Variantes da neurose tipo / Variations of type neurosis / Variantes de la névrose type

Na obra de Sigmund Freud, é possível localizarmos outra teoria da neurose que não está ancorada na existência de sintomas oriundos do processo defensivo próprio ao recalque, como pudemos verificar na constituição da neurose de caráter e das neuroses atuais. A evidência de tal problemática, presente já na elaboração teórica freudiana, nos leva à atualidade de nossa clínica. Na prática psicanalítica contemporânea, nos deparamos, cada vez mais, com fenômenos sintomáticos que não correspondem a sintomas propriamente ditos. O fenômeno da obesidade para alguns sujeitos evidencia uma forma de defesa inconsciente primária, mais arcaica, sem a produção de conflito psíquico e não sendo possível a satisfação da pulsão por meio do sintoma. A obesidade pode ser localizada como uma variante da neurose.

In Sigmund Freud's work it is possible to locate another theory of neurosis that is not anchored in the existence of symptoms arising from the defensive process at work in repression, as we could see in the constitution of the character neurosis and in the current neuroses. The evidence of such a problem, already present in the Freudian theoretical preparation, takes us to the present day of our clinic. In contemporary psychoanalytic practice, we are increasingly faced with symptomatic phenomena that do not correspond to symptoms themselves. The phenomenon of obesity for some subjects is evidence of a primary, more archaic form of unconscious defense, without the production of psychic conflict, and in which it is not possible to satisfy the drive through the symptom. Obesity can be located as a variant of neurosis.

Il est possible de localiser, dans l'œuvre de Sigmund Freud, une autre théorie de la névrose qui n'est pas ancrée dans l'existence de symptômes issus du processus défensif propre au refoulement, comme nous avons pu vérifier dans la constitution de la névrose de caractère et des névroses actuelles. L'évidence d'une telle problématique, présente déjà dans l'élaboration théorique freudienne, nous conduit à l'actualité de notre clinique. Dans la pratique psychanalytique contemporaine, nous sommes confrontés, de plus en plus, à des phénomènes symptomatiques qui ne correspondent pas à des symptômes proprement dits. Le phénomène de l'obésité pour certains sujets met en évidence une forme de défense inconsciente primaire, plus archaïque, sans la production de conflit psychique, n'étant pas possible la satisfaction de la pulsion par le symptôme. L'obésité peut être localisée comme une variante de la névrose

Sarcopenia in chronic kidney disease: prevalence by different definitions and relationship with adiposity.

This was a cross-sectional study with chronic kidney disease (CKD) patients under non-dialysis-dependent (NDD), hemodialysis (HD), and kidney transplant (KTx) treatment aimed to evaluate the prevalence of sarcopenia using the European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) guidelines, and to analyze the relationship between sarcopenia and its components and body adiposity. Body composition was assessed by dual-energy X-ray absorptiometry and anthropometry. Bioelectrical impedance provided data on the phase angle and body water. The prevalence of sarcopenia in the total sample (n = 243; 53% men, 48 ± 10 years) was 7% according to the FNIH and 5% according to the EWGSOP2 criteria, and was low in each CKD group independently of the criteria applied (maximum 11% prevalence). Low muscle mass was present in 39% (FNIH) and 36% (EWGSOP2) and dynapenia in 10% of the patients. Patients who were sarcopenic according to the EWGSOP2 criteria presented low body adiposity. Conversely, patients who were sarcopenic according to the FNIH criteria presented high adiposity. This study suggests that in CKD (i) sarcopenia and low muscle mass prevalence varies according to the diagnostic criteria; (ii) sarcopenia and low muscle mass are common conditions; (iii) the association with body adiposity depends on the criteria used to define low muscle mass; and (iv) the FNIH criteria detected higher adiposity in individuals with sarcopenia. Novelty: Prevalence of sarcopenia and low muscle mass in CKD varied according to the diagnostic criteria. Association of excess adiposity with sarcopenia and low muscle mass depends on muscle mass index applied. FNIH criteria detected higher adiposity in individuals with sarcopenia and low muscle mass.

Psicanálise no tratamento multidisciplinar e cirúrgico da obesidade mórbida: estudo de caso / Psychoanalysis in the multidisciplinary and surgical treatment of morbid obesity: a case study / La psychanlyse dans le traitement multidisciplinaire et chirurgie de l'obésité morbide: une étude de cas / Psicoanálisis en el tratamiento multidisciplinario y quirúrgico de la obesidad mórbida: estudio de caso

O objetivo do estudo é avaliar o processo psicoterapêutico de abordagem psicanalítica kleiniana como contribuição na melhoria da saúde de pacientes submetidos a cirurgia bariátrica. O método é de estudo de caso baseado na análise de vinheta clínica, acompanhado de levantamento bibliográfico. Analisaram-se trechos de conversas do processo psicoterapêutico de uma mulher obesa de 53 anos que procurou uma instituição dedicada ao tratamento cirúrgico da obesidade grave com enfoque multiprofissional. Após diagnóstico de obesidade mórbida, foi efetuada uma avaliação psicológica inicial. Como extensão, seguiu-se o processo psicoterapêutico de abordagem psicanalítica com frequência de uma vez por semana, passando depois a duas vezes. Dois meses após o primeiro encontro, a paciente submeteu-se à cirurgia bariátrica. A psicoterapia já tem a duração de três anos. Como resultado, a paciente tornou-se mais capaz de entrar em contato com o sentimento de desamparo associado ao fator destrutividade, que aparece em cenas narrativas de vingança, inveja e ciúme. Concluiu-se que o processo psicanalítico se mostrou efetivo: a paciente adquiriu mais condições de preservar suas redes afetivas constituintes, e tornou-se menos vulnerável à ansiedade e impulsividade, favorecendo a permanência da redução da obesidade e evitando a formação de outras situações de padecimento, como o alcoolismo. Essas observações confirmam algumas referências já apontadas na literatura.

We assessed the psychotherapeutic process based on a Kleinian psychoanalytic approach as a contribution to improve the health of patients undergoing bariatric surgery. To that end, we performed a case study based on the analysis of a clinical vignette accompanied by a literature review. We analyzed excerpts of conversations of the psychotherapeutic process of a very obese 53-year-old woman who sought an institution dedicated to the surgical treatment of severe obesity relying on a multidisciplinary approach. After a diagnosis of morbid obesity, an initial psychological evaluation was performed. As an extension, a psychotherapeutic process based on a psychoanalytical approach took place once a week and then later twice a week. Two months after the first meeting, the patient underwent bariatric surgery. To date, the psychotherapeutic process has lasted for three years. As a result, the patient managed to get in touch with her feeling of helplessness associated with a destructiveness factor, which appears in narrative scenes of revenge, envy and jealousy. We conclude that the psychoanalytic process proved to be effective: the patient was able to preserve her constituent affective networks and became less vulnerable to anxiety and impulsivity, favoring reduction of obesity and avoiding situations of suffering such as alcoholism. Our observations confirm some references already mentioned in the literature.

Le but de cette étude est d'évaluer le processus psychothérapeutique à l'aide d'une approche psychanalytique kleinienne pour contribuer à l'amélioration de la santé des patients subissant une chirurgie bariatrique. Pour atteindre ce but, une étude de cas a été développée à partir de la littérature et de l'analyse de vignettes cliniques et on a analysé des extraits de conversations du processus psychothérapeutique d'une femme de 53 ans qui recherchait une institution de traitement chirurgical de l'obésité sévère qui a pour base une approche multidisciplinaire. Après un diagnostic d'obésité morbide, un premier bilan psychologique a été réalisé. En prolongement, le processus psychothérapeutique basé sur une approche psychanalytique a été suivi, une fois par semaine au début et plus tard deux fois par semaine. Deux mois après la première rencontre, la patiente a subi une chirurgie bariatrique. La psychothérapie dure depuis trois ans et a permis à la patiente de faire face à son sentiment de détresse associé au facteur destructif qui surgit dans des scènes narratives de vengeance, d'envie et de jalousie. On conclut que le processus psychanalytique s'est avéré efficace: la patiente a réussi à préserver ses réseaux constitutifs affectifs et est moins vulnérable à l'anxiété et à l'impulsivité, favorisant la permanence de la réduction de l'obésité et évitant la formation d'autres situations de souffrance, comme l'alcoolisme. Ces observations confirment certaines références que l'on trouve dans la littérature.

El objetivo del estudio es evaluar el proceso psicoterapéutico a través de un enfoque psicoanalítico kleiniano como contribución a la mejora de la salud de los pacientes sometidos a cirugía bariátrica. Se trata de un estudio de caso basado en el análisis de una viñeta clínica acompañada por una encuesta bibliográfica. Se analizaron extractos de conversaciones del proceso psicoterapéutico de una mujer obesa de 53 años que acudió a una institución dedicada al tratamiento quirúrgico de la obesidad severa con un abordaje multidisciplinario. Después de un diagnóstico de obesidad mórbida, se realizó una evaluación psicológica inicial. Como extensión, se siguió el proceso psicoterapéutico con enfoque psicoanalítico, inicialmente, una vez por semana y después, dos veces por semana. Dos meses después del primer encuentro, la paciente fue sometida a cirugía bariátrica. La psicoterapia ha durado tres años. Como resultado, la paciente se volvió más capaz de conectarse al sentimiento de desamparo asociado al factor destructividad, que aparece en escenas narrativas de venganza, envidia y celos. Se concluyó que el proceso psicoanalítico resultó ser efectivo: la paciente adquirió más condiciones para preservar sus redes afectivas constituyentes y se volvió menos vulnerable a la ansiedad y a la impulsividad, favoreciendo la permanencia de la reducción de la obesidad y evitando la formación de otras situaciones de sufrimiento, como el alcoholismo. Estas observaciones confirman algunas referencias ya mencionadas en la literatura.

Green banana flour supplementation improves obesity-associated systemic inflammation and regulates gut microbiota profile in mice fed high-fat diets.

This study evaluated the effect of green banana flour (GBF) consumption on obesity-related conditions in mice fed high-fat diets. GBF was prepared using stage 1 green banana pulp, which was dehydrated and milled. Mice were fed a control diet (n = 20; 10% of energy from lipids) or a high-fat diet (n = 20; 50% of energy from lipids). After 10 weeks, mice were divided into 4 groups based on feed: standard chow (SC; n = 10), standard with 15% GBF (SB; n = 10), high-fat diet (HF; n = 10) and high-fat diet with 15% GBF (HFB; n = 10) for 4 weeks. HFB exhibited lower gains in body weight (-21%; p < 0.01) and in all fat pads (p < 0.01) compared with the HF group. SC, SB, and HFB showed smaller retroperitoneal white adipose tissue diameters (p < 0.001). SB and HFB-treated mice showed lower levels of leptin, IL-6, and TNF-α compared with the SC and HF groups (p < 0.01). In the GBF-fed groups, there was a reduction in the abundance of Firmicutes (SB: -22%; HFB: -23%) and an increase in Bacteroidetes (SB: +25%; HFB: +29%) compared with their counterparts. We demonstrated that GBF consumption attenuated inflammation and improved metabolic status, adipose tissue remodeling, and the gut microbiota profile of obese mice. Novelty: Green banana flour (GBF) consumption, rich in resistant starch, regulates body weight in mice fed high-fat diets. GBF consumption improves fat pad distribution in mice fed high-fat diets. GBF improves obesity-associated systemic inflammation and regulates gut microbiota profile in mice fed high-fat diets.

Muscle strength cut-points for metabolic syndrome detection among adults and the elderly from Brazil.

We aimed to determine cut-points for muscle strength based on metabolic syndrome diagnosis. This cross-sectional analysis comprised data from 2 cohorts in Brazil (EpiFloripa Adult, n = 626, 44.0 ± 11.1 years; EpiFloripa Aging, n = 365, 71.6 ± 6.1 years). Metabolic syndrome was assessed by relative handgrip strength (kgf/kg). Metabolic syndrome was defined as including ≥3 of the 5 metabolic abnormalities according to the Joint Interim Statement. Optimal cut-points from Receiver Operating Characteristic (ROC) curves were determined. Adjusted logistic regression was used to test the association between metabolic syndrome and the cut-points created. The cut-point identified for muscle strength was 1.07 kgf/kg (Youden index = 0.310; area under the curve (AUC)) = 0.693, 95% CI 0.614-0.764) for men and 0.73 kgf/kg (Youden index = 0.481; AUC = 0.768, 95% confidence interval (CI) = 0.709-0.821) for women (age group 25 to < 50 years). The best cut-points for men and women aged 50+ years were 0.99 kgf/kg (Youden index = 0.312; AUC = 0.651; 95% CI = 0.583-0.714) and 0.58 kgf/kg (Youden index = 0.378; AUC = 0.743; 95% CI = 0.696-0.786), respectively. Cut-points derived from ROC analysis have good discriminatory power for metabolic syndrome among adults aged 25 to <50 years but not for adults aged 50+ years. Novelty: First-line management recommendation for metabolic syndrome is lifestyle modification, including improvement of muscle strength. Cut-points for muscle strength levels according to sex and age range based on metabolic syndrome were created. Cut-points for muscle strength can assist in the identification of adults at risk for cardiometabolic disease.

Higher blood glucose impairs cardiac autonomic modulation in fasting and after carbohydrate overload in adults.

This study aimed to assess whether the blood glucose levels influence cardiac autonomic modulation under fasting and after carbohydrate overload conditions. Participants (n = 108) were separated into lower blood glucose and higher blood glucose groups, based on the median (90.5 mg·dL-1) of fasting glucose assessed. The SD2, SDNN, LF indices, and LF/HF increased, and HF decreased after dextrose overload compared with fasting (p < 0.05). Body mass (78.9 vs 69.7 kg), abdominal circumference (90.2 vs 82.2 cm), systolic (113 vs 108 mm Hg) and diastolic (72 vs 67 mm Hg) blood pressure were higher (p < 0.05) in the higher blood glucose group. Heart rate variability (HRV) indices (SD1: 21.0 vs 26.5; SD2: 76.8: vs 86.1; RMSSD: 28.7 vs 37.5; SDNN: 56.1 vs 62.5 ms; pNN50: 10.6 vs 18.9%, HF: 328.4 vs 506.0; LF: 982.8 vs 1259.0 ms2), and the area under the curve of these indices after dextrose overload were lower in the higher blood glucose group (p < 0.05). Additionally, glycemia after dextrose overload was correlated with HRV indices (ρ = -0.216 to -0.273, p < 0.05). Individuals with higher blood glucose, even in the normality range, showed impairment in the cardiac autonomic modulation both at fasting and after carbohydrate overload. Novelty: Higher fasting blood glucose impairs cardiac autonomic modulation. Carbohydrate overload impairs cardiac autonomic modulation.

Actividad física y estado nutricional en escolares del sureste mexicano / Physical activity and nutritional status in Mexican southeast scholars / Atividade física e estado nutricional em escolares do sudeste do México / Activité physique et état nutritionnel des écoliers du sud-est mexicain

Resumen Objetivo: La presente investigación tiene como objetivo principal, describir la relación entre el nivel de actividad física y el estado nutricional de los escolares de Tabasco, estado que pertenece a la región sureste de México. Material y métodos: Se utilizó un diseño descriptivo-correlacional con muestreo probabilístico irrestricto aleatorio, en una muestra de 2,084 escolares inscritos en seis escuelas de educación primaria de Tabasco. Los datos se recolectaron a través del "Four by One-day physical activity questionare", además de valoraciones antropométricas. Resultados: Los resultados mostraron que el 46.3% de los escolares se encuentran en sobrepeso y obesidad; y que las actividades físicas realizadas con mayor frecuencia por los escolares son de tipo muy ligero, lo que indica menor gasto energético. También se refleja que del 62% de infantes muy inactivos, las niñas representan el 34.7%, lo que indica que son más inactivas en comparación con los niños. Se encontró una relación negativa estadísticamente significativa (rs = -.105, p=.001) de la actividad física con el estado nutricional.

Abstract Objective: The main objective of this research is to describe relationship between physical activity and nutritional status level of schoolchildren in Tabasco, a southeastern state from Mexico. Materials and methods: It was used a descriptive-correlational design with random unrestricted probabilistic of 2,084 schoolchildren sample enrolled in six primary schools in Tabasco. Data was collected through the "Four by One-day physical activity questionnaire", in addition to anthropometric assessments. Results: The results showed that 46.3% of schoolchildren are overweight and obese and that the physical activities most frequently carried out by schoolchildren are very light, indicating lower energy expenditure. It is also reflected that from 62% of very inactive infants, girls represent 34.7%, indicating they are more inactive compared to boys. It was found a statistically significant negative relationship (rs = -, 105, p =, 001) of physical activity with nutritional status.

Resumo Objetivo: O principal objetivo desta pesquisa é descrever a relação entre nível de atividade física e o estado nutricional de escolares em Tabasco, um estado pertencente à região sudeste do México. Materiais e métodos: foi utilizado um desenho descritivo-correlacional com amostragem probabilística irrestrita aleatória em uma amostra de 2.084 escolares matriculados em seis escolas primárias de Tabasco. Os dados foram coletados por meio do "questionário de atividade física de quatro por um dia", além de avaliações antropométricas. Resultados: Os resultados mostraram que 46,3% dos escolares estão com sobrepeso e obesos e que as atividades físicas mais frequentemente realizadas pelos escolares são muito leves, indicando menor gasto energético. Também se reflete que, de 62% dos bebês muito inativos, as meninas representam 34,7%, indicando que são mais inativas em comparação aos meninos. Foi encontrada uma relação negativa estatisticamente significativa (rs = -, 105, p =, 001) da atividade física com o estado nutricional.

Résumé Objectif: Le principal objectif de cette recherche est de décrire la relation entre le niveau d'activité physique et l'état nutritionnel des écoliers de Tabasco, un état de la région sud-est du Mexique. Matériel et méthodes: Un plan descriptif-corrélationnel a été utilisé avec un échantillon aléatoire sans restriction de 2084 élèves inscrits dans six écoles primaires de Tabasco. Les données ont été collectées par le biais du «Four by One-day Physical Activity Questionnaire¼, en plus d'évaluations anthropométriques. Résultats: Les résultats ont montré que 46,3% des écoliers sont en surpoids ou obèses et que les activités physiques qu'ils pratiquent le plus fréquemment sont de très légère intensité, ce qui indique une faible dépense énergétique. Il ressort également que parmi les 62% d'enfants très inactifs, les filles représentent 34,7%, ce qui indique qu'elles sont plus inactives que les garçons. Une relation négative statistiquement significative (rs = -.105, p = .001) de l'activité physique avec l'état nutritionnel a été trouvée.

Caloric restriction-induced weight loss with a high-fat diet does not fully recover visceral adipose tissue inflammation in previously obese C57BL/6 mice.

Caloric restriction (CR) reduces body weight and systemic inflammation, but the effects on adipose tissue under dietary lipid overload are controversial. We evaluated the effects of CR-induced weight loss with a high-fat diet on adipose tissue inflammation of obese mice. Male mice were assigned into low-fat diet (LF) and high-fat diet (HF) groups. After 8 weeks, the mice in the HF group were reassigned for another 7 weeks into the following 3 conditions: (i) kept in the HF condition; (ii) changed to low-fat diet ad libitum (LFAL); and (iii) changed to high-fat calorie-restricted (RHF) diet to reach LFAL body weight. Serum markers, adipocytokines, morphology, and inflammatory infiltrates in retroperitoneal adipose tissue (RAT) were accessed. The body weights of the LFAL and RHF groups were reduced, equaling the body weights of the LF group. The LFAL mice had restored almost all inflammatory markers as the LF mice, except tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and adiponectin. Compared with the HF group, the RHF group had lowered visceral adiposity, retroperitoneal adipocyte sizes, and RAT inflammatory cell infiltration, as well as TNF-α, interleukin-6, and hepatic and serum C-reactive protein, which were higher than that of the LFAL group; adiponectin and MCP-1 did not change. CR with high-fat diet reduced body weight and attenuated visceral adiposity but did not fully recover visceral tissue inflammation. Novelty Caloric restriction in a high-fat diet ameliorated visceral adiposity. Caloric restriction in a high-fat diet did not recover visceral adipose tissue inflammation.

Lipid droplets are both highly oxidized and Plin2-covered in hepatocytes of diet-induced obese mice.

Chronic high-fat diet feeding is associated with obesity and accumulation of fat in the liver, leading to the development of insulin resistance and nonalcoholic fatty liver disease. This condition is characterized by the presence of a high number of intrahepatic lipid droplets (LDs), with changes in the perilipin pattern covering them. This work aimed to describe the distribution of perilipin (Plin) 2, an LD-associated protein involved in neutral lipid storage, and Plin5, which favors lipid oxidation in LD, and to evaluate lipid peroxidation through live-cell visualization using the lipophilic fluorescent probe C11-BODIPY581/591 in fresh hepatocytes isolated from mice fed a high-fat diet (HFD). Male C57BL/6J adult mice were divided into control and HFD groups and fed with a control diet (10% fat, 20% protein, and 70% carbohydrates) or an HFD (60% fat, 20% protein, and 20% carbohydrates) for 8 weeks. The animals fed the HFD showed a significant increase of Plin2 in LD of hepatocytes. LD from HFD-fed mice have a stronger lipid peroxidation level than control hepatocytes. These data provide evidence that obesity status is accompanied by a higher degree of lipid peroxidation in hepatocytes, both in the cytoplasm and in the fats stored inside the LD. Novelty Our study shows that lipid droplets from isolated hepatocytes in HFD-fed mice have a stronger lipid peroxidation level than control hepatocytes. C11-BODIPY581/591 is a useful tool to measure the initial level of intracellular lipid peroxidation in single isolated hepatocytes. Perilipins pattern changes with HFD feeding, showing an increase of Plin2 covering lipid droplets.

Effects of functional training and 2 interdisciplinary interventions on maximal oxygen uptake and weight loss of women with obesity: a randomized clinical trial.

Our aim was to analyze and compare functional training, interdisciplinary therapy, and interdisciplinary education on cardiorespiratory fitness (CF) and anthropometric characteristics of women with obesity. Forty-four women (age = 39.7 ± 5.9 years, body mass index (BMI) = 35.5 ± 2.8 kg/m2) completed 30 weeks of intervention randomly assigned to 3 groups: functional training (FT) (n = 14), interdisciplinary therapy (IT) (n = 19), and interdisciplinary education (IE) (n = 11). The FT group participated in the training program (3/week), the IT group received the same training intervention plus nutrition (1/week) and psychology advice (1/week) and physical therapy (1/week). The IE group participated in interdisciplinary lectures on topics related to health promotion (1/month). CF (ergospirometry), anthropometry, and body composition (electrical bioimpedance) were measured pre-intervention (Pre) and post-intervention (Post). CF increased (p ≤ 0.05) significantly (Pre vs. Post) in the FT (7.5%) and IT (10.8%) groups, but not in the IE group (1.8%). Body mass (BM), BMI, relative fat mass, and waist circumference significantly (p ≤ 0.05) decreased (Pre vs. Post) in IT (-4.4%, -4.4%, -2.3%, and -5.1%, respectively). The IE group showed a significant decrease in BM (-3.7%), BMI (-3.7%), and waist circumference (-3.5%), whereas the FT group promoted significant decrease in waist circumference (-3.4%). In conclusion, functional training increased CF but only interdisciplinary interventions improved the anthropometric profile of women with obesity. Novelty Interdisciplinary therapy provided more comprehensive adaptations in women with obesity, including morphological variables and CF. Functional training increased CF but reduced only abdominal obesity. Interdisciplinary education provided benefits on morphological variables, but it does not increase CF.

Omega-3 polyunsaturated fatty acids have beneficial effects on visceral fat in diet-induced obesity model.

This study evaluated the effects of omega-3 polyunsaturated fatty acids (PUFAs) on oxidative stress and energy metabolism parameters in the visceral fat of a high-fat-diet induced obesity model. Energy intake, body mass, and visceral fat mass were also evaluated. Male Swiss mice received either a control diet (control group) or a high-fat diet (obese group) for 6 weeks. After this period, the groups were divided into control + saline, control + omega-3, obese + saline, and obese + omega-3, and to these groups 400 mg·(kg body mass)-1·day-1 of fish oil (or saline) was administered orally, for 4 weeks. Energy intake and body mass were monitored throughout the experiment. In the 10th week, the animals were euthanized and the visceral fat (mesenteric) was removed. Treatment with omega-3 PUFAs did not affect energy intake or body mass, but it did reduced visceral fat mass. In visceral fat, omega-3 PUFAs reduced oxidative damage and alleviated changes to the antioxidant defense system and the Krebs cycle. The mitochondrial respiratory chain was neither altered by obesity nor by omega-3 PUFAs. In conclusion, omega-3 PUFAs have beneficial effects on the visceral fat of obese mice because they mitigate changes caused by the consumption of a high-fat diet.

Indicadores socioeconómicos de obesidad materna. El estudio de una cohorte en Morelos, México / Socioeconomic indicators of maternal obesity. Study of a cohort in Morelos, México / Indicadores socioeconómicos da obesidade materna. Estudo de uma coorte no Morelos, México / Indicateurs socio-économiques de l'obésité maternelle. Étude d'une cohorte au Morelos, Mexique

Resumen: Objetivo: Identificar y analizar desde una perspectiva cuanti/cualitativita los indicadores socioeconómicos de la obesidad materna en México. Material y métodos: Investigación evaluativa basada en un diseño de cohorte de tipo prospectivo/descriptivo. El tamaño de la muestra se conformó por todas las mujeres que llegaron a consulta prenatal a partir de la semana 24 de gestación en un hospital de referencia estatal. El tamaño de la muestra se estimó con un 80% de poder y 95% de confianza y significancia. Los indicadores de interés fueron aspectos socioeconómicos, alimentación, antropometría, dieta, seguridad alimentaria y actividad física. El análisis cuantitativo se realizó utilizando el software Stata versión 14 y el análisis cualitativo con Atlas-ti versión 8.0. Resultados: La cohorte estuvo conformada por 402 mujeres embarazadas en 2017. De los resultados principales encontramos que el 55% de las mujeres se encontraba en el rango de edad de 18-24 años; el 15% de las mujeres refirió contar con un empleo remunerado; el 42% de la población tenía secundaria completa; el 32.1% presentó un grado de inseguridad alimentaria; la media de IMC fue de 27.8±4.8, el 48% de las mujeres presentaron sobrepeso y obesidad. Conclusiones: Los resultados cuantitativos sugieren que poblaciones con mayor vulnerabilidad socio-económica, inseguridad alimentaria y escasa actividad física, son más propensas a la obesidad materna. Los resultados cualitativos, además de complementar y reforzar los resultados cuantitativos, plantean evidencias para identificar a mayor detalle las barreras y facilitadores para fortalecer programas de intervención en la prevención de la obesidad materna.

Abstract; Objective: To identify and analyze from a quantitative / qualitative perspective the socioeconomic indicators of maternal obesity in Mexico. Methods and material: Evaluative research based on a prospective / analytical cohort design. The sample size was established by all the women who came to the antenatal clinic from the 24th week of gestation in a state referral hospital. The sample size was estimated with 80% power and 95% confidence and significance. The indicators of interest were socioeconomic aspects, nutrition, anthropometry, diet, food safety and physical activity. The quantitative analysis was performed using the Stata version 14 software and the qualitative analysis with Atlas-ti version 8.0. Results: The cohort was comprised of 402 pregnant women in 2017. From the main results we found that 55% of the women were in the age range of 18-24 years; 15% of women reported having a paid job; 42% of the population had full secondary education; 32.1% presented a degree of food insecurity; the mean BMI was 27.8 ± 4.8, 48% of the women were overweight and obese. Conclusions: Quantitative results suggest that populations with greater socio-economic vulnerability, food insecurity and low physical activity are more prone to maternal obesity. The qualitative results, besides complementing and reinforcing the quantitative results, present evidence to identify in greater detail the barriers and facilitators to strengthen intervention programs in the prevention of maternal obesity.

Resumo: Objetivo: Identificar e analisar, de uma perspectiva quantitativa / qualitativa, os indicadores socioeconômicos da obesidade materna no México. Materiais e métodos: Pesquisa avaliativa baseada em um desenho de coorte prospectivo / analítico. O tamanho da amostra foi estabelecido por todas as mulheres que chegaram à clínica pré-natal a partir da 24a semana de gestação em um hospital estadual de referência. O tamanho da amostra foi estimado com 80% de poder e 95% de confiança e significância. Os indicadores de interesse foram aspectos socioeconómicos, nutrição, antropometria, dieta, segurança alimentar e atividade física. A análise quantitativa foi realizada utilizando o software Stata versão 14 e a análise qualitativa com Atlas-ti versão 8.0. Resultados: A coorte foi composta por 402 gestantes em 2017. Dos principais resultados, constatou-se que 55% das mulheres encontravam- se na faixa etária de 18 a 24 anos; 15% das mulheres relataram ter um emprego remunerado; 42% da população tinha ensino secundário completo; 32,1% apresentaram grau de insegurança alimentar; a média do IMC foi de 27,8 ± 4,8, 48% das mulheres estavam acima do peso e obesas. Conclusões: Os resultados quantitativos sugerem que populações com maior vulnerabilidade socioeconómica, insegurança alimentar e baixa atividade física são mais propensas à obesidade materna. Os resultados qualitativos, além de complementar e reforjar os resultados quantitativos, apresentam evidencias para identificar em maior detalhe as barreiras e facilitadores para fortalecer os programas de intervenção na prevenção da obesidade materna.

Résumé: Objectif: Identifier et analyser d'un point de vue quantitatif / qualitatif les indicateurs socio-économiques de l'obésité maternelle au Mexique. Matériel et méthodes: Recherche évaluative basée sur une conception de cohorte prospective / analytique. La taille de l'échantillon a été établie par toutes les femmes qui sont venues á la clinique prénatale á partir de la 24e semaine de gestation dans un hópital de référence. La taille de l'échantillon a été estimée avec 80% de puissance et 95% de confiance et de signification. Les indicateurs d'intéret étaient les aspects socio-économiques, la nutrition, l'anthropométrie, l'alimentation, la sécurité alimentaire et l'activité physique. L'analyse quantitative a été réalisée á l'aide du logiciel Stata version 14 et de l'analyse qualitative avec Atlas-ti version 8.0. Résultats: La cohorte était composée de 402 femmes enceintes en 2017. D'aprés les principaux résultats, nous avons constaté que 55% des femmes étaient agées de 18 á 24 ans; 15% des femmes ont déclaré avoir un travail rémunéré; 42% de la population ont fait des études secondaires complétes; 32,1% présentaient un degré d'insécurité alimentaire; l'IMC moyen était de 27,8 ± 4,8, 48% des femmes étaient en surpoids et obéses. Conclusions: Les résultats quantitatifs suggérent que les populations ayant une plus grande vulnérabilité socio-économique, l'insécurité alimentaire et une faible activité physique sont plus sujettes á l'obésité maternelle. Les résultats qualitatifs, en plus de compléter et de renforcer les résultats quantitatifs, présentent des preuves pour identifier plus en détail les obstacles et les facilitateurs pour renforcer les programmes d'intervention dans la prévention de l'obésité maternelle.

ARHGAP21 deficiency impairs hepatic lipid metabolism and improves insulin signaling in lean and obese mice.

ARHGAP21 is a Rho-GAP that controls GTPases activity in several tissues, but its role on liver lipid metabolism is unknown. Thus, to achieve the Rho-GAP role in the liver, control and ARHGAP21-haplodeficient mice were fed chow (Ctl and Het) or high-fat diet (Ctl-HFD and Het-HFD) for 12 weeks, and pyruvate and insulin tolerance tests, insulin signaling, liver glycogen and triglycerides content, gene and protein expression, and very-low-density lipoprotein secretion were measured. Het mice displayed reduced body weight and plasma triglycerides levels, and increased liver insulin signaling. Reduced gluconeogenesis and increased glycogen content were observed in Het-HFD mice. Gene and protein expression of microsomal triglyceride transfer protein were reduced in both Het mice, while the lipogenic genes SREBP-1c and ACC were increased. ARHGAP21 knockdown resulted in hepatic steatosis through increased hepatic lipogenesis activity coupled with decreases in CPT1a expression and very-low-density lipoprotein export. In conclusion, liver of ARHGAP21-haplodeficient mice are more insulin sensitive, associated with higher lipid synthesis and lower lipid export.

Aspectos psicossociais relacionados à imagem corporal de pessoas com excesso de peso / Psychosocial aspects related to body image of people with excess weight / Aspectos psicosociales relacionados a la imagen corporal de personas con sobrepeso / Aspects psychosociaux par rapport à l'image corporelle chez les personnes en surpoids

A obesidade, além de ser uma doença com impacto na saúde física e psicológica, é acompanhada por estigmas socialmente construídos no que tange, também, à imagem corporal. Comumente, verifica-se, entre as pessoas com excesso de peso, uma insatisfação com a imagem corporal. Este estudo teve por objetivo investigar a imagem corporal de pessoas com excesso de peso e os aspectos psicossociais vivenciados por elas. Participaram desta pesquisa 58 pessoas com sobrepeso ou obesidade (média de idade de 38,53 anos; DP=10,69). Para a coleta dos dados foram utilizados um questionário sociodemográfico e clínico, a escala de figuras de Stunkard e uma entrevista semiestruturada. Os resultados apontaram que nenhum dos participantes estava satisfeito com sua imagem corporal. No que diz respeito à análise dos conteúdos das entrevistas, emergiram quatro categorias, a saber: Insatisfação com imagem: os participantes declararam não gostar e/ou não se sentirem bem com a sua imagem, identificando-se a presença de conceitos autodepreciativos, permeados por sentimentos de tristeza, vergonha e a sensação de não se reconhecer naquele corpo; Insatisfação com o excesso de peso: partes do corpo foram relatadas como incômodas e, além disso, há uma preocupação com a saúde, dores e dificuldades causadas pelo peso emergiram como fatores que geram desconforto com o próprio corpo; Preconceito: apresenta-se na forma de comentários direcionados, atitudes negativas, atenção indesejada, olhares de reprovação e de curiosidade; e Aceitam-se como são: não possuem uma relação negativa com a própria imagem, mesmo se sentindo incomodados, aceitam-se como são. Os resultados deste estudo demonstram a necessidade de expandir a abordagem das pessoas com excesso de peso para além dos problemas relacionados à esfera físico-biológica, uma vez que o cuidado em saúde requer a perspectiva da integralidade.

Obesity, in addition to being a disease with an impact on physical and psychological health, is accompanied by socially constructed stigmas regarding body image. Commonly, there is dissatisfaction with body image among overweight people. This study aimed to investigate the body image of overweight people and the psychosocial aspects they experienced. 58 people who were overweight or obese (mean age 38.53 years; SD = 10.69) participated in this study. A sociodemographic and clinical questionnaire was used to collect the data, the Stunkard figures scale, and a semi-structured interview. The results showed that none of the participants were satisfied with their body image. Regarding the analysis of interview content, four categories emerged: Image dissatisfaction: participants stated that they did not like and / or did not feel well with their image, identifying the presence of self-deprecating concepts permeated by feelings of sadness, shame and the sensation of not recognizing oneself in that body; Dissatisfaction with being overweight: Body parts have been reported as bothersome and, in addition, there is a concern with health, pains and difficulties caused by weight have emerged as factors that generate discomfort with one's own body; Prejudice: it is presented in the form of directed comments, negative attitudes, undesired attention, looks of disapproval and curiosity; and they accept themselves as they are: they do not have a negative relation with the image itself, even if they feel uncomfortable, they accept themselves as they are. The results of this study demonstrate the need to expand the approach of overweight people beyond the problems related to the physical-biological sphere since health care requires the perspective of completeness.

La obesidad, además de ser una enfermedad con impacto en la salud física y psicológica, es acompañada por estigmas construidos a lo que se refiere, también, a la imagen corporal. Este trabajo tuvo el objetivo de investigar la imagen corporal de personas con sobrepeso y los aspectos psicosociales vividos por ellas. Participaron de esta investigación 58 personas con sobrepeso u obesidad (media de edad de 38,53 años; DP=10,69). Para colectar los datos fueron utilizados un cuestionario socio demográfico y clínico, la escala de figuras de Stunkard y una entrevista semi estructurada. Los resultados indican que ninguno de los participantes estaba satisfecho con su imagen corporal. Con respecto al análisis de contenidos de las entrevistas, han surgido cuatro categorías: Insatisfacción con imagen: los participantes dijeron no gustar y/o no estar a gusto con su imagen, identificando la presencia de conceptos auto-despectivos, llenos de sentimientos de tristeza, vergüenza y la sensación de no reconocerse en aquel cuerpo; Insatisfacción con el sobrepeso: partes del cuerpo fueron informadas como incómodas y, además de eso, hay una preocupación con la salud, dolores y dificultades causadas por el peso emergieron como factores que generan malestar con el propio cuerpo; Prejuicio: se presenta en la forma de comentarios direccionados, actitudes negativas, atención no deseada, miradas de reprobación y de curiosidad; y se Aceptan como son: no poseen una relación negativa con su propia imagen, aunque no se sientan a gusto, se aceptan como lo son. Los resultados de este trabajo demuestran la necesidad de expandir el enfoque de las personas con sobrepeso para allá de los problemas relacionados con la esfera físico-biológica, ya que el cuidado en salud requiere la perspectiva de la integridad.

L'obésité n'est pas seulement une maladie qui engendre des conséquences négatives sur la santé physique et psychologique. Elle est aussi accompagnée de stigmates socialement construits concernant l'image corporelle. Généralement, il existe une insatisfaction à l'égard de l'image corporelle chez les personnes en surpoids. Cette étude a eu l'objectif d'examiner l'image corporelle des personnes en surpoids et les aspects psychosociaux qu'elles ont vécu. 58 personnes obèses ou en surpoids ont participé à cette étude (âge moyen: 38,53 ans; DP=10,69). Un questionnaire sociodémographique et clinique, les figurines de Stunkard et un entretien semi-structuré ont été utilisés pour collecter les données. Les résultats ont montré qu'aucun des participants n'était satisfait de leur image corporelle. En ce qui concerne l'analyse du contenu des entretiens, quatre catégories se dégagent: Insatisfaction avec leur propre image: les participants ont déclaré qu'ils n'aiment pas et/ou ne se sent pas bien avec leur image. On a pu identifier la présence de concepts autodestructeurs, imprégnés de tristesse, de la honte et du sentiment de ne pas appartenir à ce corps; Insatisfaction avec l'excès de poids: les parties du corps sont gênant et, de plus, ils se préoccupent de la santé, de la douleur et les difficultés causées par le poids; Préjudice: Il apparait sous forme de commentaires, d'attitudes négatives, d'attention non sollicitée, de regards de désapprobation et de curiosité; Acceptation de soi: ils n'ont pas une relation négative avec leur image, même s'ils se sentent gênés, ils acceptent leurs corps comme ils sont. Les résultats de cette étude démontrent la nécessité de développer l'abordage des personnes en surpoids au-delà des problèmes rapportés à la sphère physique et biologique, car les soins de santé exigent la perspective de l'intégralité.

Aerobic training reduces immune cell recruitment and cytokine levels in adipose tissue in obese mice.

Obesity is associated with an energy imbalance that results from excessive energy intake, low diet quality, and a sedentary lifestyle. The increased consumption of a high-refined carbohydrate (HC) diet is strongly related to higher adiposity and low-grade inflammation. Aerobic training is a well-known nonpharmacological intervention to treat obesity and metabolic disturbances. However, the mechanisms through which aerobic training ameliorates the low-grade inflammation induced by an HC diet should be further investigated. Our hypothesis herein was that aerobic training would decrease the recruitment of leukocytes in adipose tissue, thereby reducing the levels of cytokines and improving metabolism in mice fed an HC diet. Male Balb/c mice were assigned to the following groups: control diet/nontrained (C-NT), control diet/trained (C-T), high-refined carbohydrate diet/nontrained (HC-NT), and high-refined carbohydrate diet/trained (HC-T). Mice were submitted to moderate-intensity training sessions that consisted of running 60 min per day for 8 weeks. An intravital microscopy technique was performed in vivo in anesthetized mice to visualize the microvasculature of the adipose tissue. The HC diet induced obesity and increased the influx of immune cells into the adipose tissue. In contrast, HC-T mice presented a lower adiposity and adipocyte area. Furthermore, relative to HC-NT mice, HC-T mice showed increased resting energy expenditure, decreased recruitment of immune cells in the adipose tissue, reduced cytokine levels, and ameliorated hyperglycemia and fatty liver deposition. Collectively, our data enhance understanding about the anti-inflammatory effect of aerobic training and shed light on the adipose tissue-mediated mechanisms by which training promotes a healthier metabolic profile.

Sex differences in subcutaneous adipose tissue redox homeostasis and inflammation markers in control and high-fat diet fed rats.

The development of obesity-related metabolic disorders is more evident in male in comparison with female subjects, but the mechanisms are unknown. Several studies have shown that oxidative stress is involved in the pathophysiology of obesity, but the majority of these studies were performed with male animals. The aim of this study was to evaluate the sex-related differences in subcutaneous adipose tissue redox homeostasis and inflammation of rats chronically fed a high-fat diet. NADPH oxidase (NOX), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase activities were evaluated in the subcutaneous adipose tissue (SC) of adult male and female rats fed either a standard chow (SCD) or a high-fat diet (HFD) for 11 weeks. NOX2 and NOX4 messenger RNA (mRNA) levels, total reduced thiols, interleukin (IL)-1ß, tumor necrosis factor α (TNF-α), and IL-6 were also determined. Higher antioxidant enzyme activities and total reduced thiol levels were detected in SC of control male compared with female rats. Chronic HFD administration increased NOX activity and NOX2 and NOX4 mRNA levels and decreased SOD and GPx activities only in male animals. IL-1ß, TNF-α, and IL-6 levels, as well as Adgre1, CD11b, and CD68 mRNA levels, were also higher in SC of males after HFD feeding. In SC of females, catalase activity was higher after HFD feeding. Taken together, our results show that redox homeostasis and inflammation of SC is sexually dimorphic. Furthermore, males show higher oxidative stress in SC after 11 weeks of HFD feeding owing to both increased reactive oxygen species (ROS) production through NOX2 and NOX4 and decreased ROS detoxification.

Parental body mass index and blood pressure are associated with higher body mass index and blood pressure in their adult offspring: a cross-sectional study in a resource-limited setting in northern Peru.

OBJECTIVES: High body mass index (BMI) and blood pressure (BP) are major contributors to the high burden of non-communicable diseases in adulthood. Individual high-risk and population approaches for prevention require newer strategies to target these risk factors and focusing on the family to introduce prevention initiatives appears as a promising scenario. Characterisation of the relationship between BMI and BP among the adult members of a given family merits evaluation. We conducted a secondary analysis of an implementation study in Tumbes, Peru, benefiting from data derived from families with at least one adult offspring. METHODS: The exposures of interest were the BMI, systolic BP (SBP) and diastolic BP (DBP) of the mother and father. The outcomes were the BMI, SBP and DBP of the offspring. Mixed-effects linear regression models were conducted. RESULTS: The mean age of the offspring, mothers and fathers was 29 (SD: 9.5), 54 (SD: 11.8) and 59 (SD: 11.6) years, respectively. Father's BMI was associated with a quarter-point increase in offspring BMI, regardless of the sex of the offspring. Mother's BMI had a similar effect on the BMI of her sons, but had no significant effect on her daughters'. Mother's SBP was associated with almost one-tenth of mmHg increase in the SBP of the adult offspring. There was no evidence of an association for DBP. CONCLUSIONS: In families with adult members, the higher the parents' BMI and SBP, the higher their adult offspring's levels will be.

Dimensões psíquicas do emagrecimento: por uma compreensão psicanalítica da compulsão alimentar / Psychic dimensions of weight loss: for a psychoanalytic understanding of binge eating disorder / Dimensions psychiques d'amaigrissement: Pour une compréhension psychanalytique de la compulsion alimentaire / Dimensiones psíquicas del adelgazamiento: por una comprensión psicoanalítica de la alimentación compulsiva

Com este artigo propomos uma pesquisa teórico-clínica com o objetivo de apresentar um entendimento psicanalítico da compulsão alimentar. Para tanto, apresentamos uma revisão crítica da literatura articulada com vinhetas de atendimentos e depoimentos públicos de pacientes. Concluiremos sublinhando o potencial de uma abordagem psicanalítica da compulsão alimentar em destacar a existência de riscos de desorganização psíquica de alguns pacientes submetidos a dietas de alta restrição calórica e seu potencial para lidar com os ciclos viciosos de perda e posterior ganho de peso.

This article proposes a theoretical-clinical research with the objective of presenting a psychoanalytic understanding of binge eating disorder. For that sake, we present a critical review of the literature articulated with patients' vignettes and public statements. We conclude by emphasizing the potential of a psychoanalytic approach to binge eating disorder in highlighting the existence of risks of psychic disorganization of some patients undergoing high calorie restriction diets and their potential to deal with the vicious cycle of loss and subsequent weight gain.

Cet article propose une recherche théorique-clinique dans le but de présenter une compréhension psychanalytique de la compulsion alimentaire. Pour tel, nous présentons une revue critique de la littérature articulée par des vignettes et des témoignages publics de patients. Nous conclurons en mettant en relief le potentiel d'une approche psychanalytique de la compulsion alimentaire en mettant en évidence l'existence d'un risque de désorganisation psychique de certains patients subissant des régimes de grand restriction calorique et son potentiel pour faire face au cercle vicieux de la perte et du gain de poids subséquents.

Este artículo propone una búsqueda teórico-clínica con el objetivo de presentar una comprensión psicoanalítica de la alimentación compulsiva. Para hacerlo, presentamos una revisión literaria crítica articulada con viñetas de anotaciones de sesiones terapéuticas y testimonios públicos de pacientes. Concluiremos resaltando el potencial de un abordaje psicoanalítico de la alimentación compulsiva que destaca la existencia de un riesgo de desorganización psíquica de algunos pacientes sometidos a dietas de alta restricción calórica, y su capacidad para lidiar con los círculos viciosos de la pérdida y posterior aumento de peso.

Dieser Artikel beschreibt eine klinisch-theoretische Studie, die zum Ziel hat, das psychoanalytisches Verständnis des Esszwangs zu vertiefen. Wir beginnen mit einem kritischen Überblick der wissenschaftlichen Literatur und stellen Verbindungen her zu Fallvignetten und öffentlichen Aussagen von Patienten. Daraus schlussfolgert, dass ein psychoanalytischer Ansatz zur Untersuchung des Esszwangs es ermöglicht, eine bestehende oder mögliche psychische Erkrankung von Patienten zu erkennen, die eine stark kalorienbeschränkende Diät befolgen. Dieser Ansatz könnte außerdem den Patienten helfen, die endlose Folge des Ab- und Zunehmens anzugehen.

Weight loss enhances hepatic antioxidant status in a NAFLD model induced by high-fat diet.

Nonalcoholic fatty liver disease (NAFLD) is a benign condition that can progress to more severe liver damage in a process mediated, in part, by disturbances in redox balance. Additionally, some argue that it is set to become the main cause of end-stage liver disease in the near future. Here, we investigated whether diet-induced weight loss is able to reverse hepatic lipid accumulation and reduce oxidative stress in liver from C57BL/6 mice fed a high-fat (HF) diet. Male C57BL/6 mice were divided into 4 groups: standard chow (SC; 10% energy from fat, 16 weeks); HF (50% energy from fat, 16 weeks); SC-HF (SC for 8 weeks followed by HF for 8 weeks); and HF-SC (HF for 8 weeks followed by SC for 8 weeks). The HF diet during 8 (SC-HF) and 16 weeks (HF) downregulated messenger RNA levels and protein expression of Nrf2 and endogenous antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase) in the liver; caused liver steatosis; affected liver function markers; increased intra-abdominal and subcutaneous adipose tissue; and induced glucose intolerance and hypercholesterolemia compared with controls (SC). Diet-induced weight loss significantly reduced the intrahepatic lipid accumulation, improved glucose tolerance, and restored both gene and protein expression of the antioxidant enzymes. Our findings suggest that a dietary intervention aimed to induce weight loss may exert protective effects in NAFLD as it can reduce hepatic oxidative stress and intrahepatic lipid accumulation, which can hinder the progression of this condition to more severe states.

A obesidade e o desmentido da castração: uma posição religiosa / Obésité et démenti de la castration: Une position religieuse / Obesity and denial of castration: A religious position

Este artigo aborda as conclusões extraídas de uma investigação clínica com uma amostra de mulheres obesas. Trabalhamos com dois pressupostos: o primeiro diz respeito ao estatuto do Outro na contemporaneidade, apresentado, na orientação lacaniana, sob o axioma de que o Outro não existe. O segundo diz respeito aos efeitos desse deslocamento da primazia do simbólico: o aparecimento dos chamados novos sintomas que são soluções de gozo. A investigação clínica troux e, entretanto, um giro de perspectiva. A configuração familiar das mulheres que entrevistamos se organiza em torno do discurso religioso, com um Outro bastante consistente. Para essas famílias, Deus (o pai) tudo pode. A função paterna está presente, mas é encarnada de modo a desmentir a castração. Essas três mulheres permanecem filhas de um pai (filhas de Deus) poderoso, que sempre pode cuidar e prover

Cet article décrit les conclusions extraites d'une recherche clinique avec un échantillon de femmes obèses. Nous travaillons avec deux hypothèses: la première concerne le statut de l'Autre à l'ép oque contemporaine, présenté dans l'orientation lacanienne selon l'axiome selon lequel l'Autre n'existe pas. La seconde concerne les effets de ce déplacement de la primauté du symbolique: l'apparition des soi - disant nouveaux symptômes qui sont des solution s de jouissance. Cependant, la recherche clinique a entraîné un changement de perspective. La configuration de la famille des femmes interrogées est organisée autour du discours religieux avec un autre assez cohérent. Pour ces familles, Dieu (le père) peut faire n'importe quoi. La fonction paternelle est présente mais incarnée pour démesonger la castration. Ces trois femmes restent des filles d'un père puissant (filles de Dieu) qui peut toujours s'occuper et fournir

This article addresses conclusions drawn from a clinical research with a sample of obese women. We work with two assumptions: the first concer ns the status of the Other in contemporary times, presented, in the Lacanian orientation, under the axiom that the Other does not exist. The second concerns the effects of this displacement of the primacy of the symbolic: the appearance of the so - called ne w symptoms, that are solutions of jouissance. Clinical research has, however, brought a shift of perspective. The familiar configuration of the women we interviewed is organized around a religious discourse, with a very consistent Other. For these families , God (the father) can do anything. The paternal function is present but incarnated in such a way as to deny castration. These three women remain daughters of a powerful father (daughters of God) who can always care for and provide.