REVISÃO DA LITERATURA SOBRE O TRATAMENTO FARMACOLÓGICO DOS TRANSTORNOS ALIMENTARES

Os distúrbios alimentares são doenças de caráter psicopatológico e quando não tratadas corretamente prejudicam o indivíduo afetando-o socialmente, mentalmente e biologicamente. Dentro desse contexto, o trabalho avaliou, com base na literatura, os fármacos utilizados no tratamento dos transtornos alimentares. A metodologia utilizada foi a revisão integrativa da literatura com apoio da análise documental de Bardin. Para a busca das literaturas foram utilizados descritores, contidos nos DECs: [Transtornos da compulsão alimentar/Binge-Eating Disorder], [Tratamento Farmacológico/Drug therapy], [Bulimia/bulimia] e [Anorexia/anorexia]. Para coleta de dados, foram utilizadas literaturas encontradas na base de dado MEDLINE, na biblioteca do SCIELO e em repositórios. Foram selecionadas 22 literaturas, sendo que 63,6% (14) são da biblioteca do SCIELO, 18,2% (4) da base de dados MEDLINE e 18,2% (4) de repositórios de Ensino Superior. Foi observado que o uso de medicamento é essencial quando a terapia não medicamentosa não surtir efeito, uso de fármacos a Fluoxetina, Imipramina e Sibutramina são as principais medicações para o tratamento. Além disso, o tratamento dos transtornos alimentares exige uma equipe multidisciplinar para auxiliar no processo, com isto, o profissional farmacêutico exerce uma função primordial que garante um diagnóstico favorável e um tratamento adequado. Portanto, medicamento como o dimesilato de lisdexanfetamina, utilizado no tratamento de lúpus, entre outros fármacos para tratar outras doenças podem ser de suma importância para o tratamento dos transtornos alimentares, quando associados a outras terapias não farmacológica e do acompanhamento com profissionais especializados

Cultivating the Community

A growing body of HCI research has sought to understand how online networks are utilized in the adoption and maintenance of disordered activities and behaviors associated with mental illness, including eating habits. However, individual-level influences over discrete online eating disorder (ED) communities are not yet well understood. This study reports results from a comprehensive network and content analysis (combining computational topic modeling and qualitative thematic analysis) of over 32,000 public tweets collected using popular ED-related hashtags during May 2020. Our findings indicate that this ED network in Twitter consists of multiple smaller ED communities where a majority of the nodes are exposed to unhealthy ED contents through retweeting certain influential central nodes. The emergence of novel linguistic indicators and trends (e.g., "#meanspo") also demonstrates the evolving nature of the ED network. This paper contextualizes ED influence in online communities through node-level participation and engagement, as well as relates emerging ED contents with established online behaviors, such as self-harassment.

Emotion Dysregulation and Eating Disorder Symptoms: Examining Distinct Associations and Interactions in Adolescents

Emotion dysregulation has been posited as a key transdiagnostic factor of mental health difficulties, including eating disorders. However, how this transdiagnostic factor interacts with the disorder-specific factor of weight and shape concerns remains unclear. The current study examined whether emotion dysregulation is associated with eating disorder behaviors over and above the association between weight and shape concerns and whether these two factors interacted. The current study used data from two samples, a community sample of high school students (n = 2699), and a clinical sample of adolescents receiving outpatient treatment for an eating disorder (n = 149). Participants completed self-report measures on their eating behaviors, weight/shape concerns, and emotion dysregulation. Findings showed that emotion dysregulation had a unique association with engaging in binge eating and purging (community sample only). Weight and shape concerns were found to have a unique association with engaging in binge eating, fasting, purging, and driven exercise (community sample only). Additionally, weight and shape concerns moderated the association between emotion dysregulation and the probability of engaging in binge eating and driven exercise, whereby the strongest association between emotion dysregulation and these behaviors were observed among adolescents with the lowest levels of weight and shape concerns. Regarding the frequency of eating disorder behaviors, emotion dysregulation had a unique association with severity of binge eating and fasting. Weight and shape concerns were uniquely associated with severity of fasting and driven exercise (community sample only). Findings suggest that emotion dysregulation is a distinct factor of eating disorder behaviors among adolescents.

Weight loss practices and eating behaviours among female physique athletes: Acquiring the optimal body composition for competition

Little is known about weight loss practices and eating behaviours in female physique athletes. This study investigated the weight loss history, practices, and key influences during the pre-competition period in a large cohort of female physique athletes stratified by division and experience level. Eating attitudes and behaviours were assessed to identify whether athletes were at risk of developing an eating disorder. Using a cross-sectional research design, female physique athletes (n = 158) were recruited and completed an anonymous online self-reported survey consisting of two validated questionnaires: Rapid Weight Loss Questionnaire and Eating Attitudes Test-26. Irrespective of division or experience, female physique athletes used a combination of weight loss practices during the pre-competition phase. Gradual dieting (94%), food restriction (64%) and excessive exercise (84%), followed by body water manipulation via water loading (73%) were the most commonly used methods. Overall, 37% of female physique athletes were considered at risk of developing an eating disorder. Additionally, 42% of female physique athletes used two pathogenic weight control methods with 34% of Figure novice athletes indicating binge eating once a week or more. The coach (89%) and another athlete (73%) were identified as key influences on athletes’ dieting practices and weight loss. The prevalence of athletes identified with disordered eating symptoms and engaging in pathogenic weight control methods is concerning. In future, female physique athletes should seek advice from registered nutritionists to optimise weight management practices and minimise the risk of developing an eating disorder.

Revisiting the Postulates of Etiological Models of Eating Disorders: Questioning Body Checking as a Longer-Term Maintaining Factor

Body checking (BC) is not only inherent to the maintenance of eating disorders but is also widespread among healthy females. According to etiological models, while BC serves as an affect-regulating behavior in the short term, in the longer term it is assumed to be disorder-maintaining and also produces more negative affect. The present study therefore aimed to empirically examine the proposed longer-term consequences of increased BC. In an online study, N = 167 women tracked their daily amount of BC over a total of 7 days: Following a 1-day baseline assessment of typical BC, participants were asked to check their bodies in an typical manner for 3 days and with a 3-fold increased frequency for 3-days. Before and after each BC episode, the impact of BC on affect, eating disorder symptoms, general pathology and endorsement of different functions of BC was assessed. Participants showed longer-term consequences of increased BC in terms of increased negative affect and general pathology, while eating disorder symptoms remained unaffected. In the case of typical BC, participants showed decreased general pathology and anxiety. Furthermore, the endorsement of a higher number of BC functions led to increased negative affect and an increased amount of typical BC. The findings support the theoretically assumed role of maladaptive BC in maintaining negative emotion in the longer term. However, though requiring replication, our finding of positive effects of typical BC calls into question the overall dysfunctionality of BC among non-clinical women who are not at risk of developing an eating disorder.

Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders

Background and aims Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes. Methods The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out. Results Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors. Discussion and Conclusions Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.

Two components of body-image disturbance are differentially associated with distinct eating disorder characteristics in healthy young women

Body-image disturbance comprises two components. The first is perceptual in nature, and is measured by a discrepancy between one’s actual body and perceived self-image (“perceived–actual discrepancy”). The other component is affective, and is measured by a discrepancy between one’s perceived self-image and ideal body image (“perceived–ideal discrepancy”). The present study evaluated the relationships between body-image disturbance and characteristics of eating disorders such as symptoms and related personality traits. In a psychophysiological experiment, female university students (mean ± SD age = 21.0 ± 1.38 years) were presented with silhouette images of their own bodies that were distorted in terms of width. The participants were asked whether each silhouette image was more overweight than their actual or ideal body images. Eating-disorder characteristics were assessed using six factors from the Japanese version of the Eating Disorder Inventory 2 (EDI2). We found that perceived–actual discrepancies correlated with negative self-evaluation (i.e., factor 3 of the EDI2), whereas perceived–ideal discrepancies correlated with dissatisfaction with one’s own body (i.e., factor 2 of EDI2). These results imply that distinct psychological mechanisms underlie the two components of body-image disturbance.