"Craving" is a motivational state that promotes an intense desire related to consummatory behaviors. Despite growing interest in the concept of food craving, there is a lack of available instruments to assess it in Brazilian Portuguese. The objectives were to translate and adapt the Trait and the State Food Craving Questionnaire (FCQ-T and FCQ-S) to Brazilian Portuguese and to evaluate the psychometric properties of these versions.The FCQ-T and FCQ-S were translated and adapted to Brazilian Portuguese and administered to students at the Federal University of São Paulo. Both questionnaires in their original models were examined considering different estimators (frequentist and bayesian). The goodness of fit underlying the items from both scales was assessed through the following fit indices: χ2, WRMR residual, comparative fit index, Tucker-Lewis index and RMSEA. Data from 314 participants were included in the analyses. Poor fit indices were obtained for both of the original questionnaires regardless of the estimator used and original structural model. Thus, three eating disorder experts reviewed the content of the instruments and selected the items which were considered to assess the core aspects of the craving construct. The new and reduced models (questionnaires) generated good fit indices. Our abbreviated versions of FCQ-S and FCQ-T considerably diverge from the conceptual framework of the original questionnaires. Based on the results of this study, we propose a possible alternative, i.e., to assess craving for food as a unidimensional construct.

BackgroundBinge eating disorder is a new category in DSM-5 and highly associated with higher body mass index. The neural mechanisms that underlie binge eating are of great interest in order to improve treatment interventions. Brain mechanisms underlying drug and food craving are suggested to be similar: for example, both are reported to be associated with increased neural activity in the orbitofrontal and anterior cingulate cortex, and a diminished regulatory influence from lateral prefrontal circuits. Several studies have begun to assess the potential benefits of brain stimulation in reducing craving and addictive behaviors. Data from a study of a one-off session of transcranial magnetic stimulation in healthy women identified as strong cravers and of individuals with bulimic-type eating disorders, reported a reduction in food craving and binge eating episodes. This provides support for a more extensive investigation of the potential therapeutic benefits of transcranial magnetic stimulation. Lastly, brain imaging studies and a dimensional approach, will improve understanding of the neural correlates of the disorders and of the mode of action of transcranial magnetic stimulation.Methods/DesignSixty eligible obese females, with binge eating disorder, will be randomly allocated to receive 20 sessions of transcranial magnetic stimulation intervention (n = 30) or the sham transcranial magnetic stimulation intervention (n = 30) scattered 3 days/week. Thirty eligible controls will complete the baseline assessment. The primary outcome (number of binge eating episodes) will be assed at each treatment sessions, and 8 weeks after intervention completion (follow-up). It is hypothesized that mean weekly binge-eating episodes will be reduced in the intervention group, compared to the sham group, and that the effect will be maintained at follow-up.DiscussionDespite the severity associated with Binge Eating Disorder, there are limited treatment options. This study is an important step in the development of more effective treatments. Importantly, the study is the first to investigating binge eating disorder using a dimensional approach, by looking at the different aspects of the disorder, such as behavioral factors, biological factors, brain circuits and chemistry.Trial registrationClinical Trials NCT02180984. Registered in July 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0569-8) contains supplementary material, which is available to authorized users.

Objective:To investigate how often physicians identify and treat tobacco dependence and whether characteristics as gender, age, marital status, medical specialty and smoking status can influence their attitude towards this question.Methods:A cross-sectional study was performed on 515 physicians working in a private hospital in São Paulo, Brazil, using a confidential voluntary questionnaire sent and answered electronically.Results:We found that 89% of physicians who answered the research questionnaire often or always asked their patients about smoking habits, but only 39% often or always treated patients' tobacco dependence. In our sample, 5.8% of individuals were current smokers. Tobacco dependent physicians provided less treatment for smoking dependence compared with those who had never smoked, or were former smokers. Being a clinician was associated with higher probability to treat tobacco dependence.Conclusion:Physicians should not only address patients' smoking habits but also provide treatment whenever tobacco dependence is diagnosed. To understand physicians' attitude towards smoking may help to develop strategies to stimulate patients' treatment. The development of smoking cessation programs meant specifically for physicians may also be a strategy to enhance patients' treatment.

Objective Research on potential brain circuit abnormalities in binge eating disorder (BED) is limited. Here, we assess white matter (WM) microstructure in obese women with BED. Method Diffusion tensor imaging data were acquired, and tract‐based spatial statistics used to examine WM in women with BED who were obese (n = 17) compared to normal‐weight (NWC) (n = 17) and to women who were obese (OBC) (n = 13). Body mass index (BMI) was a covariate in the analyses. Results The BED group (vs. NWC) had greater axial diffusion (AD) in the forceps minor, anterior thalamic radiation, superior and inferior longitudinal fasciculus, that is, in pathways connecting fronto‐limbic regions. Microstructures differences in AD between the BED and OBC groups were seen in fronto‐limbic pathways extending to temporoparietal pathways. The BED (vs. OBC) group had greater fractional anisotropy in the forceps minor and greater AD in the superior longitudinal fasciculus, cingulate gyrus, and corpus callosum, consistent with fronto‐tempoparietal pathways. Conclusion Women with BED show WM alterations in AD in fronto‐limbic and parietal pathways that are important in decision‐making processes. As BMI was a covariate in the analyses, alterations in BED may be part of the pathology, but whether they are a cause or effect of illness is unclear.

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