION: Patients with eating disorders (ED) tend to repeatedly engage in body checking behaviors which includes constantly weighing themselves, looking in the mirror, trying on clothes to check for tightness, pinching body parts and comparing their own body to that of other people, among others. These behaviors may take a few seconds or carry on for several minutes many times a day. On the other hand, some other patients take an opposite attitude and completely avoid checking their body. These behaviors are associated with the core pathology of ED: overevaluation of body weight and eating. OBJECTIVES: To compare body checking behaviors in patients with anorexia nervosa (AN), bulimia nervosa (BN), and controls. METHODS: Standard scales for the assessment of body checking, anorexia and bulimia nervosa symptoms, body image, depression and obsessive-compulsive disorder symptoms were used. The study was conducted at the Eating Disorders Program (AMBULIM) of the Institute of Psychiatry, University of São Paulo, School of Medicine (IPq - HC - FMUSP) (AN group, n = 44; and BN group, n = 41) and at the Department of Gynecology, HC-FMUSP (control group, n = 40). RESULTS: The BN group reported more body checking (mean = 57.83) than all other groups (AN mean = 46.05; control mean = 22.80; p<0.001) as well as more body avoidance (AN mean = 1.91, BN mean = 4.05, control mean = 0.80; p<0.001). The most common body checking behavior was looking in the mirror, and the body part most frequently checked was the belly. Patients with AN seem to engage in body checking for objective verification and body and diet control while patients with BN engage in it for safety beliefs and reassurance of their own body. The control group showed low motivation to engage in body checking. Body checking was associated with the desired weight (þ = -340, p<0.001), dietary restriction (þ = 0.501, p<0.001), severity of bulimic symptoms in the BN group (mean = 67.08, p=0.021), body dissatisfaction in the AN (mean = 46.05, p = 0.001) and BN groups (mean = 57.83, p=0.022), body image distortion in the BN group (mean = 57.83, p=0.030), depressive symptoms (þ = 0.509, p<0.001) and some obsessive-compulsive symptoms, especially in patients with AN (mean somatic obsessions = 57.38, p=0.004, mean compulsive rituals eating = 58.33, p=0.043). CONCLUSIONS: Body checking behaviors and related cognitions were apparently different in the three groups studied. Patients with BN reported more body checking and body avoidance than patients with AN and controls. Controls engaged less in body checking. Motivations for engaging in body checking were different in all groups studied and controls showed low motivation to engage in body checking.

Eating disorders remain extremely difficult to treat and investigation has revealed that manual-based eating disorder treatment outcomes have failed to improve over the second half of the last century. Various studies have observed that clinicians use evidence-based treatments for eating disorders inconsistently and often exclude fundamental theoretical techniques. Some argue that this departure from evidence-based practice may in some cases be the efforts of clinicians to develop methods more sensitive to real world situations. It stands to reason that some of the techniques currently being used by clinicians are promising treatment approaches. The purpose of this study was to explore the therapeutic process of a select group of clinicians at one eating disorder treatment center. Semi-structured interviews were conducted with 16 clinicians. A hermeneutic analysis of the interview transcripts revealed a common treatment approach with nine areas of focus: (a) stabilizing behaviors, (b) relationship building, (c) providing education, (d) increasing motivation, (e) challenging cognitions, (f) understanding emotions, (g) finding purpose and meaning, (h) improving body image, and (i) preventing relapse. Insights acquired from the clinicians in this study could contribute to the development of more effective treatments for clients with eating disorders.

Anorexia as a nosological category has developed in a western context and is now being applied to people around the world. In order for researchers to know they are asking the right questions about AN as knowledge expands, it is important to understand what meanings Anorexia carries and how those meanings manifest locally. The present study to aid in that understanding by employing a mixed methods (survey and in-depth interviewing) research approach in answering the following question: In what ways are Taiwanese students' explanatory models of anorexia nervosa (AN) congruent with or different from professional understandings derived from the western Bio-medical perspective? In answering this question, this study first addresses the current state of research on anorexia as well as the recent findings from studies done in Asia. Subsequently, the findings of the present research address what are young, Taiwanese adults' notions of the causality of AN. In particular, the present research found that student explanations of AN are focused predominantly on two causal forces; namely, the desire to be thin or the inability to eat as a result of psychosocial pressure arising from some interpersonal interactions. Additionally, Taiwanese students also maintain that AN can be explained by other less common factors. For instance, significantly more males than females believed that AN could be explained by some physiological dysfunction in the anorectic person. This study seeks to contribute to the literature by examining how college-age Taiwanese understand and conceptualize AN; which in turn may help towards understanding how other research conducted among Chinese populations has produced findings that are incongruent with the expectations suggested by the western, biomedical model of anorexia nervosa. There is further need for cross-cultural research on AN including lay understandings. This should focus not only on the "accurateness" of lay models as has been the case with the majority of research on lay models of AN in the past, but future research should consider the appropriateness of current research and public health models that influence both research and policy.

Eating disorders (EDs) are strikingly common among American adults. Past research has indicated that athletes in general are particularly vulnerable to developing EDs due to media pressure, athletic drive, and the population’s proclivity to perfectionism. Most ED research, both in athletic and non-athletic populations, is female-focused, as women are more likely to develop EDs. However, men are still susceptible to develop EDs and are understudied. Links between lack of autonomy and EDs exist in familial settings, but have yet to be applied in organizational settings. This quantitative thesis sought to bridge a research gap by assessing ED levels in male NCAA Division 1 athletes and examining the relationships with perceived levels of concertive, institutional, and simple control present in athletic settings. Findings indicated that although athletes perceived different forms of control in their sport, these forms of control did not negatively affect their eating habits. Implications and direction for future research are explored.