Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/S2237-60892012000400008
Trends in Psychiatry and Psychotherapy
Original Article

Interdisciplinary lifestyle therapy improves binge eating symptoms and body image dissatisfaction in Brazilian obese adults

Terapia interdisciplinar de mudança do estilo de vida melhora sintomas de compulsão alimentar e insatisfação com a imagem corporal em adultos obesos brasileiros

Joana Pereira de Carvalho-Ferreira; Marcos Alberto Taddeo Cipullo; Danielle Arisa Caranti; Deborah Cristina Landi Masquio; Stephan Garcia Andrade-Silva; Luciana Pellegrini Pisani; Ana Raimunda Dâmaso

Downloads: 0
Views: 489

Abstract

INTRODUCTION: Obesity is related to numerous negative consequences for physical and mental health. It is often associated with the presence of binge eating disorder, body image dissatisfaction, and general psychopathology. OBJECTIVE: To assess the effects of an interdisciplinary lifestyle therapy on binge eating symptoms, depression, anxiety, body dissatisfaction, and quality of life in obese adults. METHODS: A total of 49 obese adults (body mass index = 37.35±5.82 kg/m²; age = 44.14±10.00 years) participated in a weight-loss program for 6 months. Symptoms suggestive of binge eating, body dissatisfaction, depression, anxiety, and quality of life were measured using self-reported questionnaires. Food intake was assessed using a 3-day dietary record. Data were analyzed using analysis of variance (ANOVA). RESULTS: ANOVA results showed a reduction in binge eating symptoms and in body dissatisfaction results. Depression and anxiety symptoms also decreased, and an increase was observed in quality of life scores. After therapy, a significant improvement was observed in dietary patterns, as well as significant weight loss. A positive correlation was found between variation of anxiety symptoms and lipid intake. Binge eating symptoms were associated with anxiety symptoms and body image dissatisfaction, and body image dissatisfaction correlated positively with anxiety symptoms in males only. In females, a positive correlation was observed between depression and binge eating symptoms. CONCLUSION: The interdisciplinary therapy was effective in promoting positive physical and psychological changes and in improving the quality of life of obese adults.

Keywords

Binge-eating disorder, body image, depression, anxiety, obesity, interdisciplinarity

Resumo

INTRODUÇÃO: A obesidade se relaciona com inúmeras consequências negativas para a saúde física e mental. Está frequentemente associada com transtorno da compulsão alimentar periódica, insatisfação com a imagem corporal e psicopatologia geral. OBJETIVO: Avaliar os efeitos de uma terapia interdisciplinar de mudança do estilo de vida sobre sintomas de compulsão alimentar, depressão, ansiedade, insatisfação com a imagem corporal e qualidade de vida em adultos obesos. MÉTODOS: Um total de 49 adultos obesos (índice de massa corporal = 37.35±5.82 kg/m²; idade = 44.14±10.00 anos) participaram de um programa de redução de peso por 6 meses. Sintomas de compulsão alimentar, insatisfação com a imagem corporal, depressão, ansiedade e qualidade de vida foram avaliados por meio de questionários autoaplicáveis. O consumo alimentar foi avaliado utilizando-se um registro alimentar de 3 dias. Os dados foram analisados utilizando análise de variância (ANOVA). RESULTADOS: Os resultados da ANOVA mostraram uma redução nos sintomas de compulsão alimentar e na insatisfação com a imagem corporal. Os sintomas de depressão e ansiedade também diminuíram, e foi observado um aumento nos escores de qualidade de vida. Após a terapia, foi verificada melhora significativa no perfil nutricional, assim como significativa redução de peso. Foi observada uma correlação positiva entre a variação dos sintomas de ansiedade e o consumo de lipídios. Sintomas de compulsão alimentar apresentaram associação com sintomas de ansiedade e insatisfação com a imagem corporal, e a insatisfação com a imagem corporal se correlacionou positivamente com os sintomas de ansiedade nos homens. Nas mulheres, foi observada uma correlação positiva entre sintomas de depressão e de compulsão alimentar. CONCLUSÃO: A terapia interdisciplinar foi eficaz na promoção de mudanças físicas e psicológicas e proporcionou uma melhor qualidade de vida em adultos obesos.

Palavras-chave

Transtorno da compulsão alimentar, imagem corporal, depressão, ansiedade, obesidade, interdisciplinaridade

References

POF 2008-2009: Antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. .

Lawrence VJ, Kopelman PG. Medical consequences of obesity. Clin Dermatol. 2004;22:296-302.

McMillan DC, Sattar N, McArdle CS. ABC of obesity: Obesity and cancer. BMJ. 2006;333:1109-11.

Caranti DA, Lazzer S, Damaso AR, Agosti F, Zennaro R, de Mello MT. Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study. Int Journal Clin Pract. 2008;62:1526-32.

de Piano A, Tock L, Carnier J, Oyama LM, Oller do Nascimento CM, Martinz AC. Negative correlation between neuropeptide Y/agouti-related protein concentration and adiponectinemia in nonalcoholic fatty liver disease obese adolescents submitted to a long-term interdisciplinary therapy. Metabolism. 2010;59:613-9.

de Lima Sanches P, de Mello MT, Elias N, Fonseca FA, de Piano A, Carnier J. Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program. Hypertens Res. 2011;34:232-8.

Lee L, Shapiro CM. Psychological manifestations of obesity. J Psychosom Res. 2003;55:477-9.

Friedman KE, Reichmann SK, Costanzo PR, Zelli A, Ashmore JA, Musante GJ. Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults. Obes Res. 2005;13:907-16.

Jansen A, Havermans R, Nederkoorn C, Roefs A. Jolly fat or sad fat?: Subtyping non-eating disordered overweight and obesity along an affect dimension. Appetite. 2008;51:635-40.

Hill AJ. Psychological aspects of obesity. Psychiatry. 2005;4:26-30.

Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. Nutr J. 2011;10.

Diagnostic and Statistical Manual of Mental Disorders. 2002.

von Ranson KM, Stevenson AS, Cannon CK, Shah W. Changes in eating pathology and associated symptoms among chronically ill adults attending a brief psychoeducational group. Eat Behav. 2010;11:186-9.

Hudson JI, Hiripi E, Pope Jr HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61:348-58.

Yanovski SZ. Binge eating disorder and obesity in 2003: could treating an eating disorder have a positive effect on the obesity epidemic?. Int J Eat Disord. 2003;34:S117-20.

Ketata W, Aloulou J, Charfi N, Abid M, Amami O. Binge eating disorder and obesity: epidemiological, clinical and psychopathological aspects. A study of an obese population in Sfax (Tunisia). Ann Endocrinol (Paris). 2009;70:462-7.

Ferriter C, Ray LA. Binge eating and binge drinking: an integrative review. Eat Behav. 2011;12:99-107.

Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf). 2005;27:156-64.

Wee CC, Davis RB, Hamel MB. Comparing the SF-12 and SF-36 health status questionnaires in patients with and without obesity. Health Qual Life Outcomes. 2008;6.

Fontaine KR, Bartlett SJ, Barofsky I. Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord. 2000;27:101-5.

Tosetto AP, Simeão Júnior CA. Obesity and symptoms of depression, anxiety and hopelessnessin sedentary and non-sedentary women. Medicina (Ribeirão Preto). 2008;41:497-507.

Soares ASB. Qualidade de vida, depressão e ansiedade em indivíduos que procuram tratamento para obesidade. 2009.

Kulie T, Slattengren A, Redmer J, Counts H, Eglash A, Schrager S. Obesity and women's health: an evidence-based review. J Am Board Fam Med. 2011;24:75-85.

Hallal PC, Matsudo SM, Matsudo VK, Araújo TL, Andrade DR, Bertoldi AD. Physical activity in adults from two Brazilian areas: similarities and differences. Cad Saude Publica. 2005;21:573-80.

Freitas S, Lopes CS, Coutinho W, Appolinario JC. Tradução e adaptação para o português da Escala de Compulsäo Alimentar Periódica. Rev Bras Psiquiatr. 2001;23:215-20.

Di Pietro M, Silveira DXd. Internal validity, dimensionality and performance of the Body Shape Questionnaire in a group of Brazilian college students. Rev Bras Psiquiatr. 2009;31:21-4.

Cunha JA. Manual da versão em português das Escalas Beck. 2001.

WHOQOL G. Versão em português dos instrumentos de avaliação da qualidade de vida (WHOQOL). 1998.

Medlin C, Skinner JD. Individual dietary intake methodology: a 50-year review of progress. J Am Diet Assoc. 1988;88:1250-7.

Carnier J, Lofrano MC, Prado WL, Caranti DA, de Piano A, Tock L. Hormonal alteration in obese adolescents with eating disorder: effects of multidisciplinary therapy. Horm Res. 2008;70:79-84.

de Piano A, Tock L, Carnier J, Foschini D, Sanches Pde L, Correa FA. The role of nutritional profile in the orexigenic neuropeptide secretion in nonalcoholic fatty liver disease obese adolescents. Eur J Gastroenterol Hepatol. 2010;22:557-63.

Tock L, Prado WL, Caranti DA, Cristofalo DM, Lederman H, Fisberg M. Nonalcoholic fatty liver disease decrease in obese adolescents after multidisciplinary therapy. Eur J Gastroenterol Hepatol. 2006;18:1241-5.

Machado PP, Machado BC, Goncalves S, Hoek HW. The prevalence of eating disorders not otherwise specified. Int J Eat Disord. 2007;40:212-7.

Siqueira KS, Appolinário JC, Sichieri R. Relationship between binge-eating episodes and self-perception of body weight in a nonclinical sample of five Brazilian cities. Rev Bras Psiquiatr. 2005;27:290-4.

Azevedo APd, Santos CCd, Fonseca DCd. Transtorno da compulsão alimentar periódica. Rev Psiquiatr Clin. 2004;31:170-2.

Vaidya V, Malik A. Eating disorders related to obesity. Therapy. 2008;5:109-17.

Yager J, Powers PS. Manual clínico de transtornos da alimentação. 2010.

Bulik CM, Brownley KA, Shapiro JR. Diagnosis and management of binge eating disorder. World Psychiatry. 2007;6:142-8.

Darby A, Hay P, Mond J, Rodgers B, Owen C. Disordered eating behaviours and cognitions in young women with obesity: relationship with psychological status. Int J Obes (Lond). 2007;31:876-82.

Dobrow IJ, Kamenetz C, Devlin MJ. Aspectos psiquiátricos da obesidade. Rev Bras Psiquiatr. 2002;24(^s3):63-7.

Gorin AA, Niemeier HM, Hogan P, Coday M, Davis C, DiLillo VG. Binge eating and weight loss outcomes in overweight and obese individuals with type 2 diabetes: results from the Look AHEAD trial. Arch Gen Psychiatry. 2008;65:1447-55.

Duchesne M, Appolinário JC, Rangé BP, Freitas S, Papelbaum M, Coutinho W. Evidências sobre a terapia cognitivo-comportamental no tratamento de obesos com transtorno da compulsão alimentar periódica. Rev Psiquiatr Rio Gd Sul. 2007;29:80-92.

Dâmaso AR, Tock L, Tufik S, Prado WL, Stella SG, Fisberg M. Tratamento multidisciplinar reduz o tecido adiposo visceral, leptina, grelina e a prevalência de esteatose hepática não alcoólica (NAFLD) em adolescentes obesos. Rev Bras Med Esp. 2006;12:263-7.

Caranti DA, Tock L, Prado WL, Siqueira KO, de Piano A, Lofrano M. Long-term multidisciplinary therapy decreases predictors and prevalence of metabolic syndrome in obese adolescents. Nutr Metab Cardiovasc Dis. 2007;17:e11-3.

Zhao G, Ford ES, Li C, Tsai J, Dhingra S, Balluz LS. Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: national health and nutrition examination survey 2005-2006. BMC Psychiatry. 2011;11.

Carnier J, de Piano A, de Lima Sanches P, Tock L, do Nascimento CM, Oyama LM. The role of orexigenic and anorexigenic factors in an interdisciplinary weight loss therapy for obese adolescents with symptoms of eating disorders. Int J Clin Pract. 2010;64:784-90.

Lofrano-Prado MC, Prado WL, de Piano A, Tock L, Caranti DA, Nascimento CM. Eating disorders in adolescents: correlations between symptoms and central control of eating behavior. Eat Behav. 2011;12:78-82.

Brandao PP, Garcia-Souza EP, Neves FA, Pereira MJ, Sichieri R, Moura EG. Leptin/adiponectin ratio in obese women with and without binge eating disorder. Neuro Endocrinol Lett. 2010;31:353-8.

Friedman JM. Leptin and the regulation of body weigh. Keio J Med. 2011;60:1-9.

Matos MI, Aranha LS, Faria AN, Ferreira SR, Bacaltchuck J, Zanella MT. Binge eating disorder, anxiety, depression and body image in grade III obesity patients. Rev Bras Psiquiatr. 2002;24:165-9.

Toral N, Slater B. Abordagem do modelo transteórico no comportamento alimentar. Cienc Saude Coletiva. 2007;12:1641-50.

Pagoto S, Bodenlos JS, Kantor L, Gitkind M, Curtin C, Ma Y. Association of major depression and binge eating disorder with weight loss in a clinical setting. Obesity (Silver Spring). 2007;15:2557-9.

Fandino J, Moreira RO, Preissler C, Gaya CW, Papelbaum M, Coutinho WF. Impact of binge eating disorder in the psychopathological profile of obese women. Compr Psychiatry. 2010;51:110-4.

Geliebter A, Aversa A. Emotional eating in overweight, normal weight, and underweight individuals. Eat Behav. 2003;3:341-7.

Nguyen-Rodriguez S, Chou CP, Unger JB, Spruijt-Metz D. BMI as a moderator of perceived stress and emotional eating in adolescents. Eat Behav. 2008;9:238-46.

Anderson SE, Cohen P, Naumova EN, Must A. Association of depression and anxiety disorders with weight change in a prospective community-based study of children followed up into adulthood. Arch Pediatr Adolesc Med. 2006;160:285-91.

Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res. 2010;178:230-5.

Calderon C, Forns M, Varea V. Implication of anxiety and depression in eating disorders of young obese. Nutr Hosp. 2010;25:641-7.

Mond JM, Rodgers B, Hay PJ, Darby A, Owen C, Baune BT. Obesity and impairment in psychosocial functioning in women: the mediating role of eating disorder features. Obesity (Silver Spring). 2007;15:2769-79.

Kruger J, Lee C, Ainsworth BE, Macera CA. Body size satisfaction and physical activity levels among men and women. Obesity (Silver Spring). 2008;16:1976-9.

Ohsiek S, Williams M. Psychological factors influencing weight loss maintenance: an integrative literature review. J Am Acad Nurse Pract. 2011;23:592-601.

Moreira RO, Batista AP. Insatisfacção com a imagem corporal em mulheres obesas: a importância do transtorno da compulsão alimentar periódica. Rev Psiquiatr Rio Gd Sul. 2007;29:130-1.

Carraça EV, Silva MN, Markland D, Vieira PN, Minderico CS, Sardinha LB. Body image change and improved eating self-regulation in a weight management intervention in women. Int J Behav Nutr Phys Act. 2011;8.

Lofrano-Prado MC, Antunes HK, do Prado WL, de Piano A, Caranti DA, Tock L. Quality of life in Brazilian obese adolescents: effects of a long-term multidisciplinary lifestyle therapy. Health Qual Life Outcomes. 2009;7.

Fine JT, Goldtiz GA, Coakley EH, Moseley G, Manson JE, Willet WC. A prospective study of weight change and health-related quality of life in women. JAMA. 2011;282:2136-42.

Kolotkin RL, Crosby RD, Williams GR, Hartley GG, Nicol S. The relationship between health-related quality of life and weight loss. Obes Res. 2001;9:564-71.

Fontaine KR, Barofsky I, Barlett SJ, Franckowiak SC, Andersen RE. Weight loss and health-related quality of life: results at 1-year follow-up. Eat Behav. 2004;5:85-8.

Brown DW, Balluz LS, Heath GH, Moriarty DG, Ford ES, Giles WH. Assosiations between recommended levels of physical activity anf health-related quality of life: Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) Survey. Prev Med. 2003;37:520-8.

Ernersson A, Frisman GH, Sepa Frostell A, Nystrom FH, Lindstrom T. An obesity provoking behaviour negatively influences young normal weight subjects' health related quality of life and causes depressive symptoms. Eat Behav. 2010;11:247-52.

616b3339a9539538e70cd433 trends Articles
Links & Downloads

Trends Psychiatry Psychother

Share this page
Page Sections