La presente tesis doctoral "Deconstrucción literaria de los trastornos de la alimentación y de la cirugía estética en las novelas de Margaret Atwood y Fay Weldon" intenta hallar una respuesta a la acusada diferencia de género que presentan los trastornos de la alimentación: anorexia, bulimia y sobreingesta compulsiva. La mera explicación por parte del discurso médico y socio-cultural de que estas patologías son el resultado de la interiorización por parte de las adolescentes del mensaje mediático de que la delgadez es sinónimo de belleza, no satisfacían el interrogante ante la continua proliferación de mujeres anoréxicas y bulímicas. Este trabajo consta de tres capítulos: el primero introduce y establece la genealogía de los trastornos de la alimentación. La teoría freudiana y lacaniana en que se basa este primer capítulo ejemplifica que la mujer ha sido creada dentro de un sistema falócrata como "la otra". El hecho de que Foucault subraye que a través del lenguaje se construyen los objetos y que se necesitan los binomios para que uno de los elementos adquiera significado, corrobora la construcción patriarcal que necesita convertir a la mujer en pasiva para que el hombre adquiera preponderancia. Las novelas The Edible Woman (1969) y Lady Oracle (1976) de Atwood; The Life and Loves of a She-Devil (1983) y The Fat Woman's Joke (1967) de Weldon son analizadas en este primer capítulo desde las perspectivas freudiana y lacaniana con el propósito de ejemplificar cómo el sistema patriarcal es el que convierte a la mujer en un sujeto pasivo carente de poder, y donde la herramienta utilizada para este cometido es el logos falócrata.Tras la presentación en el primer capítulo de la carencia de las mujeres de un discurso propio, se analiza la novela The Edible Woman, desde una perspectiva postestructural feminista. El corpus teórico de este segundo capítulo es la deconstrucción que Luce Irigaray, Julia Kristeva y Hélène Cixous hacen de las teorías freudianas y lacanianas. Irigaray pone en tela de juicio la esquematización del orden simbólico hecha por Lacan y otorga a las mujeres la posibilidad de ascender a la parte superior de la pirámide simbólica; lugar desde donde éstas procederán a la construcción de un logos diferente. Cixous enfatiza la necesidad de deconstruir los binomios imperantes y Kristeva señala la necesidad de una unión "empoderante", es decir, de una "sororidad" entre mujeres. Este trabajo ha intentado verter dichas teorías en la novela de Atwood por medio del análisis de sus personajes. Marian, personaje principal, carece de un lenguaje propio y su anorexia se convierte en la respuesta subversiva que expresa su yo auténtico, aparentemente carente de voz y, por tanto, de poder, pero que es, como se demuestra a lo largo de este segundo capítulo, un potente lenguaje de resistencia. A través de la literatura y pese a utilizar necesariamente un discurso falócrata, Atwood es capaz de hacer ver a sus lectoras la falacia del sistema y la necesidad de un logos femenino propio. Es en este punto de la tesis donde se cuestiona el significado de "cultural dope" asociado a las anoréxicas y bulímicas. El objetivo de esta investigación, ofrecer una explicación alternativa a la acusada diferencia de género en los trastornos alimentarios, queda así establecido. El propósito del tercer capítulo es el de utilizar el mismo marco teórico, pero en otro ámbito: el de la cirugía estética. La novela de Weldon The Life and Loves of a She-Devil es el marco idóneo para ejemplificar la teoría explicada en este tercer capítulo puesto que es una sátira feminista de la calología que subraya la opresión femenina y la tiranía patriarcal. Esta novela ofrece una nueva perspectiva de la cirugía estética como lenguaje feminista reivindicativo a la vez que subvierte el discurso falócrata.

Syftet med föreliggande studie var att undersöka hur det kommer sig att vissa personer med ätstörningar väljer att starta en ätstörningsblogg samt hur de upplever sitt bloggande. Respondenterna bestod av fem kvinnor i åldrarna 23-35 år som bloggar om sina ätstörningar. En kvalitativ metod användes där semistrukturerade intervjuer genomfördes över telefon. Resultaten analyserades och tolkades med hjälp av känslan av sammanhang (KASAM) och copingteori. Resultaten visade att anledningarna till att starta en blogg var många, bl.a. kände respondenterna ett behov av en plats att ventilera sina tankar på, och att de genom att blogga om sina erfarenheter såg en möjlighet att hjälpa andra. Bloggen sågs också som ett sätt att kommunicera med sina anhöriga utan att behöva sitta ansikte mot ansikte. Bloggen upplevs medföra ökad social acceptans och den ses som ett positivt stöd i sjukdomen. Resultaten pekar på att bloggande kan ses som ett copingverktyg och att bloggen kan fungera som ett redskap för att begripa, hantera och se mening i ätstörningarna enligt komponenterna i KASAM. / The aim of the following study was to examine why some individuals who have been affected by eating disorders choose to write blogs and how they feel about this experience. The group of respondents consisted of five women aged 23-35, who currently write blogs about their eating disorders. A qualitative method was utilized by means of semi-structured interviews conducted over the telephone and then analyzed using sense of coherence and coping theory. The results showed that the main reasons to start a blog were seeing it as an outlet to vent emotions, a way to help others suffering from eating disorders and a means to communicate about problems without having to do so face to face. Furthermore the blog was viewed as a positive resource to deal with eating disorders and as a way of gaining social support. Blogging can thus be viewed as a coping tool and as a way to increase comprehensibility, manageability and meaningfulness according to the sense of coherence.

Patients with bulimia nervosa are at high risk for dental erosion. However, not all bulimic patients suffer from erosion, irrespective of the severity of their eating disorder. It is often speculated that differences in the saliva are important, however, little is known about salivary parameters in bulimic patients, particularly directly after vomiting. The aim of the clinical trial was to compare different salivary parameters of subjects suffering from bulimia with those of healthy controls. Twenty-eight subjects participated (14 patients with bulimia nervosa, 7 of them with erosion; 14 matched healthy controls). Resting and stimulated saliva of all participants was analysed as well as saliva collected from bulimic patients directly and 30 min after vomiting. Parameters under investigation were flow rate, pH, buffering capacity and the enzyme activities of proteases in general, collagenase, pepsin, trypsin, amylase, peroxidase, and lysozyme. Regarding flow rate, pH and buffering capacity only small differences were found between groups; buffering capacity directly after vomiting was significantly lower in bulimic subjects with erosion than in subjects without erosion. Differences in enzymatic activities were more pronounced. Activities of proteases, collagenase and pepsin in resting and proteases in stimulated saliva were significantly higher in bulimic participants with erosion than in controls. Peroxidase activity was significantly decreased by regular vomiting. Proteolytic enzymes seem to be relevant for the initiation and progression of dental erosion directly after vomiting, maybe by both hydrolysis of demineralized dentine structures as well as modulation of the pellicle layer. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Thesis (Ph. D.)--State University of New York at Binghamton, Department of Psychology, Clinical Psychology, 2009. / Includes bibliographical references.

This thesis consists of both theoretical and practical parts. The aim of the theoretical part is to present the basic concepts of this field of research, then discuss the types of nourishment intake defects, their causes and treatment, and also to define the term "pubescent". The entire theoretical part is based on the examined professional literature. The practical part focuses on research which ascertains pubescents´ awareness of the topic and the possible influence and occurrence of the nourishment intake defects in pubescents. Following the practical part, there is a summary and evaluation of the results based on the questionnaire method.

O presente trabalho visou a investigar comportamentos de risco para o desenvolvimento de transtornos alimentares em jovens, com ênfase em aspectos psicológicos e culturais. Para tanto, foram realizados dois estudos, dos quais paticiparam 593 jovens escolares e universitários da capital do Estado e de cidades do interior do Rio Grande do Sul. O Estudo I teve como objetivo relacionar esses comportamentos de risco com variáveis regionais, socioeconômicas e raciais. Foram realizadas análises de freqüência, além dos testes não paramétricos de Mann-Whitney e Kruskal-Wallis. Entre os resultados, 17% dos participantes apresentaram positividade no Teste das Atitudes Alimentares (EAT-26), ou seja, comportamentos de risco para o desenvolvimento de transtornos alimentares, sendo 15% dos homens e 19% das mulheres. Encontrou-se também um maior número de comportamentos de risco nos municípios do interior do Estado e entre os participantes de identidade racial não branca. Não houve diferença significativa no que se refere à classe socioeconômica. O Estudo II avaliou a satisfação com a imagem corporal, auto-estima, bem-estar subjetivo e alexitimia em jovens com comportamentos de risco para anorexia nervosa e bulimia nervosa. O teste ρ (rho) de Spearman foi utilizado para calcular as correlações entre o EAT-26 e os demais instrumentos. Para avaliar o efeito das escalas e dos itens sobre o EAT-26 realizaram-se análises de regresssão linear múltipla e de regressão não linear. Constatou-se que indivíduos com comportamentos de risco para transtornos alimentares apresentam insatisfação com a imagem corporal. As mulheres apresentam também baixa auto-estima, pouca satisfação com a vida e um alto índice de afeto negativo e alexitimia. Em relação à escolaridade verificou-se que aqueles participantes com menos anos de estudo têm mais chance de apresentar comportamentos de risco. Destaca-se também como central o resultado de que a baixa satisfação com a imagem corporal e a realização de dietas foram os fatores que mais explicaram a positividade no EAT-26, o que é preocupante já que pesquisas apontam que atualmente há uma insatisfação corporal generalizada entre a população. / The present thesis aimed to investigate risk behaviors for the development of eating disorders in adolescents with an emphasis on psychological and cultural aspects. Two studies were conducted with 593 participants who were students in high schools and in universities in Porto Alegre and in other cities of the state of Rio Grande do Sul. Study I had as an objective to relate these risk behaviors with regional, socio-economic and racial variables. The data were analysed with Mann-Whitney e Kruskal-Wallis tests. The results showed that 17% of the participants (15% male, 19% female) presented positivity (high scores) in the Eating Atitudes Test (EAT-26) which means that they presented risk behaviors for the development of eating disorders. The results also showed that there were less risk behaviors in the state capital as compared with other cities in the state. Also, white participants presented less risk behaviors than other participants. No significant differences were found for social class. Study II assessed satisfaction with body image, self esteem, subjective well being, and alexithimia in adolescents who presented risk behaviors for anorexia and bulimia. Spearman’s ρ (rho) test was used to obtain correlations between the EAT-26 scores and the other variables of the study. Linear multiple regressions and nonlinear regressions were calculated to determine how much of Eat-26 variance was explained by the other variables. The results showed that participants with risk behaviors for eating disorders also presented insatisfaction with their body image. Females also presented low self esteem, low satisfaction with life, high scores for negative affects and for alexithimia. Also, it was observed that risk behaviors were higher among participants with less years of study. Low satisfaction with body image and dieting were the factors that explained more the positivity in the EAT-26. This finding presents a problem as research has been showing generalized body insatisfaction.

O presente trabalho visou a investigar comportamentos de risco para o desenvolvimento de transtornos alimentares em jovens, com ênfase em aspectos psicológicos e culturais. Para tanto, foram realizados dois estudos, dos quais paticiparam 593 jovens escolares e universitários da capital do Estado e de cidades do interior do Rio Grande do Sul. O Estudo I teve como objetivo relacionar esses comportamentos de risco com variáveis regionais, socioeconômicas e raciais. Foram realizadas análises de freqüência, além dos testes não paramétricos de Mann-Whitney e Kruskal-Wallis. Entre os resultados, 17% dos participantes apresentaram positividade no Teste das Atitudes Alimentares (EAT-26), ou seja, comportamentos de risco para o desenvolvimento de transtornos alimentares, sendo 15% dos homens e 19% das mulheres. Encontrou-se também um maior número de comportamentos de risco nos municípios do interior do Estado e entre os participantes de identidade racial não branca. Não houve diferença significativa no que se refere à classe socioeconômica. O Estudo II avaliou a satisfação com a imagem corporal, auto-estima, bem-estar subjetivo e alexitimia em jovens com comportamentos de risco para anorexia nervosa e bulimia nervosa. O teste ρ (rho) de Spearman foi utilizado para calcular as correlações entre o EAT-26 e os demais instrumentos. Para avaliar o efeito das escalas e dos itens sobre o EAT-26 realizaram-se análises de regresssão linear múltipla e de regressão não linear. Constatou-se que indivíduos com comportamentos de risco para transtornos alimentares apresentam insatisfação com a imagem corporal. As mulheres apresentam também baixa auto-estima, pouca satisfação com a vida e um alto índice de afeto negativo e alexitimia. Em relação à escolaridade verificou-se que aqueles participantes com menos anos de estudo têm mais chance de apresentar comportamentos de risco. Destaca-se também como central o resultado de que a baixa satisfação com a imagem corporal e a realização de dietas foram os fatores que mais explicaram a positividade no EAT-26, o que é preocupante já que pesquisas apontam que atualmente há uma insatisfação corporal generalizada entre a população. / The present thesis aimed to investigate risk behaviors for the development of eating disorders in adolescents with an emphasis on psychological and cultural aspects. Two studies were conducted with 593 participants who were students in high schools and in universities in Porto Alegre and in other cities of the state of Rio Grande do Sul. Study I had as an objective to relate these risk behaviors with regional, socio-economic and racial variables. The data were analysed with Mann-Whitney e Kruskal-Wallis tests. The results showed that 17% of the participants (15% male, 19% female) presented positivity (high scores) in the Eating Atitudes Test (EAT-26) which means that they presented risk behaviors for the development of eating disorders. The results also showed that there were less risk behaviors in the state capital as compared with other cities in the state. Also, white participants presented less risk behaviors than other participants. No significant differences were found for social class. Study II assessed satisfaction with body image, self esteem, subjective well being, and alexithimia in adolescents who presented risk behaviors for anorexia and bulimia. Spearman’s ρ (rho) test was used to obtain correlations between the EAT-26 scores and the other variables of the study. Linear multiple regressions and nonlinear regressions were calculated to determine how much of Eat-26 variance was explained by the other variables. The results showed that participants with risk behaviors for eating disorders also presented insatisfaction with their body image. Females also presented low self esteem, low satisfaction with life, high scores for negative affects and for alexithimia. Also, it was observed that risk behaviors were higher among participants with less years of study. Low satisfaction with body image and dieting were the factors that explained more the positivity in the EAT-26. This finding presents a problem as research has been showing generalized body insatisfaction.

Introduction: Eating disorders are serious psychiatric disorders that often require specialized care. Associated psychiatric comorbidity is frequent, with the most common comorbid conditions being anxiety and mood disorders. Eriksbergsgården in Örebro is one of Sweden’s specialized eating disorder treatment units.Aim: Primary aims were to describe clinical characteristics of the adult patient group at Eriksbergsgården and to evaluate treatment outcome and patient satisfaction at the one-year follow-up. An additional aim was to examine if factors such as psychiatric comorbidity affected treatment outcome.Methods: This study used data from Riksät and Stepwise, two large-scale Swedish registers for eating disorder treatment. Data for this study was registered into Stepwise and Riksät at Eriksbergsgården between August 2010 and December 2017 and 489 adult patients of both genders constituted the study group. Patient characteristics and DSM-IV axis I psychiatric comorbidity were assessed at the initial evaluation. At the one-year follow-up, treatment outcome and patient satisfaction were evaluated.Results: The most common diagnoses in this patient material were eating disorder not otherwise specified, 56.6 %, followed by bulimia nervosa, 26.4 %. At the initial evaluation, 62.0 % of the patients suffered from psychiatric comorbidity. Of the patients with initial comorbidity, 43.3 % were recovered at the one-year follow-up, compared to 62.8 % of the patients with no initial comorbidity, p=0.021.Conclusion: Our results confirm the previously known fact that psychiatric comorbidity among eating disorder patients is common. Also, the results identify psychiatric comorbidity as a possible factor to have negative effect on the treatment outcome.

O presente trabalho visou a investigar comportamentos de risco para o desenvolvimento de transtornos alimentares em jovens, com ênfase em aspectos psicológicos e culturais. Para tanto, foram realizados dois estudos, dos quais paticiparam 593 jovens escolares e universitários da capital do Estado e de cidades do interior do Rio Grande do Sul. O Estudo I teve como objetivo relacionar esses comportamentos de risco com variáveis regionais, socioeconômicas e raciais. Foram realizadas análises de freqüência, além dos testes não paramétricos de Mann-Whitney e Kruskal-Wallis. Entre os resultados, 17% dos participantes apresentaram positividade no Teste das Atitudes Alimentares (EAT-26), ou seja, comportamentos de risco para o desenvolvimento de transtornos alimentares, sendo 15% dos homens e 19% das mulheres. Encontrou-se também um maior número de comportamentos de risco nos municípios do interior do Estado e entre os participantes de identidade racial não branca. Não houve diferença significativa no que se refere à classe socioeconômica. O Estudo II avaliou a satisfação com a imagem corporal, auto-estima, bem-estar subjetivo e alexitimia em jovens com comportamentos de risco para anorexia nervosa e bulimia nervosa. O teste ρ (rho) de Spearman foi utilizado para calcular as correlações entre o EAT-26 e os demais instrumentos. Para avaliar o efeito das escalas e dos itens sobre o EAT-26 realizaram-se análises de regresssão linear múltipla e de regressão não linear. Constatou-se que indivíduos com comportamentos de risco para transtornos alimentares apresentam insatisfação com a imagem corporal. As mulheres apresentam também baixa auto-estima, pouca satisfação com a vida e um alto índice de afeto negativo e alexitimia. Em relação à escolaridade verificou-se que aqueles participantes com menos anos de estudo têm mais chance de apresentar comportamentos de risco. Destaca-se também como central o resultado de que a baixa satisfação com a imagem corporal e a realização de dietas foram os fatores que mais explicaram a positividade no EAT-26, o que é preocupante já que pesquisas apontam que atualmente há uma insatisfação corporal generalizada entre a população. / The present thesis aimed to investigate risk behaviors for the development of eating disorders in adolescents with an emphasis on psychological and cultural aspects. Two studies were conducted with 593 participants who were students in high schools and in universities in Porto Alegre and in other cities of the state of Rio Grande do Sul. Study I had as an objective to relate these risk behaviors with regional, socio-economic and racial variables. The data were analysed with Mann-Whitney e Kruskal-Wallis tests. The results showed that 17% of the participants (15% male, 19% female) presented positivity (high scores) in the Eating Atitudes Test (EAT-26) which means that they presented risk behaviors for the development of eating disorders. The results also showed that there were less risk behaviors in the state capital as compared with other cities in the state. Also, white participants presented less risk behaviors than other participants. No significant differences were found for social class. Study II assessed satisfaction with body image, self esteem, subjective well being, and alexithimia in adolescents who presented risk behaviors for anorexia and bulimia. Spearman’s ρ (rho) test was used to obtain correlations between the EAT-26 scores and the other variables of the study. Linear multiple regressions and nonlinear regressions were calculated to determine how much of Eat-26 variance was explained by the other variables. The results showed that participants with risk behaviors for eating disorders also presented insatisfaction with their body image. Females also presented low self esteem, low satisfaction with life, high scores for negative affects and for alexithimia. Also, it was observed that risk behaviors were higher among participants with less years of study. Low satisfaction with body image and dieting were the factors that explained more the positivity in the EAT-26. This finding presents a problem as research has been showing generalized body insatisfaction.

This master's thesis deals with the topic of social causes of bulimia nervosa. In the first part of my thesis I focus on the theoretical introduction. I present the matter of eating disorders in general, which I consider to be an important basis for another part of my work. I am dealing here with the general introduction - what are eating disorders, which eating disorders are known to us, I introduce their causes, consequences, sexuality issues in patients with eating disorders and, last but not least, eating disorders in men and children. For a better understanding of the disease, the theoretical introduction is supplemented by brief client testimonials from my practice. In the next part of the thesis I deal with the topic itself, the social causes of bulimia nervosa. I focus on the issue of the family and its possible influence on the origin of the illness. Furthermore, the influence of society as such, especially the relationship of society to the ideal of beauty and the development of the ideal of beauty in history. I explore the influence of the printed media, television, advertising on bulimia nervosa as well. The last part of my work is a qualitative survey. It consists of three case studies and an interview with four respondents.