Genetics in eating disorders: extending the boundaries of research / Genética em transtornos alimentares: ampliando os horizontes de pesquisa

OBJECTIVE: To review the recent literature relevant to genetic research in eating disorders and to discuss unique issues which are crucial for the development of a genetic research project in eating disorders in Brazil. METHOD: A computer literature review was conducted in the Medline database between 1984 and may 2005 with the search terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "binge eating disorder", "family", "twin" and "molecular genetic" studies. RESULTS: Current research findings suggest a substantial influence of genetic factors on the liability to anorexia nervosa and bulimia nervosa. Genetic research with admixed populations should take into consideration sample size, density of genotyping and population stratification. Through admixture mapping it is possible to study the genetic structure of admixed human populations to localize genes that underlie ethnic variation in diseases or traits of interest. CONCLUSIONS: The development of a major collaborative genetics initiative of eating disorders in Brazil and South America would represent a realistic possibility of studying the genetics of eating disorders in the context of inter ethnic groups, and also integrate a new perspective on the biological etiology of eating disorders.

OBJETIVO: Revisar a literatura atual concernente à pesquisa genética em transtornos do comportamento alimentar e discutir questões relevantes ao desenvolvimento de um projeto de pesquisa genética nessa área no Brasil. MÉTODO: A revisão realizada utilizou a base de dados Medline, no período de 1984 a maio de 2005, com os seguintes termos de busca: "anorexia nervosa", "bulimia nervosa", "eating disorders", "binge eating disorder", "family studies", "twin studies", "molecular genetics studies". RESULTADOS: Os dados atuais apontam para uma contribuição relevante dos fatores genéticos na suscetibilidade à anorexia e à bulimia nervosa. A pesquisa genética com populações miscigenadas deve levar em consideração o tamanho da amostra, a densidade de genotipagem e a estratificação populacional. Através de "admixture mapping" é possível estimar a estrutura genética destas populações e localizar genes relacionados à variação étnica de doenças ou traços de interesse. CONCLUSÕES: O desenvolvimento de uma grande iniciativa de colaboração em genética de transtornos alimentares no Brasil e na América Latina viabilizará estudar os fatores genéticos em transtornos do comportamento alimentar no contexto de grupos inter-étnicos, e integrar uma nova perspectiva biológica à etiologia destes distúrbios.

Binge eating disorder, anxiety, depression and body image in grade III obesity patients

INTRODUCTION: The objective of this study was to assess the frequency of Binge Eating Disorder (BED) or Binge Eating episodes (BINGE), anxiety, depression and body image disturbances in severely obese patients seeking treatment for obesity. METHOD: We assessed 50 patients (10M and 40F) with Body Mass Index (BMI) between 40 and 81.7 Kg/m² (mean 52.2±9.2 Kg/m²) and aging from 18 to 56 years (mean 38.5±9.7). Used instruments: Questionnaire on Eating and Weight Patterns ¾ Revised (QEWP-R) for BED or BINGE assessment, Beck Depression Inventory (BDI) for depressive symptoms, State - Trait Anxiety Inventory (STAI-TRAIT and STAI-STATE) for anxiety and Body Shape Questionnaire (BSQ) for body image assessments. RESULTS: In this population BED and BINGE frequencies were 36 percent and 54 percent, respectively. Symptoms of depression were detected in 100 percent while severe symptomatology was found in 84 percent of the cases. The frequency of anxiety as a trait was 70 percent, as a state, 54 percent and 76 percent of all patients reported discomfort regarding body image. The frequency of BED was higher in patients with higher anxiety scores as a personality trait (>40) but not as a state (46 percent vs. 13 percent; p<0,05). A high frequency of BINGE was found in those with higher scores (>140) in the BSQ assessment. CONCLUSION: Our results indicate a high frequency of binge eating episodes, severe depressive symptoms, anxiety and concern with body image in grade III obesity patients