Compulsão alimentar: aspectos relacionados à mensuração, prevalência e tratamento.

Abstract

The central theme of the three studies that constitute this Doctorate s final work is binge eating (BE). Two studies have been conducted at the Obesity and Eating Disorders Outpatient Clinic at the Diabetes and Endocrinology State Institute [Ambulatório de Obesidade e Transtornos Alimentares, Instituto Estadual de Diabetes e Endocrinologia], a reference unit on the treatment of eating disorders that belongs to Health Department of the Government of Rio de Janeiro. The first study assessed the concurrent validation of a scale that evaluates BE among obese patients, the Binge Eating Scale (BES). The instrument, applied to 196 obese individuals who sought treatment to loose weight, was compared to an interview considered gold standard for binge eating disorder (BED) diagnoses, and was considered adequate at cut-off point 17 to track binge eating disorder in this population. The other study, carried out at the same institution and whose sample were patients with BED associated with obesity, evaluated the effect of a nutritional counseling program to keep the benefits of a treatment combining cognitive-behavioral therapy (CBT) and topiramate, an anticonvulsant drug. This clinical trial pointed to the efficacy of the combined treatment, as compared to CBT associated with placebo, in weight loss and remission of BE episodes. In the post-treatment study with nutritional counseling, it was observed an excessive weight regain in the group that had used pharmacotherapy, and maintenance of the discrete weight loss obtained with CBT, also showing that patients without recurrence of BE regained less weight than those who had BE again. Besides these two studies conducted among clinical samples, a third one estimated the prevalence of binge eating episodes in a representative sample of women aged 35 years or more in Rio de Janeiro City. This was the first population-based study among adults and elderly in Brazil, and also the first one to use self-rated health status, assessed through a single item, in the field of eating disorders. Our results corroborate the findings of other studies which used several quality of life measurements in the sense of a global impairment among subjects with binge eating, regardless of their body mass index.