Eating attitudes of anorexia nervosa, bulimia nervosa, binge eating disorder and obesity without eating disorder female patients: differences and similarities.

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.

Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15.

BACKGROUND: Orthorexia nervosa (ON) is described as an obsessive pathological behavior characterized by a strong preoccupation with healthy eating and the avoidance of foods or ingredients considered unhealthy by the subject. Although it is still not officially recognized as an eating disorder, previous studies have discussed its frequency in some groups and a fifteen-question test (ORTO-15) was developed elsewhere to assess ON behavior. OBJECTIVE: The present study aimed to evaluate ON behavior in a sample of Brazilian dietitians after testing the psychometric properties of the Portuguese version of ORTO-15. METHODS: A total of 392 dietitians answered an online version of the test. The answers were analyzed regarding ON tendency, according with the scoring grid proposed by its authors. Exploratory factor analysis was performed and internal consistency was assessed. RESULTS: It was found that three questions of the test presented loadings lower than 0.5. The 12 remaining question formed 3 factors with internal consistency of -0.51, 0.63 and 0.47. The answers of the participants to these questions revealed a tendency to orthorexic behavior, mainly regarding aspects such as: making food choices conditioned by worry about health status, evaluating food rather from nutritional quality than from its taste, believing that consuming healthy food may improve appearance, discrediting the influence of mood on eating behavior and banning food choices considered by them as eating transgressions. CONCLUSION: There is no evidence of the validity and reliability of the ORTO-15 with the initial psychometric evaluation performed. Further analyses are needed. Nevertheless, it was possible to observe a high frequency of orthorexic behavior among the studied Brazilian dietitians. However, additional studies are needed to completely understand dietitians behavior toward ON.

Nutritional aspects of eating episodes followed by vomiting in Brazilian patients with bulimia nervosa.

BACKGROUND: The clinical aspects of bulimia nervosa (BN) are similar in countries with different sociocultural backgrounds, but less is known about dietary composition in patients from developing countries. Little is also known about the role that nutritional aspects may play in behaviours aimed at counteracting the effects of binge eating. OBJECTIVES: To describe the daily energy intake and eating behaviour of BN patients in Brazil and compare the dietary patterns of the patients who terminated eating episodes by vomiting and those patients who did not. METHODS: Thirty patients from an eating disorders programme in a university-affiliated hospital completed a 14-day dietetic diary; the data were analysed using nutritional software. RESULTS: Mean age and BMI of the patients were respectively 27.2 +/- 9.6 years and 25.5 +/- 6.7 Kg/m2. The patients in the vomiting subgroup ate more irregularly and consumed a more variable number of meals per day than those in the non-vomiting subgroup. The daily energy intake of the patients as a whole was 2,202 kcal, with a macronutrient composition of 53% carbohydrates, 31% fats and 17% proteins. The mean energy intake of the eating episodes followed by vomiting was 1,331 kcal with a macronutrient profile of 51% carbohydrates, 36% fat and 14% protein. Intake and eating patterns were characterised by between- and within- individual variability, and so no significant differences were found in the subgroup comparisons. Foods with a high energy density were preferred during the eating episodes followed by vomiting. CONCLUSIONS: The results indicate that patients who vomit have a more irregular and variable eating pattern than those who do not vomit, but their daily nutrient content is comparable.