43 research outputs found
Binge Eating Disorder and Body Uneasiness
Debate continues regarding the nosological status of binge eating disorder (BED) and the specific diagnostic criteria, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by body image disturbances in addition to abnormal eating behaviour. The aims of this article are: a) to concisely review the main points of the literature that has developed on diagnosis and treatment (especially pharmacological) of BED and b) to present the results of an original research on body image in obese patients with BED. The study was aimed to verify the following hypothesis: in persons with obesity, BED is associated with greater body uneasiness independently of some possible modulating factors. We studied a clinical sample of 159 (89 females and 70 males) adult obese patients who fulfilled DSM-IV-TR diagnostic criteria for BED matched to 159 non-BED obese patients for gender, ethnicity, BMI class, age, weight, stature, onset age of obesity, education level, and marital status. We used the Body Uneasiness Test (BUT), a valuable multidimensional tool for the clinical assessment of body uneasiness in subjects suffering from eating disorders and/or obesity. Obese patients with BED reported higher scores than non-BED patients in the General Severity Index (BUT-A GSI) and in every BUT-A subscale. All differences were statistically significant in both sexes. As expected women obtained higher scores than men. According to some other studies, our findings suggest that a negative body image should be included among diagnostic criteria for BED. Consequently, treatment should be focused not simply on eating behaviour and outcome studies should evaluate changes of body image as well
The Effect of Obesity Management on Body Image in Patients Seeking Treatment at Medical Centers
treatment-
seeking patients with obesity. We aimed to investigate
the effects of obesity management on body image in patients
with obesity attending Italian medical centers for
weight loss programs.
Research Methods and Procedures: A total of 473 obese
patients seeking treatment in 13 Italian medical centers
(80% females; age, 45.9 standard deviation 11.0 years;
BMI, 36.8 5.7 kg/m2) were evaluated at baseline and after
a 6-month weight loss treatment. Body uneasiness, psychiatric
distress, and binge eating were tested by Body Uneasiness
Test (BUT, Part A), Symptom CheckList-90 (SCL-
90), and Binge Eating Scale (BES), respectively.
Results: At 6-month follow-up, the percentage weight loss
was significantly higher in men (9.0 6.3%) than in
women (6.8 7.3%; p 0.010). Both men and women had
a significant improvement in BUT Global Severity Index
and in all of the BUT subscales with the exception of the
Compulsive Self-Monitoring subscale. Linear regression
analysis selected baseline psychological and behavioral
measures (global score of BUT and SCL-90) and improved
psychiatric distress and binge eating as independent predictors
of changes in basal body dissatisfaction in females,
whereas in males, changes were associated only with baseline
BUT-Global Severity Index score, binge eating, and its
treatment-associated improvement. Pre-treatment BMI and
BMI changes did not enter the regression.
Discussion: Obesity treatment, even with a modest degree
of weight loss, is associated with a significant improvement
of body image, in both females and males. This effect
depends mainly on psychological factors, not on the amount
of weight loss
The Metabolic Syndrome in Treatment-Seeking Obese Persons
Obesity is a major risk factor for several metabolic diseases, frequently clustering to form the metabolic syndrome, carrying
a high risk of cardiovascular mortality. We aimed to assess the prevalence of the metabolic syndrome in treatment-seeking
obese subjects and the potential protective effect of physical activity. A cross-sectional analysis of data from a large Italian
database of treatment-seeking obese subjects was performed. The metabolic syndrome was defined according to the criteria
provisionally set by the National Cholesterol Education Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults, based on waist circumference, fasting glucose, triglyceride (TG) and high-density lipoprotein-cholesterol
(HDL-C) levels, and arterial pressure. Data were available in 1,889 Caucasian subjects, 78% females, from 25 obesity
centers. Minimum criteria for the metabolic syndrome were fulfilled in 53% of cases. The prevalence increased with age and
obesity class and was negatively associated with participation in a structured program of physical activity (odds ratio, 0.76;
0.58 to 0.99; P .041), after correction for age, sex, and body mass. The prevalence of cardiovascular disease was higher in
subjects with the metabolic syndrome. A subset of 12.8% of cases had no metabolic abnormalities. They had a lower
prevalence of abdominal obesity and cardiovascular disease. Isolated obesity was significantly associated with physical
activity (odds ratio, 1.86; 1.33 to 2.60; P .0003). Multiple metabolic disorders are present in most obese patients, and their
prevalence is lower in physically active subjects. It is time to move towards a more integrated approach and to reconsider
resource allocation to improve lifestyle changes for large-scale control of obesity
A consensus document on definition and diagnostic criteria for orthorexia nervosa
Purpose: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with “correct” eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. Methods: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A–Definition, Clinical Aspects, Duration; B–Consequences; C–Onset; D–Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. Results: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. Conclusions:
This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. Level of evidence_ Level V: opinions of expert committee
Reazioni umane alle catastrofi. Aspetti psicosociali e di igiene mentale
Quaderni della Fondazione Adriano Olivetti ; 2