Terapia oromotora: Estudio de un modelo educativo para cuidadores primarios / Oral-motor therapy: Study of a distance learning educational model for primary caregivers / Terapia motora oral: estudo de um modelo de ensino à distância para cuidadores primários

Los trastornos alimentarios y de deglución afectan considerablemente la calidad de vida de niños y niñas con discapacidades neuromotoras. La pandemia de COVID-19 agravó estos desafíos al limitar el acceso a la atención en salud. Este estudio evaluó un modelo educativo de aprendizaje a distancia en terapia oral-motora, dirigido a personas cuidadoras de niños y niñas con discapacidades neuromotoras en Mérida, México. Participaron incialmente treinta personas cuidadoras de niños y niñas entre 2 y 12 años de edad con trastornos alimentarios y de deglución, quienes recibían atención en siete instituciones. 23 participantes completaron el programa. Se usó un diseño cuasiexperimental de prueba pre y post. El programa incluyó sesiones teóricas y prácticas. Los resultados mostraron mejoras significativas en el conocimiento teórico y en las competencias prácticas, con niveles de competencia superiores al 80%. Aun así, se reconocen limitaciones del estudio como el tamaño de la muestra y la ausencia de un grupo de control. Abordar estas limitaciones en investigaciones futuras fortalecerá la evidencia sobre la efectividad de este enfoque innovador centrado en la persona cuidadora, crucial para gestionar trastornos alimentarios y de deglución de manera efectiva y mejorar la calidad de vida de niños y niñas con discapacidades neuromotoras.

Eating and swallowing disorders are prevalent among children with neuromotor disabilities, significantly impacting their overall quality of life. The COVID-19 pandemic exacerbated the challenges by restricting access to health care, underscoring the necessity for innovative solutions with caregiver involvement. This study investigated the effectiveness of a distance learning educational model in oral-motor therapy for primary caregivers of children with neuromotor impairments in Mérida, Mexico. The quasiexperimental pretest-posttest design included thirty primary caregivers of children aged 2 to 12 with feeding and swallowing disorders from seven institutions. Twenty-three participants completed the program. The program encompassed theoretical sessions on various aspects of oral motor therapy and practical sessions focusing on hands on training. Results revealed substantial enhancements in theoretical knowledge and practical competencies among caregivers, with competence levels exceeding 80% in all evaluated activities. Despite these positive outcomes, the study acknowledges limitations such as a small sample size and the absence of a control group. Addressing these constraints through future research endeavors will bolster the evidence supporting the effectiveness of this innovative caregivercentric approach. Ultimately, integrating caregivers into the care team is imperative for improving the quality of life for children with neuromotor disabilities and effectively managing eating and swallowing disorders.

Os distúrbios da alimentação e da deglutição afetam significativamente a qualidade de vida das crianças com deficiências neuromotoras. A pandemia da COVID-19 exacerbou esses desafios desafios, sendo que limitou o acesso ao atendimento. Este estudo avaliou um modelo educacional de ensino à distância sobre terapia oral-motora, orientado a cuidadores primários de crianças com deficiências neuromotoras em Mérida, México. Trinta cuida- dores de crianças de 2 a 12 anos de idade com distúrbios de alimentação e deglutição de sete instituições participaram, sendo que 23 deles concluíram o programa. Um estudo quase experimental de préteste-pós-teste foi realizado. O programa incluiu sessões teóricas e práticas. Os resultados mostraram melhorias significativas no conhecimento teórico e nas competências práticas, com níveis de competência acima de 80%. Contudo, são reconhecidas algumas limitações do estudo, como o pequeno tamanho da amostra e a falta de um grupo de controle. A abordagem dessas limitações em pesquisas futuras fortalecerá as evidências respeito da eficácia dessa abordagem inovadora centrada no cuidador, crucial para melhorar a qualidade de vida das crianças com deficiências neuromotoras e gerenciar os distúrbios de alimentação e deglutição de forma eficaz.

Is there scientific relevance to the plot of films and documentaries about eating disorders? / ¿Tiene relevancia científica la trama de películas y documentales sobre trastornos alimentarios? / Há pertinência científica no enredo dos filmes e documentários sobre transtornos alimentares?

ABSTRACT Objectives: to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field. Methods: a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used. Results: most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals. Conclusions: in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.

RESUMEN Objetivos: analizar películas y documentales sobre trastornos alimentarios de los últimos veinte años, identificando la forma en que abordan el tema, así como su relevancia para su uso didáctico en la enseñanza del campo de la salud. Métodos: estudio descriptivo, cuya recolección de datos se realizó en las principales plataformas de streaming y video, dando como resultado la encuesta a 60 medios. De estos, sólo 25 tenían audio/subtítulos en portugués (criterios de inclusión). Se analizó la relevancia científica considerando aspectos psicopatológicos y epidemiológicos de estos trastornos. Se utilizó un cuestionario sobre la trama, los personajes y el análisis de datos descriptivos. Resultados: la mayoría de los medios fueron dramas sobre mujeres adolescentes que intentaban ajustarse a estereotipos de belleza, cuyos síntomas retratados convergían con los manuales de diagnóstico médico vigentes. Conclusiones: en términos prácticos, se elaboró un listado clasificatorio de 11 medios que podrían ser utilizados como recurso didáctico para la enseñanza de este tema en el campo de la salud.

RESUMO Objetivos: analisar filmes e documentários sobre transtornos alimentares dos últimos vinte anos, identificando o modo como abordam a temática, bem como sua pertinência para o uso didático no ensino do campo da saúde. Métodos: estudo descritivo, cuja coleta de dados foi realizada nas principais plataformas de streaming e vídeos, resultando no levantamento de 60 mídias. Dessas, apenas 25 tinham áudio/legenda em português (critério de inclusão). A pertinência científica foi analisada considerando aspectos psicopatológicos e epidemiológicos desses transtornos. Utilizaram-se um questionário sobre o enredo, as personagens e análise descritiva dos dados. Resultados: a maioria das mídias eram dramas sobre adolescentes do sexo feminino que tentavam adequar-se aos estereótipos de beleza, cujos sintomas retratados convergiam com os manuais de diagnósticos médicos atuais. Conclusões: em termos práticos, elaborou-se uma lista classificatória de 11 mídias que poderão ser utilizadas como recurso didático para o ensino desse tema no campo da saúde.

Avoidant restrictive eating disorder and panic attacks in an adult man: A case report / Trastorno evitativo restrictivo de la ingesta alimentaria y ataques de pánico en un hombre adulto: Reporte de caso

Abstract Avoidant or Restrictive Food Intake Disorder (ARFID) is an eating disorder (ED) not common in adults. In this article we present a clinical case of ARFID in a 37-year-old male patient treated in an ED center in Medellin, Colombia; displaying anxious symptoms that began a year earlier and concomitant weight loss, following a traumatic event causing an overall impairment with that patient. Several medical evaluations/examinations looking for organic causes, were excluded. Interventions were implemented by a psychiatry, a psychotherapist using cognitive-behavior therapy (CBT), and a nutritionist, all in face-to-face modality, which were carried out weekly for the first three months, then biweekly and subsequently quarterly. each lasting approximately 40-60 minutes. After the set of pharmacological interventions and psychotherapy, a great improvement in the functionality of the patient was observed. Improvement was found with respect to eating in public, food variation and panic attacks. In the absence of guidelines, it is important to use standardized and replicable treatments in this population.

Resumen El trastorno evitativo restrictivo de la ingesta (TERIA) es un trastorno alimentario (TCA) raro en adultos. Se presenta el caso de un hombre de 37 años con TERIA y trastorno de pánico atendido en un centro para TCA en Medellín, Colombia, quien presentó un año de síntomas ansiosos y pérdida de peso después de evento traumático, generando disfuncionalidad. Fue evaluada y excluida organicidad. Se realizaron intervenciones por parte de psiquiatría, psicoterapia con enfoque cognitivo conductual y nutrición, todas en modalidad presencial, las cuales se realizaron semanalmente los primeros tres meses, luego quincenalmente y posteriormente trimestralmente. Cada una con una duración de 40-60 minutos aproximadamente por sesión. Posterior al conjunto de intervenciones farmacológicas y psicoterapia, se observó una gran mejoría la funcionalidad del paciente, se encontró mejoría con respecto a comer en público, variación en los alimentos y ataques de panico. Ante la ausencia de guías de manejo de TERIA en adultos es relevante realizar tratamientos estandarizados que puedan ser replicados.

Qualidade de vida e imagem corporal após cirurgia bariátrica e de contorno corporal / Quality of life and body image after bariatric and body contouring surgery

Introdução: A procura pela cirurgia de contorno corporal após a cirurgia bariátrica se deve em grande parte a uma insatisfação com a imagem corporal prejudicada pela flacidez e excesso de pele decorrente da grande perda ponderal. O objetivo deste estudo foi avaliar a qualidade de vida e a imagem corporal de pacientes submetidos a cirurgia bariátrica e posteriormente a cirurgia de contorno corporal em uma clínica privada. Método: Este estudo transversal comparou 4 grupos distintos de 21 pacientes cada, pareados por índice de massa corporal e idade antes de realizarem a cirurgia bariátrica. Foram divididos nos tempos antes/depois da cirurgia bariátrica e antes/depois da cirurgia de contorno corporal, formando assim os grupos A, B, C e D, respectivamente. Foi utilizado o questionário SF-36 para avaliação da qualidade de vida e a Escala de Silhuetas proposta por Kakeshita para avaliação da imagem corporal. Para o nível de significância, foi escolhido p<0,05. Resultados: Houve melhora em todos os domínios do SF-36 após a cirurgia bariátrica. Os pacientes que procuraram a cirurgia de contorno corporal apresentaram o menor valor do componente de saúde mental, com pouca alteração após a cirurgia de contorno corporal. Quase todos os grupos superestimaram a sua silhueta, exceto para o grupo de 6 meses após a cirurgia bariátrica, que se viu menor. Conclusão: Pacientes bariátricos que procuram a cirurgia de contorno corporal apresentam escores inferiores de qualidade de vida relacionada à saúde mental e que permanecem menores após a cirurgia de contorno corporal. A distorção da imagem corporal e expectativas irreais podem justificar esse achado.

Introduction: The demand for body contouring surgery after bariatric surgery is largely due to dissatisfaction with body image impaired by sagging and excess skin resulting from massive weight loss. This study aimed to evaluate the quality of life and body image of patients undergoing bariatric surgery and body contouring surgery in a private clinic. Method: This cross-sectional study compared 4 groups of 21 patients, matched by body mass index and age before undergoing bariatric surgery. They were divided into times before/after bariatric surgery and before/after body contouring surgery, thus forming groups A, B, C, and D, respectively. The SF-36 questionnaire assessed the quality of life, and the Silhouette Scale proposed by Kakeshita to assess body image. For the significance level, p<0.05 was chosen. Results: There was an improvement in all SF-36 domains after bariatric surgery. Patients who sought body contouring surgery had the lowest mental health component value, with little change after body contouring surgery. Almost all groups overestimated their silhouette, except for the group of 6 months after bariatric surgery, which saw itself as smaller. Conclusion: Bariatric patients seeking body contouring surgery have lower mental health-related quality of life scores that remain lower after body contouring surgery.

Avaliação e intervenção responsiva e integrativa na criança com distúrbio alimentar pediátrico com Trissomia do 21: Relato de caso / Responsive and integrative assessment and intervention in children with pediatric feeding disorder with Trisomy 21: A case report / Evaluación e intervención receptiva e integradora en un niño con trastorno alimentario pediátrico con Trisomía 21: Reporte de caso

Na criança com Trissomia do 21 a dificuldade alimentar pode estar presente. Alguns sinais são as alterações na habilidade motora-oral, no processamento sensorial, tempo elevado das refeições, recusa alimentar prolongada e falta de autonomia. Ainda pouco se discute sobre as dificuldades alimentares e seu processo terapêutico nesta população. O objetivo deste estudo foi descrever a avaliação e intervenção fonoaudiológica e da terapia ocupacional na dificuldade alimentar de uma criança com Trissomia do 21 com o uso de estratégias de alimentação responsiva e integrativa. Criança 3 anos e 2 meses, sexo masculino. Avaliação fonoaudiológica demonstrou criança com distúrbio alimentar pediátrico, caracterizado por atraso na habilidade motora-oral, baixa percepção intraoral e comportamento alimentar altamente seletivo. Na avaliação da terapia ocupacional verificou-se perfil sensorial alterado. Na fonoterapia foram trabalhados aspectos como a percepção do alimento, ritmo e o tempo de alimentação. Na terapia ocupacional, o objetivo foi adequar nível de alerta, favorecer a independência e o desenvolvimento psicomotor. Após a intervenção, a reavaliação fonoaudiológica demonstrou que houve ampliação do cardápio, melhora da percepção, da habilidade motora intraoral, aceitação de diferentes utensílios e modos de apresentação do alimento, autonomia e prazer nas refeições. A reavaliação da terapia ocupacional mostrou um nível de alerta e atenção mais adequado, uso das mãos e dedos de maneira mais funcional para se alimentar. Foram observadas evoluções positivas em relação à intervenção fonoaudiológica e da terapia ocupacional na dificuldade alimentar de uma criança com Trissomia do 21 com o uso de estratégias de alimentação responsiva e integrativa. (AU)

In children with Trisomy 21 feeding difficulty can be observed, such as changes in oral motor skills, sensory processing, longer mealtimes, food refusal, lack of autonomy and others. However, there is little discussion about feeding difficulties and rehabilitation process in this population. This study aimed to describe speech-language and occupational therapy assessment and intervention in feeding difficulties in a 3-year and 2-month-old male child with a diagnosis of Trisomy 21. Speech-language pathology assessment found that the child had feeding difficulties, delay in oral motor skills, low intraoral perception and acceptance, while the occupational therapy assessment showed an altered sensory profile. The speech-language pathology sessions included aspects such as food perception, rhythm and feeding time. In turn, occupational therapy sessions aimed to adjust the alertness level, promote independence and psychomotor development. After the intervention, the speech-language pathology reassessment showed that there was an expansion of the menu for the ingestion, improvement in perception and intraoral motor skills, acceptance of different utensils and food presentation modes, autonomy and pleasure in meals. The reassessment of occupational therapy showed a better level of alertness and attention, more functional use of hands and fingers to eat. Therefore, a positive progress was observed in the feeding difficulty of a child with Trisomy 21 after a speech-language pathology and occupational therapy intervention with the use of responsive and integrative feeding strategies. (AU)

Niños con Trisomía 21, pueden presentar dificultades de alimentación. Algunos signos son cambios en las habilidades motrices orales, procesamiento sensorial, tiempos prolongados de comida, rechazo prolongado de alimentos y falta de autonomía. Hay poca discusión sobre las dificultades de alimentación y su proceso terapéutico en esta población. El objetivo deste estudio fue describir la evaluación e intervención fonoaudiológica y de terapia ocupacional en la dificultad de alimentación de un niño con Trisomía 21 utilizando estrategias de alimentación receptiva e integradora. Niño de 3 años y 2 meses. La evaluación fonoaudiológica mostró un trastorno alimentario pediátrico, caracterizado por un retraso en las habilidades motoras orales, percepción intraoral baja y comportamiento alimentario altamente selectivo. En la evaluación de terapia ocupacional se observó un perfil sensorial alterado. En fonoaudiología se trabajaron aspectos como la percepción de alimentos, ritmo y tiempo de alimentación. En terapia ocupacional, el objetivo fue ajustar el nivel de alerta, favoreciendo la independencia y desarrollo psicomotor. Después de la intervención, la reevaluación fonoaudiológica se evidenció una ampliación del menú, mejoras en percepción, motricidad intraoral, aceptación de diferentes utensilios y formas de presentar alimentos, autonomía y placer en las comidas. La reevaluación de terapia ocupacional mostró un nivel de alerta y atención más adecuado, uso de manos y dedos de forma más funcional para alimentarse. Fueron observadas evoluciones positivas con relación a la intervención fonoaudiológica y de terapia ocupacional en la dificultad de alimentación de un niño con Trisomía 21 con el uso de estrategias de alimentación receptiva e integradora. (AU)

Atuação da Enfermagem com pacientes acometidos de transtornos alimentares: análise de filmes e documentários / Nursing performance with patients suffering from eating disorders: analysis of films and documentaries / Cuidados de enfermería con pacientes que sufren trastornos alimentarios: análisis de películas y documentales

Objetivo: analisar a atuação da Enfermagem junto a pacientes com transtornos alimentares em filmes sobre o assunto. Método: trata-se de um estudo descritivo-exploratório desenvolvido a partir de dados secundários. Utilizaram-se a base de dados cinematográfica Internet Move Database e descritores em português e inglês, que foram: "anorexia", "bulimia" e/ou "transtornos alimentares". Adotaram-se como critérios de inclusão: criações audiovisuais produzidas entre 1998 e 2020; o conteúdo estar disponível nas plataformas de streaming elencadas; as criações terem áudio e/ou legendas em português; e o filme ter alguma cena com o profissional de Enfermagem. Seis mídias atenderam a esses critérios e foram analisadas a partir de um roteiro que investiga a abordagem da Enfermagem no tratamento dos transtornos alimentares. Para elencar a produção mais indicada para finalidade didática, foram considerados seis critérios objetivos. Resultados: a maioria dos enredos veiculou a Enfermagem de modo estereotipado e com pouca autonomia, além de atribuir uma postura de "mau" ou "bom ajudante do médico" a esses profissionais. Embora nenhum enredo tenha atendido a todos os critérios objetivos de maneira satisfatória, a produção audiovisual que correspondeu à maior parte dos critérios foi aquela indicada para a finalidade didática. Conclusão: as produções, de um modo geral, condizem mais com o modelo médico assistencialista, na qual o enfermeiro desenvolve ações de prevalência tecnicistas, de supervisão e desintegradas da equipe multiprofissional em detrimento do modelo biopsicossocial, o qual demanda raciocínio clínico, pensamento crítico e conhecimento científico fundamentado.(AU)

Objective: to analyze the performance of Nursing with patients with eating disorders in films about the subject. Method: this is a descriptive-exploratory study developed from secondary data. The film database Internet Move Database and descriptors in Portuguese and English were used, which were: "anorexia", "bulimia" and/or "eating disorders". The following inclusion criteria were adopted: audiovisual creations produced between 1998 and 2020; the content is available on the listed streaming platforms; the creations have audio and/or subtitles in Portuguese; and the film has a scene with the Nursing professional. Six media met these criteria and were analyzed based on a script that investigates Nursing's approach to the treatment of eating disorders. To list the most suitable production for didactic purposes, six objective criteria were considered. Results: most plots conveyed Nursing in a stereotyped way and with little autonomy, in addition to attributing a "bad" or "good doctor's helper" attitude to these professionals. Although no plot met all the objective criteria satisfactorily, the audiovisual production that met most of the criteria was the one indicated for didactic purposes. Conclusion: the productions, in general, are more in line with the medical care model, in which the nurse develops actions that are technical, supervisory, and disintegrated from the multidisciplinary team to the detriment of the biopsychosocial model, which demands clinical reasoning, critical thinking and grounded scientific knowledge.(AU)

Objetivo: analizar los cuidados de enfermería frente a pacientes con trastornos alimentarios en películas sobre el tema. Método: se trata de un estudio descriptivo-exploratorio desarrollado a partir de datos secundarios. Se utilizó la base de datos cinematográfica "Internet Move Database" y las palabras clave en portugués e inglés, las cuales fueron: "anorexia", "bulimia" y/o "trastornos alimentarios". Fueron adoptados los siguientes criterios de inclusión: creaciones audiovisuales producidas entre los años 1998 y 2020; el contenido estar disponible en las plataformas de streaming listadas; tener audio y/o subtítulos en portugués; y alguna escena con el profesional de Enfermería. Seis medios cumplieron estos criterios y fueron analizados a...(AU)

Initial evaluation of a multidisciplinary pediatric aerodigestive program in a Brazilian hospital: challenges and mitigation strategies

Abstract Objective: To identify clinical and epidemiological characteristics of children evaluated by the pediatric aerodigestive program at the beginning of its activity, describe challenges in followup, and suggest mitigation strategies. Methods: A case series was conducted describing the first 25 patients discussed by the aerodigestive team from a Brazilian quaternary public university hospital between April 2019 and October 2020. The median follow-up was 37 months. Results: During the study period 25 children were seen by the group and the median age at first assessment was 45.7 months old. Eight children had a primary airway abnormality, five had a tracheostomy. Nine children had genetic disorders and one had esophageal atresia. Dysphagia was present in 80% of the patients, 68% had a history of chronic or recurrent lung disease, 64% had a gastroenterological diagnosis and 56% had neurological impairment. Moderate to severe dysphagia was identified in 12 children and 7 of these had an exclusive oral diet at the time. The majority of children (72%) had 3 or more comorbidities. Following team discussion, a change in feeding strategy was suggested in 56% of the children. The most frequently ordered exam was pHmetry (44%) and gastrostomy was the surgical procedure with the longest waiting list. Conclusions: Dysphagia was the most frequent issue encountered in this initial group of aerodigestive patients. Pediatricians caring for these children must be involved in aerodigestive team discussions and hospital policies must be revised to facilitate access to exams and procedures needed for this population.

Associations between bullying and risk for eating disorders in adolescents / Asociaciones entre el acoso escolar y el riesgo de trastornos alimentarios en adolescentes / Associações entre bullying e risco de transtornos alimentares em adolescentes

ABSTRACT Objectives: to analyze the associations between bullying participation profiles (victims, bullies, and bully-victims) and the risk for eating disorders in adolescents. Methods: a cross-sectional study was conducted with 491 students, aged 10 to 18 years. Data were collected through the application of the Peer Victimization and Aggression Scale and the Eating Attitudes Test, and were statistically analyzed using analysis of variance (ANOVA) and Spearman correlation. Results: the risk for eating disorders was higher for the victim profile, both for boys and girls. For both sexes, physical victimization, verbal victimization, and relational victimization were significantly associated with variables related to the risk for eating disorders. For boys, there were also significant associations related to aggression. Conclusions: student victims, especially boys, are more vulnerable to the consequences of bullying in relation to the risk for eating disorders.

RESUMEN Objetivos: analizar las asociaciones entre los perfiles de participación en el acoso escolar (víctimas, agresores y víctimas-agresores) y el riesgo de trastornos alimentarios en adolescentes. Métodos: estudio transversal con 491 estudiantes de 10 a 18 años. Los datos se recopilaron mediante la aplicación de la Escala de Victimización y Agresión entre Pares y el Test de Actitudes Alimentarias, y se analizaron estadísticamente mediante análisis de varianza (ANOVA) y correlación de Spearman. Resultados: el riesgo de trastornos alimentarios fue mayor en el perfil de víctima, tanto en niños como en niñas. Tanto para ambos sexos, la victimización física, la victimización verbal y la victimización relacional se asociaron significativamente con variables relacionadas con el riesgo de trastornos alimentarios. En el caso de los niños, también se observaron asociaciones significativas relacionadas con la agresión. Conclusiones: los estudiantes que son víctimas, especialmente los niños, son más vulnerables a las consecuencias del acoso escolar en relación con el riesgo de trastornos alimentarios.

RESUMO Objetivos: analisar as associações entre o perfil de participação no bullying (vítimas, agressores e vítimas-agressoras) e o risco de transtornos alimentares em adolescentes. Métodos: estudo transversal realizado com 491 estudantes, com idades entre 10 e 18 anos. Os dados foram coletados por meio da aplicação da Escala de Vitimização e Agressão entre Pares e do Eating Attitudes Test, e foram analisados estatisticamente por meio de análises de variância (ANOVA) e correlação de Spearman. Resultados: o risco de transtornos alimentares foi maior para o perfil de vítima, tanto para meninos quanto para meninas. Para ambos os sexos, a vitimização física, a vitimização verbal e a vitimização relacional associaram-se significativamente às variáveis de risco de transtornos alimentares. Para os meninos, também houve associações significativas relacionadas à agressão. Conclusões: os estudantes vítimas, especialmente os meninos, são mais vulneráveis às consequências do bullying em relação ao risco de transtornos alimentares.

Scurvy and food selectivity in childhood: a case report

ABSTRACT Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

Perceptions of health professionals in providing care for people with anorexia nervosa and bulimia nervosa: a systematic review and meta-synthesis of qualitative studies / Percepções de profissionais de saúde no cuidado a pessoas com anorexia e bulimia nervosa: revisão sistemática e metassíntese de estudos qualitativos / Percepciones de los profesionales de la salud en el cuidado de personas con anorexia y bulimia nerviosa: revisión sistemática y metasíntesis de estudios cualitativos

Abstract: This study sought to synthesize and reinterpret findings from primary qualitative studies on the experience of health professionals in caring for people with anorexia nervosa and bulimia nervosa. We conducted a systematic review of the literature with the SPIDER search strategy assessing six databases. A meta-synthesis was performed with data from qualitative studies. Two independent reviewers screened and assessed the articles, extracted data from the articles and elaborated thematic synthesis. Nineteen articles met the inclusion/exclusion criteria. The meta-synthesis revealed three descriptive themes: Going outside the comfort zone: hard relational experiences of health professionals in providing care for people with anorexia nervosa and bulimia nervosa; Reflecting on treatment: relevance of discussion, communication, and flexibility in health professionals' work with anorexia nervosa and bulimia nervosa; and Dealing with ambivalences: experiences of health professionals with family members of people with anorexia nervosa and bulimia nervosa. We elaborated two analytical themes: Making work with eating disorders palatable: malleability necessary for health professionals in bonding with people with anorexia and bulimia nervosa and their families; and Leaving the professional comfort zone: transition from multi to interdisciplinary. Thus, mental health professionals who work with people diagnosed with anorexia and bulimia nervosa cope with hard emotional experiences that makes them feel out of their comfort zone, requiring flexibility to benefit a good therapeutic alliance, but there are still difficulties in promoting interdisciplinarity.

Resumo: Este estudo buscou sintetizar e reinterpretar os achados de estudos qualitativos primários sobre a experiência de profissionais de saúde no cuidado a pessoas com anorexia e bulimia nervosa. Realizamos uma revisão sistemática da literatura com a estratégia de busca estruturada SPIDER em seis bases de dados. Foi realizada uma metassíntese com dados destes estudos qualitativos. Os artigos foram triados e avaliados por dois revisores independentes que extraíram dados desses artigos e elaboraram uma síntese temática. No total, 19 artigos atenderam nossos critérios de inclusão e exclusão. A metassíntese revelou três temas descritivos: Sair da zona de conforto: profissionais de saúde tiveram vivências relacionais difíceis no cuidado à pessoa com anorexia e bulimia nervosa; Refletir sobre o tratamento: a relevância da discussão, comunicação e flexibilidade no trabalho dos profissionais de saúde; e Lidar com ambivalências: vivências de profissionais de saúde com familiares de pessoas com anorexia e bulimia nervosa. Elaboramos dois temas analíticos: Tornando o trabalho com distúrbios alimentares agradável: maleabilidade necessária para vincular profissionais de saúde à pessoa com anorexia e bulimia nervosa e sua família; e Saindo da zona de conforto profissional: transição do multi para o interdisciplinar. Assim, os profissionais de saúde mental que trabalham com pessoas diagnosticadas com anorexia e bulimia nervosa enfrentam experiências emocionais difíceis que os fazem se sentir fora de sua zona de conforto, exigindo flexibilidade para o benefício de uma boa aliança terapêutica, mas ainda há dificuldades em promover a interdisciplinaridade.

Resumen: Este estudio buscó sintetizar y reinterpretar los hallazgos de estudios cualitativos primarios sobre la experiencia de profesionales de la salud en el cuidado de personas con anorexia y bulimia nerviosa. Realizamos una revisión sistemática de la literatura con la estrategia de búsqueda estructurada SPIDER en seis bases de datos. Se realizó una metasíntesis con los datos de estos estudios cualitativos. Los artículos fueron seleccionados y evaluados por dos revisores independientes que extrajeron datos de estos artículos y elaboraron una síntesis temática. En total, 19 artículos cumplieron con nuestros criterios de inclusión y exclusión. La metasíntesis reveló tres temas descriptivos: Salir de la zona de confort: los profesionales de la salud tuvieron vivencias relacionales difíciles en el cuidado a la persona con anorexia y bulimia nerviosa; Reflexionar sobre el tratamiento: la relevancia de la discusión, la comunicación y la flexibilidad en el trabajo de los profesionales de la salud; y Lidiar con las ambivalencias: experiencias de los profesionales de la salud con familiares de personas con anorexia y bulimia nerviosa. Elaboramos dos temas analíticos: Hacer agradable el trabajo con los trastornos alimentarios: maleabilidad necesaria para vincular a los profesionales de la salud con la persona con anorexia y bulimia nerviosa y su familia; y Salir de la zona de confort profesional: transición de lo múltiple a lo interdisciplinario. Por lo tanto, los profesionales de la salud mental que trabajan con personas diagnosticadas con anorexia y bulimia nerviosa enfrentan experiencias emocionales difíciles que los hacen sentir fuera de su zona de confort, lo que requiere flexibilidad en beneficio de una buena alianza terapéutica, pero aún existen dificultades para promover la interdisciplinariedad.

Perfeccionismo, estrés académico y ansiedad social en mujeres estudiantes de medicina y riesgo de padecer un trastorno alimentario: un modelo multivariado / Perfectionism, academic stress and social anxiety in female medical students and the risk for eating disorders

BACKGROUND: Both perfectionism and social anxiety have been described in patients with eating disorders (ED) and medical students. Academic stress also can increase the risk of developing ED. AIM: To analyze the dimensions of perfectionism, social anxiety, and academic stress associated with the risk of developing ED in female medical students. MATERIAL AND METHODS: The Multidimensional Perfectionism Scale, the Liebowitz Social Anxiety Scale, the SISCO academic stress inventory and the Eating Attitudes Test-26, were applied to 163 female medical students from all levels of the career. The groups with and without risk of ED were compared according to these variables. Results: Twenty-four percent of respondents were at risk of ED. There were significant differences between scores of perfectionism, social anxiety, and academic stress between respondents with and without risk for ED. In general, there was a significant correlation among the variables. In a multivariate analysis, the predictors of ED risk were the perception of academic stress (Odds ratio (OR) 1.09; 95% confidence intervals (CI) 1.03-1.16) and personal standards in the context of perfectionism (OR 1.16; 95% CI 1.06-1.27). CONCLUSIONS: A substantial proportion of female medical students were at risk for ED. The risk of ED was determined mainly by academic stress and personal standards in the context of perfectionism. In this sample, social anxiety did not play a relevant role.

Intervención multidisciplinar en línea para mujeres con trastorno por atracón / Multidisciplinary online intervention for women with binge eating disorder

Resumen: Objetivo: Evaluar la efectividad de una intervención multidisciplinar en línea (psicológica, médica y nutricional) en mujeres con trastornos por atracón (TpA). Método: participaron 5 mujeres diagnosticadas con TpA con una edad promedio de 43.2 años y un peso corporal inicial promedio de 90 kg. El tratamiento se realizó durante 24 sesiones, cada una de dos horas por semana; la primera hora era terapia grupal y la segunda individual. Se contó con cuatro momentos de evaluación: pre, post y dos seguimientos Resultados: Las comparaciones se realizaron a través de la prueba no paramétrica de Friedman, encontrando una disminución estadísticamente significativa de la sintomatología de atracón pre χ1= 30.30 al segundo seguimiento χ2=10.80 (x2=12.84; p=.005), sintomatología de ansiedad χ1= 28.80 χ2=12.40 (x2=10.83.96; p=.013) y depresión χ1= 19.80, χ2=4.0 (x2=10.18; p=.017). Se observó mejoría en la comprensión χ1= 21.00, χ2=30.20 (x2=9.63; p=.025) y regulación emocional χ1= 28.40 χ2=33.00, (x2=7.77; p=.050). Las pacientes redujeron su peso corporal, mejoraron hábitos alimentarios introduciendo fruta y verdura diariamente e incluyeron la actividad física en su rutina diaria, realizando de 20 a 30 minutos diarios. A partir del cambio clínico objetivo se observó un cambio positivo en las variables abordadas en tratamiento en todas las participantes. Conclusiones: Se puede observar que la intervención multidisciplinaria en línea fue efectiva en el tratamiento de TpA en mujeres.

Abstract: Objective: To evaluate the effectiveness of a multidisciplinary online intervention (psychological, medical, and nutritional) in women with binge eating disorder (BED). Method: 5 women diagnosed with BED with a mean age of 43.2 years and a mean initial body weight of 90 kg participated. The treatment was carried out during 24 sessions, each of two hours per week; the first hour was group therapy and the second individual. There were four moments of evaluation: pre, post and two follow-ups. Results: The comparisons were made through the non-parametric Friedman test, finding a statistically significant decrease in binge eating symptoms before χ1= 30.30 at the second follow-up χ2 =10.80 (x2=12.84; p=.005), symptoms of anxiety χ1= 28.80, χ2=12.40 (x2=10.83.96; p=.013) and depression χ1= 19.80, χ2=4.0 (x2= 10.18, p=.017). Improvement was observed in comprehension χ1= 21.00, χ2=30.20 (x2=9.63; p=.025) and emotional regulation χ1= 28.40 χ2=33.00, (x2=7.77; p=.050). The patients reduced their body weight, improved their eating habits by introducing fruit and vegetables daily and included physical activity in their daily routine, performing 20 to 30 minutes a day. From the objective clinical change, a positive change was observed in the variables addressed in treatment in all the participants. Conclusions: The online multidisciplinary intervention was effective in the treatment of BED in women.

Las percepciones de crianza materna podrían influenciar las conductas autolesivas en adolescentes con diagnóstico de trastornos de la conducta alimentaria / Memories of maternal upbringing could influence self-injurious behaviors in adolescents with diagnosis of eating disorders

RESUMEN Objetivo : Explorar las percepciones de crianza parental en adolescentes diagnosticados con algún trastorno de la conducta alimentaria, e identificar posibles diferencias con alteraciones de la conducta alimentaria y conductas autolesivas. Material y métodos : Un total de 45 adolescentes con algún tipo de trastorno de la conducta alimentaria (TCA) (11 diagnosticados con anorexia nervosa, 23 con bulimia nervosa y 11 con trastorno "por atracón"), pacientes en áreas de consulta externa y hospitalización del Hospital Psiquiátrico Infantil Juan N. Navarro fueron sistemáticamente estudiados. Resultados : Se encontró que cuánto mayores las percepciones de favoritismo (r = 0,41, valor p = 0,005) o rechazo (r = 0,36, valor p = 0,016) del padre, mayores fueron también los puntajes en la Escala de Actitudes Alimentarias. Se encontraron asimismo diferencias en la dimensión de calidez de la madre, entre los adolescentes que presentaron autolesiones (media = 39,6, d.e = 11,3) comparados con aquéllos que no las presentaron (media = 47,4, d.e = 8.8) (t = -2,6, valor p = 0,015). Conclusiones : Los adolescentes con diagnóstico de TCA presentaron diferencias en la percepción de crianza parental, factor que puede influenciar decisivamente la manifestación de otras conductas psicopatológicas.

SUMMARY Objective : To explore the perceived parental rearing behavior in adolescents diagnosed with an eating disorder, and to identify eventual differences with altered eating and self-injurious behaviors. Material and methods : A total of 45 adolescents diagnosed with some eating disorder (11 diagnosed with anorexia nervosa, 23 with bulimia nervosa and 11 with binge eating disorder), recruited from the outpatient and hospitalization areas of the Juan N Navarro Children's Psychiatric Hospital, were included. Results : It was found that the greater the memories of favoritism (r = 0.41, p-value = 0.005) or rejection (r = 0.36, p-value = 0.016) by the father, the higher the scores ​​on the Eating Attitude Scale. Differences were also found in the mother's warmth dimension, between the adolescents who presented self-injuries (mean = 39.6, de = 11.3) and those who did not present them (mean = 47.4, de = 8.8) (t = -2.6, value p = 0.015). Conclusions : Adolescents with a diagnosis of eating disorders presented differences in their perception of parental rearing, a factor that may decisively influence the manifestation of other psychopathological behaviors.

Considerações sobre a busca por muscularidade entre homens gays / Considerations about drive for muscularity among gay men

Apresenta-se um manuscrito no formato de "carta ao editor", em que é abordada a busca por muscularidade por homens gays e suas possíveis funções, como reparação da autoestima danificada por exposição crônica a experiências de homofobia, necessidade ou desejo de uma aparência mais masculina, sensação de força e capacidade de autoproteção e evitação da constatação da própria fragilidade psíquica. São apresentadas indicações a profissionais de saúde mental que cuidam dessa população. Alguns fragmentos da experiência clínica do primeiro autor são apresentados a título de ilustração. (AU)

A manuscript in the form of a "letter to the editor" is presented, in which the search for muscularity by gay men and its possible functions is addressed, such as repairing self-esteem damaged by chronic exposure to experiences of homophobia, need or desire for a more masculine appearance, feeling of self-confidence and capacity for self-protection and avoidance of the realization of one's own psychic fragility. Indications are presented to mental health professionals who care for this population. Some fragments of the first author's clinical experience are presented by way of illustration.(AU)

Se presenta un manuscrito en forma de "carta al editor", en el que se aborda la búsqueda de la musculatura por parte de los hombres homosexuales y sus posibles funciones, como reparar la autoestima dañada por la exposición crónica a experiencias de homofobia, necesidad o deseo de apariencia más masculina, sentimiento de fortaleza y capacidad de autoprotección y evitación de la realización de la propia fragilidad psíquica. Se presentan indicaciones a los profesionales de la salud mental que atienden a esta población. A modo de ilustración se presentan algunos fragmentos de la experiencia clínica del primer autor.(AU)

The body asks and the mind judges: the episode of food craving, its triggers and nutritional treatment

ABSTRACT Food desires are defined as motivations that drive the search for and consumption of food. However, when domains of intensity and urgency are activated, these desires can become intense (i.e. food craving), being then characterized by episodes or cognitive events loaded with affectivity, in which food is associated with obtaining pleasure or relief, which is the only attentional focus. Specificity and urgency mark the differentiation between food desires and cravings. The process of elaboration with vivid images, the retention in working memory, the emergence of a negative affect state (awareness of the lack), and a committed attentional focus to seek food are characterized as stages of an episode of food craving. Individuals with eating disorders have the lowest levels of food craving when it comes to anorexia nervosa and the subsequent increase to bulimia nervosa and binge eating disorder. Some environmental and cultural triggers and internal factors of cognition and emotions play a crucial role in the emergence of food craving episodes. The external factors include positive/negative events, food environment, advertisements, cultural beliefs about food, specific locations, and food itself. The internal factors comprise dietary restriction, food reward, impulsivity/inflexibility, emotions, thoughts and feelings about food, hunger/satiety/appetite, and anxious/depressive symptoms. Treatment involves the association of flexibility, awareness, and questioning strategies about dietary practices based on three principles: unconditional permission to eat, eating more for physical than emotional reasons, and tuning in with the body's signs of hunger and satiety (intuitive eating).

Maternal complaints about feeding problems and anthropometric parameters of children with a diagnosis of pediatric feeding disorder

ABSTRACT Purpose: to describe the anthropometric parameters of children diagnosed with pediatric feeding disorder by a multiprofessional team. Methods: a retrospective clinical study conducted on 196 children on maternal complaints of feeding difficulties and a diagnosis of pediatric feeding disorder. Children with neurological diseases or having no pediatric feeding disorder diagnosis were excluded from the study. Weight and height data were obtained and parameters such as weight-for-age, length/height-for-age and body mass index for-age were analyzed, according to the recommendations of the World Health Organization. The two-proportion equality test was used and the level of significance was set at 0.05 (5%) in all analyses. Results: results showed mean (±Standard Deviation) values of 13.09±5.1 for weight (kg), 0.61±15.53 for height (cm) and 15.37±1.56 for body mass index (kg/m²). The results also showed that 87.2% of the children were within the adequate z-score for weight-for-age, 93.4% were within the adequate z-score for length/height-for-age, and that 88.8% had a normal z-score for-age for body mass index. Conclusion: the sample of children diagnosed with pediatric feeding disorder exhibited adequate anthropometric parameters for their age range.

Body dissatisfaction among undergraduate medical students in the city of Juiz de Fora, Minas Gerais, Brazil

ABSTRACT Objective To assess the level of body dissatisfaction among undergraduate medical students in the city of Juiz de Fora, Minas Gerais, Brazil. Methods A cross-sectional study with 232 volunteers of both sexes at a private college. The Body Shape Questionnaire was used, which is a tool based on the sum of values that allow classifying body dissatisfaction according to the following scores: less than 111, if absence of body dissatisfaction; between 111 and 138, if mild body dissatisfaction; between 139 and 167, if moderate body dissatisfaction, and from 168, if severe body dissatisfaction. In addition, the self-reported body mass index and an assertion were used to assess the degree and perception (insight) of body dissatisfaction. For the statistical analysis, descriptive comparison, and binary logistic regression tests were performed. Results The mean result of the Body Shape Questionnaire among women was 96.0±34.1 and among men, 76.7±24.7, with 26.3% of students with some level of dissatisfaction with self-image. Most participants (76.3%) wished to have a body mass index lower than the real one. Women (odds ratio of 5.7), overweight individuals (odds ratio of 6.1), and individuals with insight into their condition (odds ratio of 89.7) were more likely to be dissatisfied with the body image measured by the Body Shape Questionnaire. Conclusion The search for a thin body among undergraduate medical students is a reality. In addition to overweight individuals, the female population has a significant level of body distortion, being recognized as the highest rate of body dissatisfaction in the sample surveyed.

Abuso sexual infantil y adolescente y su relación con trastornos alimentarios / Child and adolescent sexual abuse and its relationship with eating disorders

ANTECEDENTES: El antecedente de abuso sexual (AS) en la infancia o adolescencia en los trastornos alimentarios (TCA) está documentado en la experiencia clínica y en la literatura. Sin embargo, las complejas relaciones entre ambas condiciones no han sido sistematizadas. OBJETIVO: Describir la relación clínica y neurobiológica entre AS y TCA. MÉTODO: Se analizó exhaustivamente la literatura especializada en textos y artículos incluidos en Medline/PubMed, SciELO. Se perfilaron los conceptos centrales y se redactó la información buscando didáctica cohesión incluyendo un caso clínico ilustrativo. RESULTADOS: Aunque el AS es un factor inespecífico para el desarrollo de trastornos mentales, constituye un fenómeno significativo predisponente, desencadenante y perpetuante para la emergencia de un TCA, principalmente bulimia nerviosa. Se describen los factores de riesgo, mediadores, predictores, protectores y de resiliencia. Ambas condiciones poseen correlatos neurobiológicos y clínicos análogos (síntomas nucleares y funciones adaptativas). Existen disfunciones similares en los circuitos de recompensa y regulación emocional, con alteraciones estructurales distintas en áreas prefrontales. CONCLUSIONES: Existe contundente evidencia de la co-existencia de AS en los TCA. No obstante, es necesario continuar desarrollando modelos de investigación que integren realmente los procesos genéticos, hormonales, neurotransmisores, de personalidad y socioculturales de riesgo.

BACKGROUND: A history of childhood sexual abuse (SA) or adolescence in eating disorders (ED) is documented in clinical experience and in the literature. However, the complex relationships between both conditions have not been systematized. OBJECTIVE: To describe the clinical and neurobiological relationship between SA and ED. METHOD: The specialized literature in texts and articles included in Medline/PubMed, SciELO was thoroughly analysed. Central concepts were outlined and information was written seeking didactic cohesion, including an illustrative clinical case. RESULTS: Although SA is a nonspecific factor for the development of mental disorders, it constitutes a significant predisposing, triggering and perpetuating phenomenon for the emergence of ED, mainly bulimia nervosa. Risk, mediator, predictor, protective and resilience factors are described. Both specific conditions show analogous neurobiological and clinical correlates (core symptoms and adaptive functions). Similar dysfunctions exist in reward and emotional regulation circuits, with limited structural disturbances in prefrontal areas. CONCLUSIONS: There is strong evidence of the coexistence of SA in ED. However, it is necessary to develop research models that truly integrate genetic, hormonal, neurotransmitter, personality and sociocultural risk processes.

Relação entre comportamentos de risco para ortorexia nervosa, mídias sociais e dietas em estudantes de nutrição / Relationship between risk behaviors for orthorexia nervosa, social media and diets in nutrition students

O estudo visou identificar comportamentos de risco para ortorexia nervosa e sua relação com as mídias sociais, dietas da moda e período letivo em estudantes de Nutrição de uma Instituição de Ensino Superior em São Paulo. Trata-se de pesquisa transversal envolvendo 285 alunos. O questionário ORTO-15 avaliou comportamentos de risco para ortorexia nervosa e foi associado ao Questionário de Frequência e Uso de Mídias Sociais, aplicados via internet. Utilizou-se a análise de variância ANOVA one-way com post hoc de Fisher e teste t Student independente, adotando nível de significância de 0,05. Constatou-se tal comportamento em 72% da amostra, porém observou-se um declínio ao longo do curso. Aqueles que já fizeram dieta e usavam frequentemente mídias sociais digitais apresentaram escore significativamente menor, favorecendo o desenvolvimento da prática. Estudantes de nutrição revelaram-se um grupo suscetível a comportamentos ortoréxicos, que estão relacionados aos semestres cursados, à prática de realizar dietas e ao uso de mídias sociais. A conscientização dessa prática e a prevenção são necessárias devido aos riscos biopsicossociais.

The study aimed to identify risk behaviors for orthorexia nervosa and their relationship with social media, fad diets and academic term in nutrition students at a higher education institution in São Paulo. The method used was a cross-sectional study involving 285 students. ORTO-15 questionnaire assessed risk behaviors for orthorexia nervosa and was associated with the Frequency and Use of Social Media Questionnaire, applied through internet. ANOVA one-way analysis of variance was used with Fisher's post hoc and Student's t-test, adopting a significance level of 0.05. The orthorexic behavior was found in 72% of the sample, however, a decline was observed over the course. Those who have already dieted and frequently used social media had a significantly lower score, favoring the development of the practice. Nutrition students demonstrated to be a group susceptible to orthorexic behaviors and those behaviors are related to the semesters they are attending, fad diets and social media. Awareness of this practice and prevention are necessary, avoiding biopsychosocial losses.

Impulsividad y asertividad en mujeres con trastornos de la conducta alimentaria / Impulsivity and assertiveness in eating disordered women

ANTECENTES: Impulsividad y asertividad son dos de los rasgos más estudiados en los trastornos de la conducta alimentaria (TCA), aunque la impulsividad no ha sido suficientemente caracterizada y la evidencia en cuanto a asertividad es insuficiente. OBJETIVO: Analizar niveles de impulsividad y asertividad en mujeres con y sin TCA. MÉTODO: Se llevó a cabo un estudio analítico transversal, con muestreo no probabilístico en pacientes de sexo femenino con TCA, contrastándolas con mujeres controles sin TCA. Se aplicaron el Test de Actitudes Alimentarias (EAT-40), las escalas de Barratt (BIS) y de Rathus (RAS) a 42 sujetos controles y 42 con TCA. RESULTADOS: No hubo diferencias estadísticamente significativas entre grupos en cuanto a características sociodemográficas. El puntaje del EAT-40 fue mayor en las pacientes con TCA (p=0,000). No hubo diferencias significativas en RAS total, excepto en las subescalas R1 (p= 0,004) y R3 (p=0,035). El puntaje BIS total también tuvo diferencias significativas (p=0,003) así como las subescalas de Impulsividad Cognitiva (IC) (p=0,000) y de Impulsividad Motora (IM) (p=0,0032). Hubo correlación positiva, estadísticamente significativa entre los puntajes totales del EAT-40 y RAS, y las subescalas R1 y R2, y negativa entre EAT-40 y BIS, y las subescalas IC e IM. CONCLUSIONES: Las pacientes con TCA presentan niveles más elevados de impulsividad y más bajos de asertividad.

BACKGROUND: Impulsivity and assertiveness are two of the most studied features in eating disorders (ED), although impulsivity has not been sufficiently characterized and the evidence regarding assertiveness is scarce. OBJECTIVE: To analyse levels of impulsivity and assertiveness in women with and without ED. METHOD: A cross-sectional analytical study, with non-probabilistic sampling in female patients with ED was carried out, contrasting them with women without ED as controls. The Eating Attitude Test (EAT-40), the Barratt (BIS) and Rathus (RAS) scales were applied to 42 control subjects and 42 patients with ED. RESULTS: There were no statistically significant differences between groups in terms of sociodemographic characteristics. EAT-40 scores were higher in eating disordered patients (p = 0.000). There were no statistically significant differences between groups in total RAS scores, except for R1 (p = 0.004) and R3 (p = 0.035) subscales. Total BIS score also had statistically significant differences (p = 0.003) as well as Cognitive Impulsivity (CI) (p = 0.000) and Motor Impulsivity (IM) subscales (p = 0.0032). There was a statistically significant positive correlation between total scores of EAT-40 and RAS, and R1 and R2 subscales, and a statistically significant negative one between EAT-40 and BIS, and IC and IM subscales. CONCLUSIONS: Patients with ED have higher levels of impulsivity and lower levels of assertiveness.