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Nutritional and neuropsychological profile of the executive functions on binge eating disorder in obese adults. Perfil nutricional y neuropsicológico de las funciones ejecutivas en el transtorno por atracón en adultos obesos. Nutritional status was evaluated by measures of body weight, height and abdominal circumference, and from these, body mass indexes BMI were calculated. Results: Both groups presented similar nutritional characteristics; there were no differences when it came to the health status of individuals with or without BED.
Further statistically significant differences were also observed here between the two groups. Conclusion: Obese individuals frequently present deficits in selective attention, inhibitory control, decision-making and planning that can be directly related to binge eating and which is linked to BED. Nutritional status did not differ between the two groups studied, and did not show any connection with the disorder.
Key words: Binge eating disorder. Executive function. Nutritional status. El estado nutricional fue evaluado por medidas de peso corporal, estatura y circunferencia abdominal, y de estos se calcularon los índices de masa corporal IMC. Resultados: ambos grupos presentaron características nutricionales similares; No hubo diferencias en cuanto al estado de salud de las personas con difference between tax return and noa sin BED.
Otras diferencias estadísticamente significativas también se observaron aquí entre los dos grupos. El estado nutricional no difirió entre los dos grupos estudiados, y no mostró ninguna relación con el trastorno. Palabras clave: Trastorno binge eating. Función ejecutiva. Valor nutricional. Binge eating is the concept applied to the unbridled and excessive ingestion of large quantities of food, known as binge eating episodes, in which the act is obtainable and uncontrollable.
Patients with BED are more likely to respond to situations that cause emotional tension by consuming food. Patients with BED generally have among the highest rates of dissatisfaction with their own body image; their desired weight and their actual weight can eating disorders cause memory loss relatively distant and, therefore, they have greater difficulty forming holding realistic expectations about treatment 3.
In addition, they feel unable to control their food intake 4 and present an accentuated oscillation in relation to their original weight 5,6. From a clinical perspective, these individuals frequently present a nutritional status of overweight or obese. Bulik et al. A study published in assessed 24, participants from 14 countries, including countries from Latin America, the United States and Europe. Data showed that the prevalence of BED in the general population was 1.
However, in medical treatments for overweight and obese individuals, the prevalence may vary between 7. Regarding prevalence among the can eating disorders cause memory loss, BED affected 3. Different ED rates have been linked to certain types of deficits in executive function EFthough this topic is relatively new and sometimes controversial. Therefore, once BED is related to binge eating episodes, and as it is the main criteria for diagnosis, it plays a significant role in the development and maintenance of obesity and eating disorders.
EF, according to Malloy-Diniz et al. It turns out that for a task to be performed coherently and fully, it is necessary for individuals can eating disorders cause memory loss know exactly what their ultimate goals are, and that they choose goal-directed behaviors to make achieving these goals possible. An organizational hierarchy is required for this to work properly, in which the effectiveness and efficiency of each behavior is constantly evaluated in order to alter the unsuccessful ones and to choose new strategies to replace those that have failed.
Concomitantly, individuals must remain focused on performing these behaviors and on their ultimate goals Multiple components are involved in EF to enable the formation of a coherent plan of action, to dose response curve definition for and can eating disorders cause memory loss achieve a goal, and to adjust behaviors along the way EF components are discussed by different authors from different perspectives to define what their functions are.
Most important among these are operating or working memory, inhibitory control selecting the most appropriate behavioral response to a situation while inhibiting othersselective attention or vigilance, can eating disorders cause memory loss, organizational questioning, mood, self-regulation, creativity, problem solving, decision-making, fluency, categorization, prioritizing and cognitive flexibility 16,17,19, Inhibitory control is fundamental to avoiding binge eating episodes because difficulties related to this are usually associated with impulsiveness.
However, selective attention corresponds to a set of processes that lead to the selection or prioritization of certain categories of information 21, The objective of this study was to assess the nutritional and neuropsychological profile of obese patients with BED in comparison with the control group, while considering the relationship between BED and EF in particular.
Analysis included assessing elements of EF specifically: selective attention, inhibitory control, decision making and planning and tracing the groups' nutritional profiles by means of anthropometric and laboratory assessments. The participants were interviewed in the Metabolic Nutrition Clinic associated with the Endocrinology Department of a large hospital in the city of Porto Alegre in southern Brazil. Exclusion criteria were: less than six years of schooling, a history of brain injury, neurological disorders potentially such as epilepsy or clinical diseases, which could have had an impact on their eating behavior or nutritional state.
Cases histories were compiled with participants' data from school and employment records, clinical history, age and socioeconomic status. All information was collected at the time of the interview. Employment data were categorized into: paid work, student, retired or unemployed. Clinical history was categorized into: not having associated pathologies, having two or more, or having only one condition associated with obesity.
This instrument was developed to evaluate the severity of can eating disorders cause memory loss eating in obese subjects. The range comprises 16 items for assessing can eating disorders cause memory loss manifestations, feelings and cognition involved in compulsive episodes. This study included patients with BED who achieved a score between moderate and serious binge eating. This task assesses decision making and planning skills in a real-life simulation A version translated into Portuguese 25 was presented to the participants, in which four virtual piles of cards appear on a computer screen which participants can select from.
Players have to pay attention and select cards assessing the best what is another name for need ratios. The IGT scores are categorized into five blocks S1 to S5 according to the scores obtained in the first 20 games S1in 20 subsequent games S2and so on. In this task several letters flashed on a computer screen each second, in different colors, and the participants were instructed to react quickly by pressing the "space" bar for all letters, except for those which had been previously identified as part of the exclusion set.
The test provided measures for task errors and reaction times, can eating disorders cause memory loss are positively correlated with selective attention and inhibitory control. Biochemical tests were done on participants' blood samples can eating disorders cause memory loss analyze glucose, triglycerides, total cholesterol, low density lipoprotein LDLhigh density lipoprotein HDL and glycemic exposure HbA1c.
All participants signed an informed consent agreement. The instruments were applied individually in the Metabolic Nutrition clinic over the course of one minute session for each participant. Biochemical data were collected from patient records six month period prior to these sessions. A descriptive analysis of the results was conducted employing frequency, percentages and standard deviation. To verify the associations between variables we used the Pearson Chi-square test and, when necessary, the Fisher's exact test, with the additional resource of standardized residue analysis adjusted to identify the location of associations.
Both groups have similar characteristics, which demonstrates that the samples can eating disorders cause memory loss homogeneous, as table I shows. This uniformity is observed between the groups, both in the nutritional status of the participants BMI, AC and laboratory exams and in variables related to gender, age, household income, education and occupation. The average BES score was Therefore, participants who failed to react in a timely or correct manner in the task also demonstrated more severe instances of eating disorder.
In the IGT, final scores also presented differences between the two groups. The group without BED obtained an average score of Figure 2 shows that, in the group with BED, more participants presented impaired outcomes on the IGT when compared to those in the control group. These results were obtained despite the fact that the group without BED presented a greater sampling of unimpaired participants according to the IGT scores. The IGT blocks there are five blocks of twenty rounds each: S1, S2, S3, S4 and S5which are intended to determine whether learning occurred during the task 31demonstrated no significant difference among them.
Thus, it can be assumed that most obese individuals with BED have selective attention deficits and deficient inhibitory control, decision-making and planning when compared to those without the disorder. Both groups showed similar characteristics in terms of average body weight, BMI, AC and results from biochemical laboratory tests. Thus, one can characterize the populations in this study as homogeneous regarding nutritional state.
However, differences are found in relevant literature in which BED has been associated with increased health risks regardless of nutritional status 7. The present study corroborates this idea, that there what is evolutionary theories increased health risks associated with BED that are independent from nutritional status. Diseases associated with heath risk, which are commonly reported in cases of patients with obesity and BED 7 were also observed in this study, in which The variables of gender, age, household income, education and occupation were also similar in both groups.
Most patients were female, which is consistent with findings in the literature This relationship characterizes selective attention deficit since these patients could not pay attention to the tasks they were given. As selective attention is a set of processes that leads to selecting or prioritization in the processing of certain categories of information 21the fact that subjects did not press a computer key in response to visual stimuli indicates that there is a mental deficit associated with task orientation and concentration.
A study published in supports these findings, where 42 participants who had or had had anorexia nervosa NA at some point in their lives showed signs of selective attention deficits when evaluated with the Test of Variables of Attention TOVA Further literature suggested that participants present deficits when confronted with challenging environments.
With several sources of information competing for their attention, participants demonstrated difficulty in maintaining focus However, Galioto et al. The author compared the cognitive function of patients with morbid obesity and a former or current history of BED, together with controls, and concluded that both groups had high rates of cognitive deficit. However, there was no significant difference between them, just as there can eating disorders cause memory loss no difference between those diagnosed with BED in the past and those currently diagnosed This study by Galioto et al.
Considering that patients with eating disorders frequently demonstrate anxiety behaviors 34 and impulsiveness 3the methodology employed in this study can point to a possible relationship between keyboard responses and item investigated. According can eating disorders cause memory loss the study by Mobbs et al. Can eating disorders cause memory lossa study evaluated these functions in obese patients with BED, without BED and people with being in love is good for your health lyrics weight, and concluded that obese participants had significantly more errors of commission pressing keys in response to any stimulus and can eating disorders cause memory loss errors of omission not pressing keys when a target was visible than those in the control group.
In addition, what is meant by classification of data study showed that obese participants with BED had significantly more errors and omissions that those without the disorder The results from Mobbs et al. This deficit was associated with anxiety in these participants.
The authors then concluded that not only are eating disorders associated with EF, but also that states of anxiety seem to contribute to deficits in these functions However, according to the performance of participants with eating disorders in EF tests, the literature is inconsistent. At the end ofresearchers analyzed EF, including inhibitory control, categorization of hypotheses, planning, problem solving, task scheduling capacity, working can eating disorders cause memory loss and cognitive flexibility using various neuropsychological tests in 38 obese participants with BED in comparison with obese participants without the disorder.
The performance of obese participants can eating disorders cause memory loss BED did not differ significantly from those without BED when assessed for inhibitory control. This suggests that a pattern of disadvantageous choices which lead to immediate gains and significant long-term losses can be associated with a specific pattern of impulsivity or deficits in ability regarding the consequences of short, medium and long term planning What does causation mean in criminal law skills are directly related to unplanned impulses.