IntroduçãoOs transtornos alimentares são síndromes comportamentais cujos critérios diagnósticos têm sido amplamente estudados nos últimos 30 anos. São descritos como transtornos e não como doenças por ainda não se conhecer bem sua etiopatogenia.Os atuais sistemas classificatórios de transtornos mentais, DSM-IV (Diagnostic and Statistical Manual, IV edition) 1 e CID-10 (Classificação Internacional de Doenças, 10ª edição), 2 ressaltam duas entidades nosológicas principais: a Anorexia Nervosa (AN) e a Bulimia Nervosa (BN). Embora classificados separadamente, os dois transtornos acham-se intimamente relacionados por apresentarem psicopatologia comum: uma idéia O presente artigo apresenta o "estado de arte" da discussão acerca dos critérios diagnósticos atuais dos transtornos alimentares: Anorexia Nervosa (AN), Bulimia Nervosa (BN) e Transtorno da Compulsão Alimentar Periódica (TCAP). Dentre os aspectos controversos da AN, destacam-se: a concepção da distorção de imagem corporal, a necessidade da presença de amenorréia para o diagnóstico e a possibilidade de manifestação de AN sem seu aspecto característico, o medo de engordar, em culturas não ocidentalizadas. Quanto à BN, discute-se especialmente a concepção de compulsão alimentar sua freqüência e duração necessárias para o diagnóstico. O artigo apresenta também os critérios sugeridos para o diagnóstico de TCAP e comenta sua difícil distinção com a BN não purgativa. As questões aqui discutidas possibilitarão o aprimoramento da nosologia da área.Anorexia nervosa. Bulimia nervosa. Transtornos alimentares. Diagnóstico. Classificação. This article presents the "the state of art" of the discussion over the current diagnostic criteria for eating disorders: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge-Eating Disorder (BED). Within the controversial aspects of AN, it is outlined: the conception of body image disturbance, the necessity of amenorrhea fpr the diagnosis and the possibility of AN without its characteristic aspect, the morbid fear of weight, in not Westernized cultures. For BN, it is specially discussed the conception of binge-eating and the frequency and duration of episodes necessary for the diagnosis. The article also presents the suggested criteria for BED diagnosis and comments on its difficult distinction from non-purging BN . The issues here discussed shall improve the nosology in the field. Anorexia nervosa. Bulimia nervosa. Eating disorders. Diagnosis. Classification.prevalente envolvendo a preocupação excessiva com o peso e a forma corporal (medo de engordar), que leva as pacientes a se engajarem em dietas extremamente restritivas ou a utilizarem métodos inapropriados para alcançarem o corpo idealizado. Tais pacientes costumam julgar a si mesmas baseando-se quase que exclusivamente em sua aparência física, com a qual se mostram sempre insatisfeitas. Os critérios diagnósticos para AN e BN acham-se descritos na Tabela 1.Dentre os transtornos alimentares sem outra especificação (TASOE) descritos na Tabela 2, ressaltam-se os quadros atípicos (pa...

BORGES, M. BEATRIZ F., MIGUEL R. JORGE, CHRISTINA M. MORGAN, DARTIU XAVIER DA SILVEIRA, AND OSVLADIR CUSTÓ DIO. Binge-eating disorder in Brazilian women on a weight-loss program. Obes Res. 2002;10:1127-1134. Objective: To examine binge-eating disorder (BED) and its association with obesity, weight patterns, and psychopathology in a Brazilian sample of female participants of a weightloss program in São Paulo, Brazil. Research Methods and Procedures: Two hundred and seventeen overweight (body mass index Ն 25 kg/m 2 ) women, ages 15 to 59 years, enrolled in the Weight Watchers Program were recruited for the study at a program branch meeting after completing the Questionnaire on Eating and Weight Patterns-Revised, Beck Depression Inventory, and the Toronto Alexithymia Scale-20. Participants were categorized into four groups: those who met questionnaire criteria for BED, those who met questionnaire criteria for bulimia nervosa (BN), those that reported binge eating but did not meet all the criteria for any eating disorder (BE), and those with no eating disorder symptoms (No ED). Groups were compared on measures of weight, depressive symptoms, and alexithymia. Results: Binge eating was frequently reported by women in this study (BED, 16.1%; BN, 4.6%; BE, 22.6%). BED women had significantly higher body mass index, greater highest weight ever, and more frequent weight cycling than the No ED group. BED women also reported more depressive symptoms than BE and No ED women, and were more alexithymic than the No ED group. BE women presented more frequent weigh cycling and were also more depressed and alexithymic than the No ED group. Discussion: BED is not uncommon in overweight Brazilian women, and similar to North American and European samples, it is associated with overweight and higher levels of psychopathology in this population.

(QEWP-R) for the screening of binge eating disorder Validação da versão em português do Questionário sobre Padrões de Alimentação e Peso -Revisado (QEWP-R) para o rastreamento do transtorno da compulsão alimentar periódica A b s t r a c t Objective: The present paper describes the validation of the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) designed for the diagnosis of binge eating disorder (BED) and sub-clinical binge eating. Methods: 89 overweight women seeking treatment for binge eating and/or obesity were assessed with the Portuguese version of the Questionnaire of Eating and Weight Patterns and were, subsequently, interviewed with the eating disorders module of the Structured Clinical Interview for DSM-IV (SCID-I/P The QEWP-R includes questions on overeating and loss of control, distress related to eating behavior, importance of weight and shape and compensatory weight control behaviors. It provides decision rules for the differential diagnosis between BED and purging or non-purging bulimia nervosa based on YES-or-NO answers to questions assessing the presence or absence of binge eating and compensatory methods for weight control.13 Following DSM-IV criteria, BED is considered positive when the subject endorses binge eating occurring at least twice a week associated with significant distress, without inappropriate compensatory methods for weight control. The instrument also assesses age, gender, ethnic background, education, height, weight and dieting behavior.The QEWP-R was translated into Portuguese by eating disorders experts 13 and pilot-tested on eating disorders patients of the Eating Disorders Program of UNIFESP. The Portuguese version was then back-translated into English and submitted to one of the authors of the original questionnaire (S.Z.Y.), whose suggestions were included in the final version of the translation.In this study, subjects were classified as having BED when meeting full criteria as proposed in the Appendix B of the DSM-IV.