Instrumentos utilizados na avaliação psicológica no tratamento da obesidade: revisão integrativa

Os instrumentos utilizados na avaliação psicológica no tratamento clínico ou cirúrgico da obesidade tem grande relevância no resultado e processo da avaliação. Identificar personalidade, ansiedade, depressão e compulsão alimentar é fundamental, pois são fatores que podem afetar diretamente na manutenção do peso e adesão ao tratamento. O objetivo desta pesquisa foi analisar a literatura científica sobre instrumentos utilizados na avaliação psicológica da pessoa obesa. Trata-se de uma revisão integrativa realizada nas bases de dados: BVS, Medical Subject Headings (MeSH), da National Library, com os seguintes descritores controlados: "psychometrics”, "psychological test", “Psychological Assessment”, "psychologist", "obesity", "overweight" e o descritor não controlado "psychological assessment” e os operadores booleanos “OR” e “AND”. Ao final das buscas, 14 publicações atenderam aos critérios de análise e foram selecionadas para o estudo. Diante dos estudos selecionados, encontramos 52 ferramentas utilizadas na avaliação, dentre eles, os mais utilizados nos programas de perda de peso foram respectivamente o Beck Depression Inventory – BDI (Inventário de Depressão de Beck); o Binge Eating Scale - BES (Escala de Compulsão Alimentar Periódica - TCAP); e a Escala Hospitalar de Ansiedade e Depressão – HADS. Essa pesquisa nos dá evidências importantes para elaboração instrumentos específicos do tratamento da obesidade no Brasil.

Self-Control at Meals in Order Not to Gain Weight and Its Relationship with Food Cravings in Low-Carb Dieters

Aims: This study’s objective was to verify the level of food cravings and cognitive restraint in women who reported having followed a low-carb diet. Methods: The volunteers filled out the binge eating scale, the cognitive restraint subscale, the food cravings trait and state questionnaires, and the food frequency questionnaire. This study has also compared participants according to the self-reported practice of a low-carb diet. Parametric tests were used to compare the groups and Pearson’s correlations between some variables of interest (p > 0.05 adopted). Results: According to the question regarding the practice of the low-carb diet, 39 participants had tried a low-carb diet in the last six months (46.2% of these with binge eating) and 48 did not (16.7% with binge eating). Dieters showed higher levels of binge eating, cognitive restriction, and food cravings (trait and state). Dieters consumed less rice and bread but did not present lower consumption of sweets. Correlations showed that for dieters who ‘Consciously hold back at meals in order not to gain weight’, it was negatively associated with ‘Intention and plans to eat’, ‘positive reinforcement’ and ‘relieving negative states’ and food cravings scores. Conclusions: Despite the higher levels of cognitive restriction in dieters, they are negatively correlated with food craving factors and negatively associated with the consumption of sweets.

Binge eating behavior in a sample of Lebanese Adolescents: Correlates and Binge Eating Scale validation

Background Binge eating disorder is a common eating disorder among the adolescent population. The available literature in the Middle East in general, and Lebanon specifically, is relatively scarce and/or outdated. The objectives of this study were to (1) validate the Binge Eating Scale (BES) for use in Lebanese adolescents, and (2) assess correlates of binge eating behavior among this population. Methods A cross-sectional study conducted between May and June 2020, enrolling 555 adolescents between the ages of 15–18 years old from all Lebanese governorates. The Binge Eating Scale was used to screen for the presence/absence of binge eating. Results A confirmatory factor analysis revealed that the one-factorial model fits the data best. The results of a linear regression, taking the binge eating score as the dependent variable, showed that higher body dissatisfaction, more alcohol use disorder, higher depression, vomiting to lose weight and starving to lose weight were significantly associated with more binge eating. Higher self-esteem was significantly associated with less binge eating. Conclusion The Arabic Version of the BES scale seems to be a reliable tool to be used in Lebanese adolescents for the assessment of binge eating. More body dissatisfaction, lower self-esteem, increased depressive symptoms were associated with more binge eating. We hope this tool will be a reliable one to be used in epidemiological studies and research about eating behaviors/disorders. Plain English summary The results showed that higher body dissatisfaction, higher depression, vomiting to lose weight and starving to lose weight were significantly associated with more binge eating. Our study also showed that the Binge Eating Scale is an adapted and validated tool to be used among Lebanese adolescents for the assessment of binge eating. We hope that the study results will help clinicians in the screening and management of Binge Eating behaviors among Lebanese adolescents.

Risks of Obesity in Adolescence: The Role of Physical Activity in Executive Functions

The aim of this study was to analyze the efficiency of a physical activity program on executive performance in obese adolescents. Fifteen adolescents (5 males and 10 females), with a mean age of 14.73 years and an IMC mean of 36.74 participated in the study. None of the participants presented a compulsive eating disorder when screened by the Binge Eating Scale. A pretest and posttest assessment, twelve months later, was conducted by using a neuropsychological battery that evaluated the cognitive flexibility (Comprehensive Trail Making Test), inhibition control (Stroop Neuropsychological Screening Test and by the Frontal Assessment Battery), and planning (Tower of London). ANOVA of repeated measures was performed. The within-subjects tests demonstrated significant statistical differences between the two moments of evaluation at the level of inhibitory control and cognitive flexibility tasks, with higher performances in the second evaluation. These results suggest that the inclusion of obese adolescents in such programs may promote their executive capacities.

Binge eating among young adults: association with sociodemographic factors, nutritional intake, dietary n-6:n-3 ratio and impulsivity

Binge eating behaviour (BE) is the major symptom of binge eating disorder (BED). This study aimed to compare the nutritional intake in the presence or absence of BE, with a particular focus on dietary n-6:n-3 ratio, to assess the association between BE and impulsivity and the mediating effect of BMI on this association. A total of 450 university students (age 18–28 years) participated. The self-administered questionnaires were a semi-quantitative FFQ and the UPPS-P Impulsive Behavior Scale and the binge eating scale. The average BE score was 11·6 (se 7·388), and 20 % of the total participants scored above the cut-off of 17, thus presenting BE with 95 % CI of 16·3, 23·7 %. Our study revealed that greater BMI, higher total energy intake, greater negative urgency and positive urgency scores were significantly associated with BE. Participants with high value of dietary n-6:n-3 ratio were 1·335 more at risk to present a BE compared with those with a lower value of this ratio (P = 0·017). The relationship between BE score and UPPS domains score was not mediated by the BMI. This is the first study reporting a link between high dietary n-6:n-3 ratio and BE as well as the fact that BE was linked to both, negative and positive urgencies, and that the association between BE and impulsivity was not mediated by BMI. These findings can help to deal more efficiently with people suffering from BE, a symptom that can precede the development of BED.

Instruments and Diagnostic Criteria for Binge Eating Assessment in Adults: A Systematic Review

Objective: The aim of this study was to systematically review the methodologies used for BE evaluation/identification diagnosis in clinical trials (CT) with adults. Methods: The search was performed on PUBMED until July 2018. The PRISMA statement was used to improve the reporting of results.Results: 93 CTs were included among the 225 studies retrieved. The main BE evaluation/identification methods used in studies were: Binge Eating Scale; Diagnostic and Statistical Manual of Mental Disorders; Eating Disorder Diagnostic Scale; Eating Disorder Examination; Eating Disorder Examination Questionnaire; Eating Disorder Inventory; Loss of Control Over Eating Scale and Three-Factor Eating Questionnaire. Overlaps between methods were observed in studies, 61 used both DSM and an evaluation instrument, 06 only DSM and 26 only standardized questionnaires to assess BE disorder. Conclusions: The DSM-5 diagnostic criterion for binge eating disorder is considered excellent and widely used, however, when the objective of the study is to identify emotional, nutritional and qualitative issues, a questionnaire or interview about subjective perceptions can be used in a complementary way.

Psychometric Properties of Binge Eating Scale Indonesian Version

This research aims to examine the psychometric properties of the Indonesian version of the Binge Eating Scale (BES) and to describe characteristics of binge eating among emerging adults aged 19 – 25 years old in 3 private universities in Indonesia. The Indonesian version of BES was translated forward and backwards, according to the second edition of the ITC guidelines to confirm conceptual and linguistic equivalence. The result provided factor structure evidence and showed good reliability of the BES Indonesian version. No significant difference between man and woman and Body Mass Index was observed.

The Relative Associations of Body Image Dissatisfaction among Psychiatric Out-Patients in Singapore

Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with mental illness in Singapore. Methods: Data was collected from 310 psychiatric out-patients using a self-administered questionnaire. Measurements used were socio-demographic characteristics, Body Mass Index scores, Body Shape Questionnaire, Binge Eating Scale, Eating Attitudes Test, Beck’s Depression Inventory, Beck’s Anxiety Inventory and Alcohol Use Disorders Identification Test. Results: A prevalence of 30.9% of BID was established among psychiatric out-patients in Singapore. Being female, having higher BMI scores, binge eating behavior, eating disorders, and those diagnosed with depression were positively associated with BID. Conclusion: BID is prevalent among those with psychiatric illnesses which could lead to a higher degree of psychological distress and the emergence of eating disorders.

Effectiveness of Group Schema Therapy on Eating Attitude and Self-Regulation in Overweight Adolescent Females with Binge Eating Disorder

Background and Objective: Obesity and overweight are among the most common health problems in adolescence, which is rapidly increasing as a serious threat to health. Eating attitude is one of the most crucial issues in eating disorders that include beliefs, thoughts, feelings, behaviors, and relationships with food. This study aimed to investigate the effectiveness of group schema-therapy on eating attitude and self-regulation of overweight adolescent females with binge eating disorder. Materials and Methods: This quasi-experimental study was conducted using a pretest-posttest design with a three-month follow-up. In total, 30 female students were selected purposefully within the age range of 15-17 years and body mass index of 25-29.9 from high schools in Sari, Iran during 2018. Subsequently, according to the obtained score of 17 and higher in the binge eating scale, they were assigned into two experimental (n=15) and control groups (n=15) using a randomized complete block design. The experimental group participated in 13 group schema therapy sessions of 1.5 h weekly. Both groups were assessed again one week after the intervention and three months after the last session of the treatment. The data were collected using the Binge Eating Scale, Young Schemas Questionnaire with 90-question Short Form, Eating Attitude Test-26, and self-regulation questionnaire. Moreover, the data were analyzed in SPSS software (version 22) through repeated measures of ANOVA and covariance analysis. Results: The results indicated significant differences between pretest and posttest regarding the eating attitude and self-regulation scores in the experimental group, which were consistent until the follow-up stage (P<0.05). Conclusions: According to the results of this study, it is recommended that clinical specialists use the group schema therapy approach in the treatment of people with binge eating disorder.