Abstract In addition to dietary factors and sedentary habits, there is a relationship between obesity and psychological variables, even without a clear distinction between cause, effect, and correlation. Despite this relationship, weight-loss programs are limited to a combination of nutrition and physical education, leaving psychological intervention out of the treatment plan. Self-esteem issues, depression, and anxiety are just some of the emotional conditions related to obesity. However, there is no information in the literature about the importance of psychological counseling in a multidisciplinary program for weight-loss in adults. In this context, the main objective of this study was to analyze the effect of cognitive-behavioral therapy in groups (CBTG) combined with nutrition and physical education within a multidisciplinary approach to treat obesity. 46 individuals (7 men and 39 women) were divided into two groups: control (GC) and psychology (GP). Baseline and intervention measures were obtained prior to intervention and before the final meeting, including physical capacity tests and the administering the International Physical Activities Questionnaire (IPAQ). Both groups attended weekly lectures given by a nutritionist and two physical education professionals for 12 weeks. In addition, the GP participated in weekly sessions of CBTG for the same period. After the program, there were significant changes in body mass index, waist circumference, body fat percentage, and strength of the lower limbs in both groups. In addition to these changes, the GP also showed improvements in diastolic blood pressure and IPAQ scores, being the only one that increased its time of weekly physical activity. Thus, it was concluded that the psychological treatment might play an important role in a multidisciplinary weight-loss program.
PURPOSE: to determine daily calcium ingestion and its correlation with bone density in patients with anorexia nervosa. PATIENTS AND METHODS: fourteen women with anorexia nervosa recorded their 24 h food ingestion in a standardized diary and were submitted to bone densitometry. Data were analyzed statistically by the c² test and the Pearson correlation, with the level of significance set at p<0.05. RESULTS: mean bone density in the lumbar spine and in the femur were 0.95 ± 0.15 and 0.88 ± 0.26, respectively. There was a significant correlation between time of amenorrhea and bone mass loss both in the lumbar spine (r=-0.65; p=0.01) and in the femur (r=-0.71; p=0.006). All patients but one presented lower calcium ingestion than the recommended dietary allowances, with a mean of 554.5 mg/day (range from 120 to 840 mg/day). Sixty-four percent of the patients presented some degree of bone mass loss (osteopenia or osteoporosis) in the spine and 57% in the femur. None of the six patients with a deficit in calcium ingestion of less than 60% presented osteoporosis; on the other hand, three of eight patients who had deficit in calcium ingestion higher than 60% presented osteoporosis. CONCLUSION: patients with anorexia nervosa had a low calcium ingestion and a significant bone mass loss, which were directly intercorrelated. Low bone density was also correlated with time of amenorrhea.
OBJETIVO: avaliar a ingestão diária de cálcio e estabelecer sua correlação com a densidade óssea de pacientes com anorexia nervos. PACIENTES E MÉTODOS: quatorze mulheres com anorexia nervosa registraram, em diário alimentar padronizado, sua ingestão em 24 horas e foram submetidas ao exame de densitometria óssea. A análise estatística foi feita pelos testes do c² e correlação de Pearson, adotando-se como significância estatística p<0,05. RESULTADOS: a média da densidade óssea na coluna lombar foi de 0,95 ± 0,15 e no colo do fêmur foi de 0,88 ± 0,26. Houve correlação significativa entre o tempo de amenorréia e a perda de massa óssea, tanto na coluna lombar (r=-0,65; p=0,01) como no fêmur (r=-0,71; (p=0,0068). Com exceção de uma paciente, todas apresentavam ingestão de cálcio inferior ao recomendado pelo RDA, com média de 554,5 mg/dia (variando de 120 a 840 mg/dia). Observou-se que 64% das pacientes apresentavam algum grau de perda de massa óssea (osteopenia ou osteoporose) na coluna e 57% no fêmur. Das seis pacientes com déficit na ingestão de cálcio inferior a 60%, nenhuma apresentou osteoporose, ao passo que das oito pacientes com déficit superior a 60% na ingestão de cálcio, três tinham osteoporose. CONCLUSÃO: Pacientes com anorexia nervosa têm baixa ingestão de cálcio e perda significativa de massa óssea, que estão diretamente relacionadas entre si. A baixa densidade óssea está, também, correlacionada com o tempo de amenorréia.