Obesidade e transtorno da compulsão alimentar periódica : um estudo sobre a dinâmica familiar

Abstract

Recent research describe that between people with serious obesity exists a subpopulation with similar haracteristics, that do not answer to the mannering treatment for loss of weight. This group presents a type of eating disorders known as Binge Eating Disorder (BED). Although diverse studies investigate the family environment of people with eating disorders, the revision of literature the family disclosed a shortage of studies that unite familiar functioning, obesity and BED. Therefore, the objective of this research was to investigate the family dynamics of people with serious obesity who present or not BED. The research was delineated in the form of a mixed study, with a first quantitative stage, composed of a transversal analytical study and one second qualitative, with a case study with two families: one with obesity, another one with obesity and BED. All the patients with serious obesity who, in the period of October the December of 2006, had been taken care of by the Program of Research and Attendance in Obesity (PASSO) of the University of Brasília had been invited to participate of the research. The transversal study the was realized through the application of scales ECAP and FACES III. The case study the was realized through in two visits domiciliary for construction of the genogram, ecomap, glue of the family and accomplishment of two tasks. The transversal study identified a prevalence of 49% of TCAP and a of lesser family cohesion that the population, in general independent of the moment of the life cycle. In relation to the adaptability, the families with obesity and without BED present less adaptative rigidity that the families of the population in general. Moreover, she was identified to positive correlation between the familiar adaptability and the degree of binge eating. In relation to the case study, the families had presented some imilarities how much to the functioning of described systems with obesity in literature: diffuse borders internal and rigid borders external: few activities of leisure: emphasis to family loyalty: strong linking between feeding, affectivity and belonging: obesity as only familiar problem: avoidance of conflicts and communication marked for low expression of feeling. On the familiar functioning of people with BED, also we observe characteristics told in literature, as rejection and paternal recklessness: vulnerability to the obesity and low cohesion in the origin family. On the other hand, our study it identified aspects of the dynamics that had not been found in the revised studies and that can be related with then development of obesity and TCAP; the parentalization of the patient with the symptom, its history of life marked for losses; the difficulty of family adaptation and paradoxical communication. On the basis of these results, researcher suggests the inclusion of the family therapy in the treatment of the obesity and the BED.