Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-26T11:56:29Z No. of bitstreams: 1 giselleteixeiramaulerdorio.pdf: 1906661 bytes, checksum: d2c04e715b00189f3b3e4709b03915f5 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:31:44Z (GMT) No. of bitstreams: 1 giselleteixeiramaulerdorio.pdf: 1906661 bytes, checksum: d2c04e715b00189f3b3e4709b03915f5 (MD5) / Made available in DSpace on 2016-09-26T20:31:44Z (GMT). No. of bitstreams: 1 giselleteixeiramaulerdorio.pdf: 1906661 bytes, checksum: d2c04e715b00189f3b3e4709b03915f5 (MD5) Previous issue date: 2016-07-27 / Atualmente, vive-se uma epidemia da obesidade. Como o estereótipo de beleza caracteriza-se pelo corpo magro, ser obeso pode gerar uma imagem corporal negativa de si mesmo. O presente estudo tem como objetivo avaliar a imagem corporal e obesidade em estudantes de uma Instituição de Ensino Superior particular, em Juiz de Fora - MG. Este estudo se caracteriza como quantitativo e transversal. Para tanto, esta pesquisa foi dividida em duas etapas: na primeira, foi realizada uma triagem inicial nos alunos da Instituição, a fim de determinar quais destes apresentavam obesidade; na segunda etapa, foram aplicados os seguintes instrumentos nos indivíduos obesos: Escala de figuras de silhuetas, BSQ, BCQ, MBCQ, BDI e IPAQ, validados para a população adulta. Estes instrumentos avaliaram a imagem corporal atual e ideal, a insatisfação corporal, os comportamentos de checagem corporal em mulheres e homens, depressão e nível de atividade física, respectivamente. Também foram coletados dados sociodemográficos e antropométricos. Da primeira etapa deste estudo participaram 2376 alunos. Da segunda etapa, participaram 199 alunos classificados como obesos, a partir do IMC autorreferido coletado na primeira etapa. Verificaram-se elevados coeficientes de consistência interna dos questionários utilizados. De maneira geral, os resultados da primeira etapa deste estudo apontaram baixo percentual de alunos com obesidade. Já os resultados da segunda etapa apontaram confiabilidade nos dados autorreferidos de altura, embora exista uma tendência a subestimar a massa corporal em ambos os sexos. A caracterização da amostra mostrou elevado índice de obesidade entre as mulheres, consumo de álcool e refrigerantes. Além disso, foi notado alto percentual de obesos na família, realização de tratamentos para emagrecer, percepção do estado de saúde ruim, presença de dor e sedentarismo. Esses resultados mostraram hábitos pouco saudáveis nos indivíduos obesos. Foi verificada diferença estatisticamente significativa dos valores médios de imagem corporal, entre a percepção de imagem corporal atual e a ideal. Esses resultados mostraram existir insatisfação corporal em ambos os sexos. Tanto obesos satisfeitos como insatisfeitos apresentaram a mesma percepção da imagem corporal. O tamanho da diferença observada entre a imagem corporal atual e ideal foi de elevada magnitude. Observou-se forte correlação da insatisfação corporal com a depressão. Os obesos insatisfeitos com a imagem corporal apresentam elevado grau de depressão (p<0,001). Os resultados da presente pesquisa mostraram que os obesos insatisfeitos com a imagem corporal apresentam maior número de dores, maior tempo em atividades sentado, são os que menos realizam atividades físicas e apresentam maiores valores de checagem corporal. Já os resultados do instrumento IPAQ, correlacionaram-se negativamente com a insatisfação corporal. Quanto mais ativo o indivíduo, menos insatisfeito ele estará com a sua imagem corporal. Assim, os resultados do presente estudo evidenciam para a necessidade de orientação dos universitários obesos para um estilo de vida saudável e a oferta de programas de atividades físicas que visem à redução do excesso de peso e depressão. Sugere-se novas pesquisas que vinculem a imagem corporal, inatividade física e depressão à obesidade, no público em geral. / An obesity epidemic is currently noticed among society. Since the stereotype of beauty is characterized by having a thin body, being obese can lead to a negative body image regarding one’s own body. This study aims at evaluating body image and obesity among students of a private higher education institution, in the city of Juiz de Fora, in the state of Minas Gerais, Brazil. This is characterized as being a quantitative, cross-sectional study. Therefore, this study was divided into two stages: first, an initial screening was performed on the students of the institution in order to determine which of these were obese; in the second stage, the following instruments were applied to the obese individuals: Silhouette Scale Figures, BSQ, BCQ, MBCQ, BDI and IPAQ validated for the adult population. These instruments assessed both the current and the ideal body images, body dissatisfaction, body checking behaviors in women and men, depression and level of physical activity, respectively. Demographic and anthropometric data were also collected. A total of 2,376 students participated in the first stage of the study. As for the second stage, 199 students classified as being obese took part in the study, based on the self-reported BMI collected in the first stage. High internal consistency coefficients were noticed regarding the questionnaires used. Overall, the results of the first stage of this study show a low percentage of obese students. As for the second stage, results showed reliability in terms of the self-reported data for height, although a tendency to underestimate body mass in both genders was noticed. The characterization of the sample showed high rates of obesity among women, as well as high consumption of alcohol and soft drinks. In addition, a high percentage of obese individuals was noticed within the family, as well as treatments for weight loss, perception of poor health, pain and inactivity. These results showed unhealthy habits among the obese individuals. There was a statistically significant difference in the mean values when comparing the currently perceived and ideal body images. These results showed body dissatisfaction in both genders. Both satisfied and dissatisfied obese individuals had the same body image perception. High magnitude was noticed regarding the size of the difference between the current and the ideal body images. A strong correlation was shown between body dissatisfaction and depression. Obese individuals dissatisfied with their body images have a high degree of depression (p <0.001). The results of this study showed that obese individuals dissatisfied with their body images have more pain, spend more time performing sitting activities, present the lowest amount of physical activities and have the highest values for body checking behaviors. As for the results of the IPAQ instrument, a negative correlation was shown with body dissatisfaction. The more active the individual, the less dissatisfied they will be with their body image. Thus, the results of this study indicate the need for guiding obese students towards a healthy lifestyle, as well as providing them with physical activity programs aimed at reducing their overweight and depression. It also suggests further research binding body image, physical inactivity and depression caused by obesity among the individuals in general.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-21T11:08:04Z No. of bitstreams: 1 naryllemariabacelarchaibzanolli.pdf: 1132095 bytes, checksum: 5fd9f15df27da6162b1b82df22f44357 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T18:43:11Z (GMT) No. of bitstreams: 1 naryllemariabacelarchaibzanolli.pdf: 1132095 bytes, checksum: 5fd9f15df27da6162b1b82df22f44357 (MD5) / Made available in DSpace on 2016-01-25T18:43:11Z (GMT). No. of bitstreams: 1 naryllemariabacelarchaibzanolli.pdf: 1132095 bytes, checksum: 5fd9f15df27da6162b1b82df22f44357 (MD5) Previous issue date: 2014-03-27 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / A figura mental relacionada ao tamanho e forma do corpo, além dos sentimentos e das atitudes relacionados a essas características, é designada pelo termo imagem corporal. Apesar de singular e indivisível, a imagem corporal integra múltiplas dimensões, sendo vulnerável a processos dinâmicos internos e externos, estando em constante transformação. A insatisfação corporal está ligada à baixa autoestima e limitações no desempenho psicossocial, associando-se a quadros depressivos, além de estar relacionada aos distúrbios de comportamento alimentar como anorexia, bulimia e comer compulsivo. O objetivo do presente estudo foi determinar os fatores associados à insatisfação corporal entre estudantes regularmente matriculados nas séries iniciais do Ensino Fundamental de uma escola pública do município de Juiz de Fora – MG e identificar as impressões quanto à imagem e insatisfação corporais daqueles com estado nutricional adequado. Foi realizado um estudo de delineamento transversal, de natureza quantitativa e qualitativa, descritivo, analítico e exploratório. A amostra foi constituída por escolares entre oito e doze anos regularmente matriculados no Ensino Fundamental I de uma escola pública de Juiz de Fora - MG. O instrumento utilizado para avaliar a insatisfação corporal foi uma escala de figuras de silhuetas, sendo os demais dados coletados por meio de questionários. A coleta dos dados qualitativos se deu por meio de grupo focal. Os dados quantitativos foram analisados através do pacote estatístico Statistical Software for Professional (STATA), versão 12.0. A medida de associação utilizada foi a Razão de Prevalência (RP), determinada através da regressão de Poisson com estimador de variância robusta. Foi considerado um nível de significância de 5% para a definição do modelo final. A análise do grupo focal foi realizada utilizando-se diretamente os conteúdos provenientes das discussões. Observou-se frequência de insatisfação corporal de 86,5% e sua associação significativa com o porcentagem de gordura corporal, duração da atividade física, escolaridade materna e trabalho materno. Os resultados obtidos através do método qualitativo demonstram a preocupação com o corpo, aparência e com a opinião das outras pessoas a respeito da imagem corporal, além do desejo em realizar alguma alteração corpórea. Também foram observadas a influência da família e da mídia sobre a imagem corporal. A infância e a adolescência são períodos em que se adquirem hábitos que poderão ser levados por toda a vida, além de representarem um público propenso a atitudes inadequadas. Assim, destaca-se a importância em se realizar pesquisas com estes indivíduos, especialmente relativas à imagem corporal, já que a insatisfação com o corpo traz pensamentos e sensações negativos, influenciando a saúde emocional, a qualidade de vida e o convívio social. / The mental picture related to the size and shape of the body, besides the feelings and attitudes related to these characteristics, is designated by the term body image. Although single and indivisible, the body image integrates multiple dimensions, being vulnerable to internal and external dynamic processes and being in constant transformation. Body dissatisfaction is linked to low self-esteem and limitations of the psychosocial performance. It is also associated with depression, as well as being related to eating disorders like anorexia, bulimia and compulsive eating. The present study aimed to determine the factors associated to body dissatisfaction among students enrolled in the early grades of elementary school in a public school in the city of Juiz de Fora – MG, and identify the impressions on the body image and body dissatisfaction of those with adequate nutritional status. A cross design of quantitative and qualitative, descriptive, analytical and exploratory study was performed. The sample consisted of children between eight and twelve years, enrolled in the elementary school in a public school of Juiz de Fora - MG. The instrument used to assess body dissatisfaction was a body shape figures scale, and the remaining data was collected through questionnaires. The qualitative data was collected through the focus group method. The quantitative data was analyzed using the statistical package Statistical Software for Professional (STATA) version 12.0. The measure of association used was the prevalence ratio (PR), determined by the Poisson regression with robust variance estimator. It was considered a significance level of 5% for the definition of the final model. The analysis of the focus group was performed using the content of the discussions. It was observed a frequency of body dissatisfaction of 86.5% and significant association with body fat percentage, duration of physical activity, maternal education and maternal employment. The results obtained by the qualitative assay demonstrate the concern with the body appearance and the opinion of others about body image, besides the desire to perform some corporal change. The influence of family and media on body image was also observed. Childhood and adolescence are periods in which people acquire habits that may be taken for life, and they represent people prone to take inadequate attitudes. Thus, it is important to conduct research with these individuals, especially relating to body image, as body dissatisfaction brings negative thoughts and feelings, influencing emotional health, quality of life and social interaction.

Studiens syfte är att undersöka hur personer med ätstörning upplever att sjukdomen påverkar sexualiteten samt undersöka vilka erfarenheter de har av samtal om sexuell hälsa och välbefinnande inom ätstörningsvården. Tidigare forskning har visat på sambandet mellan kroppsuppfattning, kroppsmissnöje, kroppsskam och ätstörningar och även sett samband mellan dessa och sexuella dysfunktioner. Forskningen avseende ätstörningar och sexuella svårigheter är något bristfällig, även om det på senare år kommit studier som lyfter ämnet, och i dessa har man sett att individer som har ätstörningar också rapporterar högre vad gäller sexuella svårigheter. Större delen av de studier som gjorts är kvantitativa och i en internationell kontext. Många med ätstörningar kommer i kontakt med hälso- och sjukvården och tidigare forskning har visat att samtal om sexualitet inom en vårdkontext generellt sett är otillräckligt. Studien har en fenomenologisk ansats men även socialkonstruktivistisk och genomförts med en kvalitativ metod bestående av elva halvstrukturerade intervjuer och materialet har analyserats utifrån en reflexiv tematisk analys. Resultaten har analyserats med hjälp av begreppen livsvärld, spegeljag, stigma, skam och skamkompassen för att förstå och visa på samband i kommande analys. Resultatanalysen bygger på de fyra teman: Livsvärlden - en inblick, I-världen-varo med en ätstörning, En hemlös värld samt Vägen mot en tillfredsställande sexualitet - finns den och på vem ligger ansvaret? Resultaten visar att en ätstörning har en biopsykosocial påverkan på sexualiteten och har för många blivit ett hinder vad gäller utlevnad av denna. Resultaten visar även på ett uttryckt behov av sexologiska och relationella samtal inom hälso- och sjukvården för att närma sig en tillfredsställande sexualitet med allt vad det innebär. / The aim of the study is to investigate adults' experiences of how an eating disorder affects their sexuality and to investigate what experiences they have of conversations about sexual health and well-being within eating disorder healthcare services. Previous research has shown the connection between body image, body dissatisfaction, body shame and eating disorders and also seen a correlation between these and sexual dysfunctions. The research regarding eating disorders and sexual difficulties is somewhat lacking, although in recent years there have been studies that highlight the subject, and in these it has been stated that individuals who have an eating disorder also report higher levels of sexual difficulties. Most of existing studies that have been done are quantitative and in an international context. Many people with eating disorders come into contact with healthcare systems and previous research has shown that talking about sexuality within a healthcare context is generally insufficient. This study has a phenomenological but also social constructivist approach. It was conducted with a qualitative method consisting of eleven semi-structured interviews and has been analyzed through a reflexive thematic analysis. The results have been analyzed using the concepts of lifeworld, mirror self, stigma, shame and the compass of shame to understand and show connections in future analysis. The result analysis is based on the four themes: The world of life - an insight, Being-in-the-world with an eating disorder, A homeless world and The road to a satisfying sexuality - does it exist and who is responsible? The results show that an eating disorder has a biopsychosocial impact on sexuality and has for many become an obstacle in terms of experiencing it. The results also show an explicit need for sexological and relational conversations within the healthcare system in order to approach a satisfactory sexuality with all that it entails.

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L’objectif de recherche principal poursuivi dans cette thèse de doctorat est de mieux comprendre le rôle d’une insatisfaction corporelle dans l’adoption de pratiques de maintien et de changement du poids chez des adolescent(e)s québécois(es). Pour atteindre cet objectif de recherche principal, trois articles scientifiques liés les uns aux autres ont été rédigés. Chaque article poursuit des objectifs spécifiques (1er article: estimer les proportions d’adolescent(e)s québécois(e)s poursuivant un objectif de poids apparié et non-apparié à leur poids actuel et identifier les déterminants des objectifs de poids non-apparié au poids actuel, 2e article: identifier des associations entre un objectif de poids apparié vs. non-apparié au poids actuel et la fréquence d’utilisation de différents comportements liés au poids et à l’alimentation, 3e article: observer des associations entre différents degrés d’insatisfaction corporelle et l’utilisation de divers comportements liés au poids et à l’alimentation et examiner le rôle modérateur d’un objectif de poids apparié vs. non-apparié au poids actuel dans ces associations) permettant de répondre à l’objectif de recherche principal. Ces articles ont tous été élaborés à partir de l’analyse secondaire d’une banque de données quantitatives constituée par l’Institut de la statistique du Québec (ISQ) et nommée: Enquête sociale et de santé auprès des enfants et des adolescents québécois (ESSEA). L’ESSEA a été constitué auprès d’un échantillon populationnel et représentatif d’enfants et d’adolescent(e)s québécois(es) âgé(e)s de neuf, 13 et 16 ans. Les résultats de cette thèse indiquent qu’une insatisfaction corporelle est associée à la poursuite d’un objectif de poids non-apparié au poids actuel, ainsi qu’à l’utilisation de comportements liés au poids et à l’alimentation sains, malsains et déviants. Des associations ont également été observées entre l’objectif de poids poursuivi par un adolescent(e) et divers comportements utilisés pour l’atteindre. En effet, la poursuite d’un objectif de poids non-apparié au poids actuel est associée à l’utilisation de comportements malsains. Cette association n’est cependant pas présente en ce qui à trait à l’utilisation de comportements sains et déviants, ceux-ci étant strictement prédits par une insatisfaction corporelle. Des effets de médiation et de modération ont aussi été identifiés. Une insatisfaction corporelle est une variable de médiation entre une détresse psychologique chez les adolescentes et la poursuite d’un objectif de poids non-apparié au poids actuel. Finalement, un objectif de poids non-apparié au poids actuel est une variable modifiant l’association entre une insatisfaction corporelle et l’utilisation de comportements malsains chez les adolescent(e)s québécois(es). En conclusion, il existe diverses associations entre une insatisfaction corporelle et l’adoption de pratiques de maintien et de changement du poids chez des adolescent(e)s québécois(es). Une insatisfaction corporelle est donc une cible d’intervention pertinente pour la santé publique puisqu’elle peut servir de base à l’élaboration d’interventions visant la promotion d’un poids santé ainsi que de saines stratégies de contrôle du poids. / The main objective of this doctoral thesis is to better understand the role of body (dis)satisfaction in the adoption of practices directed toward body weight maintenance or body weight modification among Quebec adolescents. To reach this overall thesis objective, three theoretically and conceptually linked scientific papers were written. Although linked to one another, each paper pursues specific research objectives (1st article: to estimate proportions of adolescents with a weight goal that matched and mismatched weight status, and to identify correlates of a mismatched weight goal, 2nd article: to examine associations between matched vs. mismatched weight goals and the frequency of use of different weight-related behaviors, 3rd article: to examine associations between different levels of body dissatisfaction and different frequencies of use of weight-related behaviors and, to investigate whether or not the person’s weight goal moderates these associations) which allow for answering the main thesis objective. These papers were generated from secondary data analyses on a quantitative dataset built by the Institut de la statistique du Québec (ISQ) and named: Quebec Child and Adolescent Health and Social Survey. This dataset was based on data collected from a representative population-based sample of Quebec children and adolescents aged nine, 13, and 16 years old. The results of this thesis indicate that body dissatisfaction is associated with pursuing a mismatched weight goal as well as with the use of healthy, unhealthy, and disordered health behaviors. Associations are also observed between weight goals and weight-related behaviors used to reach weight goals. Indeed, pursuing a mismatched weight goal was found to be associated with the use of unhealthy weight-related behaviors across both sexes. This association is however not significant for the use of healthy and disordered health behaviors. These behaviors were solely predicted by body dissatisfaction. Mediation and moderation effects were also identified. It was found that being body dissatisfied mediated the association between psychological distress among adolescent girls and pursuing a mismatched weight goal. Finally, pursuing a mismatched weight goal was also found to moderate associations between body dissatisfaction and using unhealthy weight-related behaviors among both Quebec adolescent boys and girls. We conclude that there are various associations between body dissatisfaction and the adoption of practices directed toward body weight maintenance or body weight modification among Quebec adolescents. Body dissatisfaction thus represents a pertinent target for public health intervention in the sense that it can serve as the basis for the elaboration of interventions aimed at promoting healthy body weights and healthy weight management strategies.

Introdução - Pacientes portadores de diabetes tipo 1 que manifestam comportamentos de risco para transtornos alimentares (TA) possuem grandes chances de complicações microvasculares e macrovasculares e maiores taxas de mortalidade. Objetivo Avaliar a freqüência de comportamento de risco para TA em adolescentes e adultos portadores de diabetes tipo 1 bem como sua relação com variáveis socioeconômicas, nutricionais, relacionadas ao diabetes e satisfação corporal. Metodologia: Foram aplicados: Teste de Investigação Bulímica de Edinburgh (BITE), Teste de Atitudes Alimentares (EAT), Escala de Compulsão Alimentar Periódica (ECAP) e Escala de Silhuetas de Stunkard, além da mensuração de peso, estatura e cálculo do IMC. Foram verificadas associações ou diferenças estatísticas por meio dos testes de Qui-Quadrado e T-Student e Regressão Logística para identificar fatores que influenciaram o risco da doença. Resultados: Um total de 58,7% dos pacientes apresentaram escore positivo em algum dos testes utilizados para risco de TA. Houve diferença significante entre os grupos com e sem risco para TA com relação ao IMC (p=0,009), gênero (p=0,001), omissão de insulina (p=0,003), uso de insulina NPH (p=0,006), ausência do uso da insulina Glargina (p=0,021), ausência do uso da técnica de contagem de carboidratos (p=0,019), controle da glicemia (p=0,049) e insatisfação corporal (p=0,001). Conclusão: Portadores de diabetes tipo 1 apresentaram grande freqüência de comportamentos de risco para o TA, o que requer atenção e cautela dos profissionais de saúde. / Introduction - Patients suffers of type 1 diabetes that reveal risk behavior for eating disorders (ED) have more chances of micro and macro vascular complications and a high mortality level. Objective Evaluate the frequency of risk behavior for ED in teenagers and adults suffers of type 1 diabetes as well as its relation to the socially economical variable, nutritional variable, related to diabetes and body satisfaction. Methodology: There was applied: The Bulimic Inventory Test of Edinburgh (BITE), Eating Attitudes Test (EAT), Binge Eating Scale (BES) and The Stunkard´s Figure Rating Scale, besides weight measure, height and BMI calculation of the patients. There were verified associations or statistical differences through tests of Chi-Square and T-student and Logistical Regression to identify the factors that influenced the risk of the disease. Results: A total of 58,7% patients presented positive score in tests used for ED risk. There was a significant difference among the groups with and without risk for ED in relation to the BMI (p=0,009), gender (p=0,001), omission of insulin (p=0,003), usage of NPH insulin (p=0,006), lack of usage of Glargine insulin (p=0,021), lack of usage of the technique of carbohydrate counting (p=0,019), blood glucose control (p=0,049) and body dissatisfaction (p=0,001). Conclusion: The suffers of type 1 diabetes presented high frequency of risk behavior for ED, which require more attention when caring for patients for the prevention of the disease.

Introdução - Pacientes portadores de diabetes tipo 1 que manifestam comportamentos de risco para transtornos alimentares (TA) possuem grandes chances de complicações microvasculares e macrovasculares e maiores taxas de mortalidade. Objetivo Avaliar a freqüência de comportamento de risco para TA em adolescentes e adultos portadores de diabetes tipo 1 bem como sua relação com variáveis socioeconômicas, nutricionais, relacionadas ao diabetes e satisfação corporal. Metodologia: Foram aplicados: Teste de Investigação Bulímica de Edinburgh (BITE), Teste de Atitudes Alimentares (EAT), Escala de Compulsão Alimentar Periódica (ECAP) e Escala de Silhuetas de Stunkard, além da mensuração de peso, estatura e cálculo do IMC. Foram verificadas associações ou diferenças estatísticas por meio dos testes de Qui-Quadrado e T-Student e Regressão Logística para identificar fatores que influenciaram o risco da doença. Resultados: Um total de 58,7% dos pacientes apresentaram escore positivo em algum dos testes utilizados para risco de TA. Houve diferença significante entre os grupos com e sem risco para TA com relação ao IMC (p=0,009), gênero (p=0,001), omissão de insulina (p=0,003), uso de insulina NPH (p=0,006), ausência do uso da insulina Glargina (p=0,021), ausência do uso da técnica de contagem de carboidratos (p=0,019), controle da glicemia (p=0,049) e insatisfação corporal (p=0,001). Conclusão: Portadores de diabetes tipo 1 apresentaram grande freqüência de comportamentos de risco para o TA, o que requer atenção e cautela dos profissionais de saúde. / Introduction - Patients suffers of type 1 diabetes that reveal risk behavior for eating disorders (ED) have more chances of micro and macro vascular complications and a high mortality level. Objective Evaluate the frequency of risk behavior for ED in teenagers and adults suffers of type 1 diabetes as well as its relation to the socially economical variable, nutritional variable, related to diabetes and body satisfaction. Methodology: There was applied: The Bulimic Inventory Test of Edinburgh (BITE), Eating Attitudes Test (EAT), Binge Eating Scale (BES) and The Stunkard´s Figure Rating Scale, besides weight measure, height and BMI calculation of the patients. There were verified associations or statistical differences through tests of Chi-Square and T-student and Logistical Regression to identify the factors that influenced the risk of the disease. Results: A total of 58,7% patients presented positive score in tests used for ED risk. There was a significant difference among the groups with and without risk for ED in relation to the BMI (p=0,009), gender (p=0,001), omission of insulin (p=0,003), usage of NPH insulin (p=0,006), lack of usage of Glargine insulin (p=0,021), lack of usage of the technique of carbohydrate counting (p=0,019), blood glucose control (p=0,049) and body dissatisfaction (p=0,001). Conclusion: The suffers of type 1 diabetes presented high frequency of risk behavior for ED, which require more attention when caring for patients for the prevention of the disease.

Há evidências que associam a prática de atividade física (AF) nos transtornos alimentares (TA) como método compensatório na busca do controle do peso e apetite. O objetivo da pesquisa foi determinar o perfil de AF dos pacientes atendidos no Programa de Transtornos Alimentares (AMBULIM) do Instituto de Psiquiatria da Faculdade de Medicina da USP. A amostra foi composta por pacientes com diagnóstico de anorexia nervosa (AN, n=27), bulimia nervosa (BN, n=31) e um grupo controle (GC, n=13). A coleta de dados envolveu avaliar as variáveis da AF por meio de uma medida objetiva (acelerômetro), atividades físicas autorreferidas, e o grau de compromisso com o exercício. Variáveis nutricionais e psicológicas foram mensuradas por meio de escalas de atitudes alimentares, de insatisfação corporal, depressão e ansiedade para análise de associações. A comparação entre os grupos de AN, BN e GC, foi feita por meio de Kruskal Wallis. Para analisar as prevalências e os possíveis fatores relacionados à prática de AF foram realizados o teste Quiquadrado, a razão de prevalências (RP) e a medida de Odds Ratio (OR). Nas variáveis antropométricas, nutricionais e psicológicas o grupo controle apresentou resultados adequados, dentro das faixas limítrofes à saúde, com baixo risco para TA, níveis de depressão e de ansiedade em comparação aos grupos de TA (p<0,05). Na medida objetiva, a BN apresentou o maior tempo de duração na AF leve, em comparação aos demais grupos (p<0,001). Nas associações de RP, ao assumir uma nota de corte pela mediana, aquelas que permaneceram na AF leve no acelerômetro, por um tempo superior a 973 minutos apresentaram 2,1 vezes a prevalência de ter BN, quando comparado com quem ficou um tempo igual ou inferior; na AN a medida de risco não foi significativa. Limitações da pesquisa exigem cautela na observação dos resultados. A prática compulsiva, baseada no escore total do grau de compromisso com o exercício, não interferiu na prevalência de TA na amostra estudada. Também não foram encontradas associações entre a prática de AF e as variáveis antropométricas, nutricionais e psicológicas, exceto a insatisfação corporal. Aquelas que apresentaram insatisfação corporal tiveram 3,4 vezes mais chances de praticar AF. É necessário aprofundar os estudos e buscar instrumentos validados que auxiliem na investigação da prática excessiva e/ou compulsiva nos TA / Evidence shows that physical activity (PA) for eating disorder (ED) individuals is a compensatory behavior seeking weight and appetite control. The purpose of this research was to determine the PA of the patients from the Eating Disorders Program (AMBULIM) at the Sao Paulo Universitys Psychiatric Institute. The sample was composed of patients diagnosed with Anorexia Nervosa (AN, n=27), Bulimia (BN, n=31) and a control group (CG, n=13). The data collection involved assessing PA by using an objective instrument (accelerometer), self-reported physical activities, and commitment to exercise. Nutritional and psychological variables were measured with scales of eating attitudes, body dissatisfaction, depression, and anxiety. Comparison between AN, BN and CG groups, was tested by Kruskal Wallis. In order to analyze the prevalence and the possible factors related to PA, Chi Square, Prevalence Ratio (RP), and Odds Ratio (OR) were performed. In the anthropometric, nutritional and psychological variables, CG presented the expected low risk for ED, depression and anxiety levels when compared to the ED groups (p<.05). In the objective instrument, BN presented the longer duration time of light PA, when compared to the other groups (p<.001). Considering the median as the cutoff for RP associations, those who exercised at light intensity measured with by accelerometer for over 973 minutes, presented 2.1 more prevalence of developing BN, when compared to those exercising equally or less time. The risk was negligible for AN. Limitations for this study are warranted: the compulsive exercise, based on the degree of the commitment to exercising, did not interfere in the prevalence of ED. Associations between the practice of PA and the anthropometric, nutritional and psychological variables, except for body dissatisfaction were not found. Those who presented dissatisfaction had 3.4 more chances of practicing PA. It is necessary to further study this population and use validated tools to investigate ED and levels of PA

L’objectif de recherche principal poursuivi dans cette thèse de doctorat est de mieux comprendre le rôle d’une insatisfaction corporelle dans l’adoption de pratiques de maintien et de changement du poids chez des adolescent(e)s québécois(es). Pour atteindre cet objectif de recherche principal, trois articles scientifiques liés les uns aux autres ont été rédigés. Chaque article poursuit des objectifs spécifiques (1er article: estimer les proportions d’adolescent(e)s québécois(e)s poursuivant un objectif de poids apparié et non-apparié à leur poids actuel et identifier les déterminants des objectifs de poids non-apparié au poids actuel, 2e article: identifier des associations entre un objectif de poids apparié vs. non-apparié au poids actuel et la fréquence d’utilisation de différents comportements liés au poids et à l’alimentation, 3e article: observer des associations entre différents degrés d’insatisfaction corporelle et l’utilisation de divers comportements liés au poids et à l’alimentation et examiner le rôle modérateur d’un objectif de poids apparié vs. non-apparié au poids actuel dans ces associations) permettant de répondre à l’objectif de recherche principal. Ces articles ont tous été élaborés à partir de l’analyse secondaire d’une banque de données quantitatives constituée par l’Institut de la statistique du Québec (ISQ) et nommée: Enquête sociale et de santé auprès des enfants et des adolescents québécois (ESSEA). L’ESSEA a été constitué auprès d’un échantillon populationnel et représentatif d’enfants et d’adolescent(e)s québécois(es) âgé(e)s de neuf, 13 et 16 ans. Les résultats de cette thèse indiquent qu’une insatisfaction corporelle est associée à la poursuite d’un objectif de poids non-apparié au poids actuel, ainsi qu’à l’utilisation de comportements liés au poids et à l’alimentation sains, malsains et déviants. Des associations ont également été observées entre l’objectif de poids poursuivi par un adolescent(e) et divers comportements utilisés pour l’atteindre. En effet, la poursuite d’un objectif de poids non-apparié au poids actuel est associée à l’utilisation de comportements malsains. Cette association n’est cependant pas présente en ce qui à trait à l’utilisation de comportements sains et déviants, ceux-ci étant strictement prédits par une insatisfaction corporelle. Des effets de médiation et de modération ont aussi été identifiés. Une insatisfaction corporelle est une variable de médiation entre une détresse psychologique chez les adolescentes et la poursuite d’un objectif de poids non-apparié au poids actuel. Finalement, un objectif de poids non-apparié au poids actuel est une variable modifiant l’association entre une insatisfaction corporelle et l’utilisation de comportements malsains chez les adolescent(e)s québécois(es). En conclusion, il existe diverses associations entre une insatisfaction corporelle et l’adoption de pratiques de maintien et de changement du poids chez des adolescent(e)s québécois(es). Une insatisfaction corporelle est donc une cible d’intervention pertinente pour la santé publique puisqu’elle peut servir de base à l’élaboration d’interventions visant la promotion d’un poids santé ainsi que de saines stratégies de contrôle du poids. / The main objective of this doctoral thesis is to better understand the role of body (dis)satisfaction in the adoption of practices directed toward body weight maintenance or body weight modification among Quebec adolescents. To reach this overall thesis objective, three theoretically and conceptually linked scientific papers were written. Although linked to one another, each paper pursues specific research objectives (1st article: to estimate proportions of adolescents with a weight goal that matched and mismatched weight status, and to identify correlates of a mismatched weight goal, 2nd article: to examine associations between matched vs. mismatched weight goals and the frequency of use of different weight-related behaviors, 3rd article: to examine associations between different levels of body dissatisfaction and different frequencies of use of weight-related behaviors and, to investigate whether or not the person’s weight goal moderates these associations) which allow for answering the main thesis objective. These papers were generated from secondary data analyses on a quantitative dataset built by the Institut de la statistique du Québec (ISQ) and named: Quebec Child and Adolescent Health and Social Survey. This dataset was based on data collected from a representative population-based sample of Quebec children and adolescents aged nine, 13, and 16 years old. The results of this thesis indicate that body dissatisfaction is associated with pursuing a mismatched weight goal as well as with the use of healthy, unhealthy, and disordered health behaviors. Associations are also observed between weight goals and weight-related behaviors used to reach weight goals. Indeed, pursuing a mismatched weight goal was found to be associated with the use of unhealthy weight-related behaviors across both sexes. This association is however not significant for the use of healthy and disordered health behaviors. These behaviors were solely predicted by body dissatisfaction. Mediation and moderation effects were also identified. It was found that being body dissatisfied mediated the association between psychological distress among adolescent girls and pursuing a mismatched weight goal. Finally, pursuing a mismatched weight goal was also found to moderate associations between body dissatisfaction and using unhealthy weight-related behaviors among both Quebec adolescent boys and girls. We conclude that there are various associations between body dissatisfaction and the adoption of practices directed toward body weight maintenance or body weight modification among Quebec adolescents. Body dissatisfaction thus represents a pertinent target for public health intervention in the sense that it can serve as the basis for the elaboration of interventions aimed at promoting healthy body weights and healthy weight management strategies.