Alvarenga M S, Koritar P, Pisciolaro F, Mancini M, Cordás T A, Scagliusi F B
Department of Nutrition, Public Health School, University of Sao Paulo, Avenida Doutor Arnaldo, 715, São Paulo/SP 01246-904, Brazil; AMBULIM, Eating Disorders Unit of Clinics Hospital, Department of Psychiatry, Institute of Psychiatry, University of Sao Paulo, R. Dr. Ovídeo Pires de Campos, 785, São Paulo/SP 01060-970, Brazil.
Department of Nutrition, Public Health School, University of Sao Paulo, Avenida Doutor Arnaldo, 715, São Paulo/SP 01246-904, Brazil; AMBULIM, Eating Disorders Unit of Clinics Hospital, Department of Psychiatry, Institute of Psychiatry, University of Sao Paulo, R. Dr. Ovídeo Pires de Campos, 785, São Paulo/SP 01060-970, Brazil.
Physiol Behav. 2014 May 28;131:99-104. doi: 10.1016/j.physbeh.2014.04.032. Epub 2014 Apr 24.
The objective was to compare eating attitudes, conceptualized as beliefs, thoughts, feelings, behaviors and relationship with food, of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) patients and a group of obese (OBS) without eating disorders (ED). Female patients from an Eating Disorder (ED) Unit with AN (n=42), BN (n=52) and BED (n=53) and from an obesity service (n=37) in Brazil answered the Disordered Eating Attitude Scale (DEAS) which evaluate eating attitudes with 5 subscales: relationship with food, concerns about food and weight gain, restrictive and compensatory practices, feelings toward eating, and idea of normal eating. OBS patients were recruited among those without ED symptoms according to the Binge Eating Scale and the Questionnaire on Eating and Weight Patterns. ANOVA was used to compare body mass index and age between groups. Bonferroni test was used to analyze multiple comparisons among groups. AN and BN patients presented more dysfunctional eating attitudes and OBS patients less dysfunctional (p<0.001). For DEAS total score, AN and BN patients were similar and all other were different (p<0.001). Similarities suggested between BN and BED were true just for the "Relationship with food" and "Idea of normal eating." BED patients were worst than OBS for "Relationship with food" and as dysfunctional as AN patients - besides their behavior could be considered the opposite. Differences and similarities support a therapeutic individualized approach for ED and obese patients, call attention for the theoretical differences between obesity and ED, and suggest more research focused on eating attitudes.
目的是比较神经性厌食症（AN）、神经性贪食症（BN）和暴饮暴食症（BED）患者以及一组无饮食失调（ED）的肥胖（OBS）者的饮食态度，饮食态度被概念化为与食物有关的信念、想法、感受、行为及关系。来自巴西一个饮食失调（ED）科室的女性患者，其中AN患者42例、BN患者52例、BED患者53例，以及来自一个肥胖症服务机构的37例患者，回答了饮食失调态度量表（DEAS），该量表通过5个分量表评估饮食态度：与食物的关系、对食物和体重增加的担忧、限制和补偿行为、对进食的感受以及正常饮食观念。OBS患者是根据暴饮暴食量表和饮食与体重模式问卷从无ED症状者中招募的。采用方差分析比较各组间的体重指数和年龄。使用Bonferroni检验分析组间的多重比较。AN和BN患者表现出更多功能失调的饮食态度，而OBS患者的功能失调程度较轻（p<0.001）。对于DEAS总分，AN和BN患者相似，其他所有组均不同（p<0.001）。BN和BED之间仅在“与食物的关系”和“正常饮食观念”方面存在相似性。在“与食物的关系”方面，BED患者比OBS患者更差，且与AN患者功能失调程度相同——尽管他们的行为可能被认为相反。差异和相似性支持对ED患者和肥胖患者采取个体化治疗方法，引起人们对肥胖与ED之间理论差异的关注，并建议开展更多聚焦于饮食态度的研究。
