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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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BACKGROUND: Cognitive deficits are implicated in theoretical explanatory models for binge eating disorder (BED). Furthermore, evidence suggest that alterations in executive function may underlie symptoms in BED. The current systematic review and meta-analysis provides an update on executive functioning in individuals with BED. METHODS: Literature searches (up to November 2019) were conducted in electronic databases combining binge eating or BED with executive functions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was used. Studies of any design comparing adults with BED with those without BED in executive function domains were selected. Methodological quality of studies was based on the Newcastle-Ottawa scale. RESULTS: Of 1,983 citations identified, 28 case-control studies met inclusion criteria for this review. Six meta-analyses that examined four domains (decision-making, cognitive flexibility, inhibitory control, and working memory) were conducted. The only meta-analysis to show a significant difference in executive functioning between BED and obese controls was working memory (SMD = 0.32, 95% IC: -0.60, -0.03; p = 0.028), with an effect size of small magnitude. Qualitative inspection of the literature indicated mixed findings for control inhibition, decision making and cognitive flexibility in individuals with BED compared to controls (obese or normal weight). In addition, people with BED showed poorer problem solving performance, but similar planning abilities to obese controls. CONCLUSIONS: Individuals with BED were found to show worse performance on working memory tasks compared to obese individuals without the disorder. The findings did not provide definitive evidence of alterations in other aspects of executive functioning. Interest in executive functioning in people with BED is increasing but is limited by insufficient data from small studies with varied methodology. Future studies should focus on using similar tests and outcome measures, in order to enable more pertinent comparisons across studies.

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BACKGROUND: Female adolescents with type I diabetes mellitus (TIDM) have an increased risk of developing eating disorders (ED) due to the dietary recommendations. OBJECTIVE: Investigate the association between dietary intake and increased risk of ED. METHODS: Case-control study with 50 T1DM female adolescents (11-16 years) and 100 healthy peers (CG). Measures included food frequency questionnaire (FFQ-PP), Child-EDE.12, economic and anthropometric data. RESULTS: Comparing female adolescents with T1DM vs CG, the first had higher intake of: bread, cereal, rice, and pasta (29.7 vs 23.8%, p = 0.001), vegetables (6.5 vs 2.8%, p < 0.001), milk yogurt and cheese (9.9 vs 7.6%, p = 0.032), fat, and oils (8.2 vs 5.9%, p = 0.003), besides higher fiber intake (19.2 vs 14.7%, p = 0.006) and lower consumption of sweets (13.6 vs 30.7%, p < 0.001). No differences on ED psychopathology (Child-EDE subscales and global score) were found between groups. In unadjusted association between the ED psychopathology and dietary intake, a diet rich in fiber was significantly associated with both the global and eating concern scores. Among CG, increased intake of meat, poultry, fish, and eggs and decreased bread, cereal, rice, and pasta consumption were significantly associated with higher ED psychopathology. When BMI and age are adjusted, the association between fiber intake and ED psychopathology is no longer significant among diabetic participants; however, in the CG, this association remains. CONCLUSIONS: The study suggests that an association between dietary intake and ED psychopathology might exist in female adolescents with and without TIDM and that careful evaluation of the dietary profile and risk of developing an ED should be considered in clinical practice. LEVEL OF EVIDENCE: Level III, case-control study.

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"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.

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RESUMO O objetivo deste relato foi refletir sobre a adaptação, sobre as dificuldades e sobre as potencialidades de implementação do programa de prevenção conjunta de obesidade e transtornos alimentares New Moves para meninas de escolas públicas de São Paulo (SP). A versão brasileira do programa tem como potencialidades utilizar técnicas comportamentais efetivas, como a teoria sociocognitiva e a entrevista motivacional, e apresentar um conteúdo que aborda fatores comuns à obesidade e aos transtornos alimentares, o qual pode ser aplicado considerando-se as dificuldades quanto à adaptação e implementação apresentadas no estudo.

ABSTRACT The aim of this study was to reflect upon the adaptation process, difficulties and potentials of the implementation of the New Moves program, designed to prevent obesity and eating disorders in girls of public schools in São Paulo (SP). The Brazilian version of the program has the potential to use effective behavioral techniques such as socio-cognitive theory and motivational interviewing, and present a content that addresses factors common to obesity and eating disorders, which can be applied considering the difficulties related to adaptation process and implementation presented in the study.

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PURPOSE: To conduct a cluster randomized controlled trial comparing the Brazilian version of the New Moves program (NMP) versus observation among Brazilian adolescent girls. METHODS: Ten schools were randomly allocated to the Brazilian NMP or the observation arm. Study participants included 12-14-year-old girls. Recruitment occurred between February 2014 and March 2015. The NMP included sports, nutritional support, motivational interviews, collective lunch, and parental information materials. Our main outcome was the Body Shape Questionnaire (BSQ). Secondary outcomes included the Rosenberg Self-Esteem Scale and the Unhealthy Weight-Control Behaviors Index, as well as body mass index. Study results were evaluated through generalized estimating equations. RESULTS: A total of 270 adolescents participated in the study. At baseline, mean age was 13.4 years, and average BMI was 21.4. The intervention did not result in any statistically significant differences between the NMP and the observation arm, including BSQ (predicted means of 64.33 - IC 95% 59.2-69.47 vs. 62.02 - IC 95% 56.63-67.4), respectively) and our secondary outcomes. Adherence was low during the intervention (32.9%) and maintenance (19.1%) phases of the program. CONCLUSION: The New Moves program did not lead to significant changes in our measured outcomes. Future studies should investigate whether changes might occur when comprehensive behavioral programs are sustained over longer periods while also being customized to local population characteristics.

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Abstract: "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.

Resumo: A compulsão alimentar ("craving" ou "fissura") é um estado motivacional que produz um desejo intenso relacionado a comportamentos de consumo. Apesar do crescente interesse no conceito da compulsão alimentar, para poder avaliá-la adequadamente, faltam instrumentos traduzidos e adaptados para o português do brasileiro. Os objetivos foram traduzir e adaptar o Trait e o State Food Craving Questionnaire (FCQ-T e FCQ-S) para o português brasileiro e avaliar as propriedades psicométricas destas versões. O FCQ-T e FCQ-S foram traduzidos e adaptados para ao português brasileiro e aplicados a alunos da Universidade Federal de São Paulo. Os modelos originais de ambos os questionários foram analisados com diferentes estimadores (de frequência e bayesianos). Foi avaliada a qualidade do ajuste subjacente aos itens de ambas escalas, usando os seguintes índices: χ2, WRMR, índice de ajuste comparativo, índice de Tucker-Lewis e RMSEA. As análises incluíram os dados de 314 participantes. Foram obtidos índices de ajuste baixos para ambos questionários originais, independentemente do estimador utilizado e do modelo estrutural original. Assim, três especialistas em transtornos alimentares revisaram o conteúdo dos instrumentos e selecionaram os itens para avaliar os aspectos centrais do construto de compulsão alimentar. Os modelos (questionários) novos e reduzidos produziram índices satisfatórios de qualidade de ajuste. Discussão: Nossas versões abreviadas do FCQ-S e do FCQ-T divergem consideravelmente do arcabouço conceitual dos questionários originais. Com base nos achados, propomos uma alternativa possível, isto é, para avaliar a compulsão alimentar enquanto construto unidimensional.

Resumen: "Craving" es un estado motivacional que suscita un deseo intenso relacionado con hábitos de consumo. A pesar del creciente interés en el concepto de food craving (antojos alimentarios), existe una falta de disponibilidad de instrumentos para evaluarlo con el portugués de Brasil. Los objetivos fueron traducir y adaptar el Trait y el State Food Craving Questionnaire (FCQ-T y FCQ-S) al portugués de Brasil y evaluar las propiedades psicométricas de estas versiones. El FCQ-T y el FCQ-S fueron traducidos y adaptados al portugués de Brasil y se administraron a estudiantes en la Universidad Federal de São Paulo. Se examinaron los modelos originales en ambos cuestionarios, considerando diferentes estimadores (de frecuencia y bayesianos). La bondad de ajuste que subyace en los ítems de ambas escalas se evaluó mediante los siguientes índices de ajuste: χ2, WRMR, índice de ajuste comparativo, el índice de Tucker-Lewis y la RMSEA. Los resultados contaron con los datos de 314 participantes que fueron incluidos en los análisis. Se obtuvieron escasos índices de ajuste en ambos cuestionarios originales, independientemente del estimador usado y modelo estructural original. De este modo, tres expertos en desórdenes alimenticios revisaron el contenido de los instrumentos y seleccionaron los ítems que fueron considerados, con el fin de evaluar los aspectos fundamentales del constructo "craving". Los modelos nuevos y reducidos (cuestionarios) generaron índices de ajuste positivos. Nuestras versiones abreviadas del FCQ-S y FCQ-T divergían considerablemente del marco conceptual respecto a los cuestionarios originales. Basado en los resultados de este estudio, proponemos una posible alternativa, por ejemplo, evaluar el craving for food como un constructo unidimensional.

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OBJECTIVE: To develop and validate the weight-control behaviors (WCBs) scale and to evaluate its psychometric properties. STUDY DESIGN: We made use of data from a cluster-randomized trial assessing the effectiveness of the Brazilian New Moves Program. The Brazilian New Moves Program was a multicomponent intervention aimed at preventing weight-related problems among adolescent girls in public schools in São Paulo, Brazil. RESULTS: Healthy and unhealthy WCBs were strongly associated. A 2-factor solution was the best model to explain the correlation across items, including following constructs: (1) healthy WCB: exercising, eating more fruits and vegetables, drinking less regular soda or sweetened drinks, eating fewer sweets, and paying attention to portion sizes; and (2) unhealthy WCB: skipping meals and the presence of any other, combined unhealthy weight-control behaviors, including fasting, eating little, going on a diet, vomiting, taking diet pills, using diuretics (water pills), using laxatives, using food substitutes (powder/special drinks), and smoking more cigarettes. The WCB scale was determined to be reliable (internally consistent) and valid, with high scores positively associated with body dissatisfaction and high body mass index values. Individual reliability values were high for factors representing healthy and unhealthy WCBs. CONCLUSIONS: Our findings support the use of the WCB scale as a screening tool for overall weight control behaviors among female adolescents. This assessment tool should be considered in future observational and experimental prospective studies. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials: RBR-6ddpb3.

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OBJECTIVES: (1) To collect, analyze and synthetize the evidence on muscle dysmorphia diagnosis as defined by Pope et al. and (2) To discuss its appropriate nosology and inclusion as a specific category in psychiatric classificatory systems. METHOD: A systematic search in the MEDLINE, the PsycNET, the LILACS and SciELO databases and in the International Journal of Eating Disorders was conducted looking for articles published between January 1997 and October 2014 and in EMBASE database between January 1997 and August 2013. Only epidemiological and analytical studies were considered for selection. The methodological quality of included studies was assessed according to the Evidence-Based Mental Health and the National Health and Medical Research Council's guidelines. The support for inclusion of muscle dysmorphia in psychiatric classificatory systems was examined against Blashfield et al.'s criteria. RESULTS: Thirty-four articles were considered eligible out of 5136. Most of the studies were cross-sectional and enrolled small, non-clinical samples. The methodological quality of all selected papers was graded at the lowest hierarchical level due to studies' designs. Forty-one percent of the publications considered the available evidence insufficient to support the inclusion of muscle dysmorphia in any existing category of psychiatric disorders. The current literature does not fulfill Blashfield et al.'s criteria for the inclusion of muscle dysmorphia as a specific entity in psychiatric diagnostic manuals. CONCLUSION: The current evidence does not ensure the validity, clinical utility, nosological classification and inclusion of muscle dysmorphia as a new disorder in classificatory systems of mental disorders.

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BACKGROUND: Binge 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/DESIGN: Sixty 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. DISCUSSION: Despite 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 REGISTRATION: Clinical Trials NCT02180984 . Registered in July 2014.

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BACKGROUND: Objective binge eating episodes (OBEs) refer to binge eating on an unusually large amount of food and are the core symptom in current definitions of bulimia nervosa (BN) and binge eating disorder (BED). Subjective binge eating episodes (SBEs) refer to eating on a small or moderate amount of food (that is perceived as large) and like OBEs are associated with loss of control (LOC). Reaching consensus on what is considered a large amount of food can however be problematic and it remains unclear if the size of a binge is an essential component for defining a binge eating episode. The aim of this study was to compare the eating disorder features and general psychopathology of subjects reporting OBEs with those reporting only SBEs. METHODS: This is a retrospective secondary analysis of data from 70 obese participants at the recruitment phase of a multicentre trial for BED. Individuals who answered positively to the presence of binge eating and LOC over eating had their binge eating episodes further explored by interview and self-report. Two groups, those who reported current OBEs (with or without SBEs) and those who reported current SBEs only were compared for age, gender, marital status, body mass index (BMI), indicators of LOC over eating, severity of binge-eating and associated psychopathology. RESULTS: The majority of participants in both the OBE and SBE groups endorsed the experience of at least four indicators of LOC. There were no significant differences between the groups. Both groups had high levels of binge-eating severity, moderate severity of associated depressive symptoms and frequent psychiatric co-morbidity. CONCLUSION: Treatment seeking participants with obesity who reported SBEs alone were similar to those who reported OBEs in terms of eating disorder features and general psychopathology. These findings suggest that classificatory systems of mental illnesses should consider introducing SBEs as a feature of the diagnostic criteria for binge eating and, thus, facilitate the inclusion of participants with SBEs in treatment trials.

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OBJECTIVE: To review the state of the art of the scientific literature on binge eating disorder in Latin America. METHOD: A literature search of studies conducted in Latin American countries using the term "binge eating" was performed in the following electronic databases: PubMed, LILACS, SciELO, and PsycINFO. Selected articles described studies developed with Latin American samples that met partial or complete DSM-IV diagnostic criteria for binge eating disorder. RESULTS: 8,123 articles were screened and 30 studies met the inclusion criteria (18 cross-sectional studies, 5 clinical trials, 4 case reports, 2 validity studies, and 1 cohort study). Most of the studies were conducted in Brazil (27), one in Argentina, one in Colombia, and one in Venezuela. The prevalence of binge eating disorder among obese people attending weight loss programs ranged between 16% and 51.6%. The comparison between obese people with and without binge eating disorder showed a tendency of higher weight, longer history of weight fluctuation, more concern about shape and weight, and association with psychiatric comorbidity in those with binge eating disorder. CONCLUSION: Binge eating disorder is a detectable phenomenon in Latin America with clinical features similar to those found in the international literature. This review provides support for the consideration of binge eating disorder as a distinct eating disorder in the International Classification of Diseases - 11th edition.

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OBJETIVO: Revisar o estado de arte da literatura latino-americana sobre o transtorno da compulsão alimentar periódica. MÉTODO: Foi feita uma busca sobre estudos realizados em países latino-americanos usando-se o termo "binge eating", nas seguintes bases eletrônicas: PubMed, LILACS, SciELO e PsycINFO. O critério de inclusão foi selecionar estudos desenvolvidos com amostras latino-americanas que preencheram critérios parciais ou completos do transtorno da compulsão alimentar periódica pelo Manual Diagnóstico e Estatístico de Transtornos Mentais-4ª Edição. RESULTADOS: Foram rastreados 8.123 artigos e 30 preencheram o critério de inclusão (18 estudos de corte transversal, cinco ensaios clínicos, quatro relatos de casos, dois estudos de validade, um estudo de coorte). A maioria dos estudos foi conduzida no Brasil (27), um na Argentina, um na Colômbia e um na Venezuela. A prevalência de transtorno da compulsão alimentar periódica em obesos em programas para perda de peso esteve entre 16 por cento e 51,6 por cento. A comparação entre obesos com e sem transtorno da compulsão alimentar periódica mostrou uma maior tendência para peso mais alto, oscilação ponderal, preocupação com peso e forma corporal e associação com comorbidades psiquiátricas naqueles com transtorno da compulsão alimentar periódica. CONCLUSÃO: O transtorno da compulsão alimentar periódica mostra-se um fenômeno verificável na América Latina com características clínicas semelhantes às encontradas na literatura internacional. Esta revisão fornece subsídios para que o transtorno da compulsão alimentar periódica seja considerado uma categoria distinta de transtorno alimentar na Classificação Internacional de Doenças-11ª Edição.

OBJECTIVE: To review the state of the art of the scientific literature on binge eating disorder in Latin America. METHOD: A literature search of studies conducted in Latin American countries using the term "binge eating" was performed in the following electronic databases: PubMed, LILACS, SciELO, and PsycINFO. Selected articles described studies developed with Latin American samples that met partial or complete DSM-IV diagnostic criteria for binge eating disorder. RESULTS: 8,123 articles were screened and 30 studies met the inclusion criteria (18 cross-sectional studies, 5 clinical trials, 4 case reports, 2 validity studies, and 1 cohort study). Most of the studies were conducted in Brazil (27), one in Argentina, one in Colombia, and one in Venezuela. The prevalence of binge eating disorder among obese people attending weight loss programs ranged between 16 percent and 51.6 percent. The comparison between obese people with and without binge eating disorder showed a tendency of higher weight, longer history of weight fluctuation, more concern about shape and weight, and association with psychiatric comorbidity in those with binge eating disorder. CONCLUSION: Binge eating disorder is a detectable phenomenon in Latin America with clinical features similar to those found in the international literature. This review provides support for the consideration of binge eating disorder as a distinct eating disorder in the International Classification of Diseases - 11th edition.

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Pessoas com diagnóstico de transtorno da compulsão alimentar periódica (DSM-IV) são descritas como propensas a distúrbios nos processos de pensamento que são relevantes para a manutenção do quadro e para o tratamento. Este é um estudo exploratório visando avaliar o funcionamento cognitivo de sujeitos com o diagnóstico citado, sendo escolhido como instrumento o método de Rorschach, que permite acessar aspectos psicológicos menos sujeitos ao controle consciente do que os aferidos por escalas e auto-relatos. Foram selecionadas variáveis do Rorschach associadas ao funcionamento ideacional. A amostra constitui-se de 43 mulheres (média de 37,2 anos de idade), que, no Rorschach, evidenciam dificuldades na atividade ideativa, com predominância de um nível concreto e imaturo de ideação, perda dos limites da realidade e dos limites entre os eventos. Também há tendência a cognições de tom negativo. O uso defensivo de intelectualizações frágeis predispõe a sobrecargas emocionais. Mas também é observada a capacidade para pensar de forma flexível e construtiva, recurso associado a bom prognóstico em psicoterapias(AU)

Subjects with binge eating disorder (DSM-IV) have been described as being prone to difficulties in thinking processes which are important for the maintenance of their psychopathological picture and their treatment. To assess the cognitive functioning of subjects diagnosed with binge eating disorder. The design was of an exploratory study, and the elected instrument was the Rorschach method, Comprehensive System, which allows us to access the psychological aspects with less conscious control than self-reports, questionnaires and scales. The selected Rorschach variables were those associated with the ideational functioning. The sample consisted of 43 adult women (mean= 37, 2 years) with binge eating disorder. In the Rorschach they showed difficulties in the ideational activity, predominance of a more concrete and immature level of ideation, loss of reality boundaries and boundaries among events. There is also a tendency to cognitions of a negative tone. The defensive use of fragile intellectualizations predisposes these women to emotional overload. However, also observed was a capacity to think in a flexible and constructive way, resources associated with a good prognostic in psychotherapy(AU)

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Pessoas com diagnóstico de transtorno da compulsão alimentar periódica (DSM-IV) são descritas como propensas a distúrbios nos processos de pensamento que são relevantes para a manutenção do quadro e para o tratamento. Este é um estudo exploratório visando avaliar o funcionamento cognitivo de sujeitos com o diagnóstico citado, sendo escolhido como instrumento o método de Rorschach, que permite acessar aspectos psicológicos menos sujeitos ao controle consciente do que os aferidos por escalas e auto-relatos. Foram selecionadas variáveis do Rorschach associadas ao funcionamento ideacional. A amostra constitui-se de 43 mulheres (média de 37,2 anos de idade), que, no Rorschach, evidenciam dificuldades na atividade ideativa, com predominância de um nível concreto e imaturo de ideação, perda dos limites da realidade e dos limites entre os eventos. Também há tendência a cognições de tom negativo. O uso defensivo de intelectualizações frágeis predispõe a sobrecargas emocionais. Mas também é observada a capacidade para pensar de forma flexível e construtiva, recurso associado a bom prognóstico em psicoterapias

Subjects with binge eating disorder (DSM-IV) have been described as being prone to difficulties in thinking processes which are important for the maintenance of their psychopathological picture and their treatment. To assess the cognitive functioning of subjects diagnosed with binge eating disorder. The design was of an exploratory study, and the elected instrument was the Rorschach method, Comprehensive System, which allows us to access the psychological aspects with less conscious control than self-reports, questionnaires and scales. The selected Rorschach variables were those associated with the ideational functioning. The sample consisted of 43 adult women (mean= 37, 2 years) with binge eating disorder. In the Rorschach they showed difficulties in the ideational activity, predominance of a more concrete and immature level of ideation, loss of reality boundaries and boundaries among events. There is also a tendency to cognitions of a negative tone. The defensive use of fragile intellectualizations predisposes these women to emotional overload. However, also observed was a capacity to think in a flexible and constructive way, resources associated with a good prognostic in psychotherapy

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