RESUMO Objetivo Realizar a avaliação psicométrica da Escala de Atitudes Alimentares Transtornadas (EAAT) para adolescentes. Métodos A amostra foi composta por 1.119 adolescentes (12-18 anos; 59,6% do sexo feminino) estudantes de escolas técnicas do estado de São Paulo, que responderam online à EAAT, ao Teste de Atitudes Alimentares (EAT-26) e à Escala de Restrição (RS). A consistência interna da EAAT foi avaliada usando o alpha de Cronbach e a validade convergente por meio do coeficiente de correlação de Pearson com o EAT-26 e a RS. A confiabilidade teste-reteste foi avaliada usando uma subamostra de 61 adolescentes. A validade known-groups foi determinada pela comparação dos escores médios de estudantes do sexo feminino com os escores de 33 adolescentes do sexo feminino com transtornos alimentares. Resultados A consistência interna foi de 0,79, e as pontuações no EAT-26 e na RS estiveram positivamente correlacionadas com a pontuação da EAAT (EAT: 0,78 para o sexo feminino e 0,59 para o masculino, p < 0,001; RS: 0,63 para o sexo feminino e 0,48 para o masculino, p < 0,001). O escore da EAAT diferenciou estudantes e pacientes com transtornos alimentares (p < 0,001). O coeficiente de correlação intraclasse na confiabilidade teste-reteste foi de 0,87. Conclusão A versão da EAAT para adolescentes mostrou boa consistência interna, validade convergente, known-groups e confiabilidade teste-reteste, sugerindo o seu potencial na identificação de atitudes alimentares transtornadas entre adolescentes. Ela pode, portanto, ser útil na identificação de adolescentes com risco de transtornos alimentares, auxiliando em programas de prevenção.

ABSTRACT Objective To perform the psychometric evaluation of the Disordered Eating Attitude Scale (DEAS) for adolescents. Methods Sample consisted of 1,119 Brazilian adolescents (12-18 years old; 59.6% female) studying at technical schools in São Paulo state-Brazil, who answered an online survey with the DEAS, the Eating Attitude Test (EAT-26), and the Restraint Scale (RS). The internal consistency of the DEAS was assessed using Cronbach’s alpha. The convergent validity of DEAS was evaluated by means of Pearson’s coefficient correlation with EAT-26 and RS. The test-retest reliability was evaluated using a sub-sample of 61 adolescents. Known-groups validity was determined by comparing female student mean scores with scores of 33 female adolescents with eating disorders. Results The reliability of the DEAS was 0.79. EAT-26 and RS scores were positively correlated with DEAS scores (EAT: 0.78 for females and 0.59 for males, p < 0.001; RS: 0.63 for females and 0.48 for males, p < 0.001). The DEAS total and subscale scores differentiated students and patients with eating disorders (p < 0.001). The intra-class correlation coefficient for test-retest reliability was 0.87. Conclusion Results indicate that the DEAS adolescent version showed good internal consistency, convergent validity, known-groups validity, and test-retest reliability, suggesting its potential in identifying disordered eating attitudes among adolescents. It could also be helpful in identifying adolescents at risk from eating disorders, assisting in prevention programs.

O objetivo do estudo foi apresentar a adaptação transcultural e validação da Escala de Atitudes em Relação ao Sabor da Health and Taste Attitude Scale para o Português. A metodologia contou com a tradução da escala; avaliação da equivalência conceitual, operacional e de item, por 14 experts e 51 universitárias; avaliação da equivalência semântica e mensuração, por 12 mulheres bilíngues por meio do teste t pareado, do coeficiente de correlação de Pearson e do coeficiente de correlação intraclasse; avaliação da consistência interna e confiabilidade teste-reteste por meio do Alpha de Cronbach e do Coeficiente de Correlação Intraclasse, respectivamente, após aplicação em 216 universitárias; avaliação da validade discriminante e concorrente, por meio do teste T e do Coeficiente de Correlação de Spearman, respectivamente; além de Análise Fatorial Confirmatória e Analise Fatorial Exploratória. A escala foi considerada adequada e de fácil compreensão pelos experts e universitárias e apresentou boa consistência interna e confiabilidade (µ 0,86; CCI 0,84). Os resultados apontam que a escala é válida e pode ser utilizada em estudos com mulheres, para entender melhor as atitudes em relação ao sabor.

The scope of this study was to show the cross-cultural adaptation and validation of the Health and Taste Attitude Scale in Portuguese. The methodology included translation of the scale; evaluation of conceptual, operational and item-based equivalence by 14 experts and 51 female undergraduates; semantic equivalence and measurement assessment by 12 bilingual women by the paired t-test, the Pearson correlation coefficient and the coefficient intraclass correlation; internal consistency and test-retest reliability by Cronbach's alpha and intraclass correlation coefficient, respectively, after application on 216 female undergraduates; assessment of discriminant and concurrent validity via the t-test and Spearman's correlation coefficient, respectively, in addition to Confirmatory Factor and Exploratory Factor Analysis. The scale was considered adequate and easily understood by the experts and university students and presented good internal consistency and reliability (µ 0.86, ICC 0.84). The results show that the scale is valid and can be used in studies with women to better understand attitudes related to taste.

O objetivo do estudo foi apresentar a adaptação transcultural e validação da Escala de Atitudes em Relação ao Sabor da Health and Taste Attitude Scale para o Português. A metodologia contou com a tradução da escala; avaliação da equivalência conceitual, operacional e de item, por 14 experts e 51 universitárias; avaliação da equivalência semântica e mensuração, por 12 mulheres bilíngues por meio do teste t pareado, do coeficiente de correlação de Pearson e do coeficiente de correlação intraclasse; avaliação da consistência interna e confiabilidade teste-reteste por meio do Alpha de Cronbach e do Coeficiente de Correlação Intraclasse, respectivamente, após aplicação em 216 universitárias; avaliação da validade discriminante e concorrente, por meio do teste T e do Coeficiente de Correlação de Spearman, respectivamente; além de Análise Fatorial Confirmatória e Analise Fatorial Exploratória. A escala foi considerada adequada e de fácil compreensão pelos experts e universitárias e apresentou boa consistência interna e confiabilidade (µ 0,86; CCI 0,84). Os resultados apontam que a escala é válida e pode ser utilizada em estudos com mulheres, para entender melhor as atitudes em relação ao sabor.

The scope of this study was to show the cross-cultural adaptation and validation of the Health and Taste Attitude Scale in Portuguese. The methodology included translation of the scale; evaluation of conceptual, operational and item-based equivalence by 14 experts and 51 female undergraduates; semantic equivalence and measurement assessment by 12 bilingual women by the paired t-test, the Pearson correlation coefficient and the coefficient intraclass correlation; internal consistency and test-retest reliability by Cronbach's alpha and intraclass correlation coefficient, respectively, after application on 216 female undergraduates; assessment of discriminant and concurrent validity via the t-test and Spearman's correlation coefficient, respectively, in addition to Confirmatory Factor and Exploratory Factor Analysis. The scale was considered adequate and easily understood by the experts and university students and presented good internal consistency and reliability (µ 0.86, ICC 0.84). The results show that the scale is valid and can be used in studies with women to better understand attitudes related to taste.

The aim of this study was to evaluate clinical differences and similarities between anorexia nervosa (AN) patients with and without a history of obesity. We evaluated 108 patients (10-18 years old) with the restricting or purging subtype of AN, treated at a public referral facility in Brazil. To evaluate clinical characteristics, we used a standardized psychiatric interview, the Development and Well-Being Assessment, the Children's Global Assessment Scale, the Eating Disorder Examination Questionnaire (EDE-Q), and body mass index (BMI)-for-age percentile. The mean age was 14.8±2.5 years, and 95 (88.0%) of the patients were female. Of the 108 patients evaluated, 78 (72.2%) had restrictive AN and 23 (21.3%) had a history of obesity. Patients with and without a history of obesity were similar in terms of age at onset, time from symptom onset to treatment, duration of treatment, impact of the disease on global functioning, and comorbidities. At treatment initiation, those with a history of obesity were at a higher BMI-for-age percentile and scored higher on the Weight Concern subscale of the EDE-Q. We conclude that severe cases of AN can occur in patients with and without a history of obesity with no differences in terms of the baseline characteristics and the duration of treatment. The significantly higher BMI-for-age percentiles amongst patients with a history of obesity (at treatment initiation) suggests that the urge for treatment shouldn't be based on BMI percentile only.

El objetivo de este estudio fue identificar las diferencias clínicas entre pacientes con anorexia nerviosa (AN) con y sin antecedentes de obesidad. Se evaluaron 108 pacientes (10-18 años de edad) con AN del subtipo restrictivo o purgativo, tratados en un centro público de referencia en Brasil. Para evaluar las características clínicas, se utilizaron una entrevista estandarizada psiquiátrica, el Development and Well-Being Assessment, la Children's Global Assessment Scale, el Eating Disorder Examination Questionnaire (EDE-Q), y el percentil del índice de masa corporal (IMC) para la edad. La edad media fue de 14.80±2, años, y 95 (88.00%) de los pacientes eran del sexo femenino. De los 108 pacientes, 78 (72.20%) tenían AN restrictiva y 23 (21.30%) tenían antecedentes de obesidad. Los pacientes con y sin antecedentes de obesidad eran similares en términos de edad de inicio de la enfermedad, tiempo desde el inicio de los síntomas hasta el inicio del tratamiento, duración del tratamiento, impacto de la enfermedad en el funcionamiento general y comorbilidades. Al inicio del tratamiento, los pacientes con antecedentes de obesidad estaban en un percentil más alto de IMC para la edad y puntuaron más alto en la subescala preocupación por el peso del EDE-Q. En conclusión, casos graves de AN pueden ocurrir en pacientes con y sin antecedentes de obesidad.

Objective: To evaluate the frequency of risk behaviors for eating disorder (ED) in patients with type 1 diabetes (T1D) and their association with gender, nutritional status, variables related to T1D, and body satisfaction. Method: 189 individuals with T1D (12-56 years old) answered the Bulimic Investigation Test (BITE), the Eating Attitude Test (EAT), the Binge Eating Scale (BES), Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. Results: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively). There were significant differences between groups with and without risk for ED related to BMI (p = 0.009), gender (p = 0.001), insulin omission (p = 0.003), use of the carbohydrate counting method (p = 0.019), and body dissatisfaction (p = 0.001). The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036). Conclusions: Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor.

Objetivos: Investigar o perfil sociodemográfico e clínico de pacientes de um serviço especializado no tratamento de crianças e adolescentes com transtornos alimentares (TA) em São Paulo, Brasil, e comparar os dados com a literatura científica relevante. Métodos: Este estudo transversal avaliou pacientes com diagnóstico de TA de ambos os sexos, com idade até 18 anos. Os dados foram coletados na admissão dos pacientes ao serviço. Resultados: A amostra foi composta por 100 sujeitos. A idade média foi de 15,41±0,18 anos, e a média de idade ao início dos TA foi de 13,5±0,19 anos. O tempo médio de duração da doença foi de 21,06±1,67 meses. Da amostra total, 82% dos pacientes eram meninas, 84% eram brancos, 64% provinham das classes econômicas A e B. Além disso, 60% iniciaram a patologia com 14 anos ou menos e 74% tinham comorbidades psiquiátricas. A forma total da anorexia nervosa foi o diagnóstico mais prevalente (43%). Os pacientes hospitalizados tiveram menor índice de massa corporal, mais tempo de TA e escores mais graves na Escala de Avaliação Global de Crianças quando comparados com pacientes do ambulatório (p < 0,05). Conclusões: Os pacientes brasileiros jovens com TA avaliados no presente estudo apresentaram características epidemiológicas e sintomatológicas muito semelhantes aos dados da literatura científica, inclusive com relação à alta prevalência de comorbidades psiquiátricas. A maior frequência das síndromes totais dos TA, o predomínio de quadros de início precoce, o longo tempo decorrido até iniciar tratamento especializado e a maior gravidade dos pacientes hospitalizados observados nesta amostra chamam atenção por diferirem do que tem sido relatado em estudos semelhantes e também por indicarem uma maior gravidade do TA.

Objectives: To investigate the sociodemographic and clinical profile of patients receiving treatment at a specialized service for children and adolescents with eating disorders (ED) in São Paulo, Brazil, and to compare data with the relevant literature. Methods: This cross-sectional study assessed male and female patients with ED up to 18 years of age. All data were collected upon admission. Results: A total of 100 subjects were assessed. Mean age was 15.41±0.18 years, and mean age at ED onset was 13.5±0.19 years. Mean disease duration was 21.06 ±1.67 months. Of the total sample, 82% of the patients were female, 84% were Caucasian, 64% came from A and B economic tiers. Moreover, in 60% ED started at 14 years of age or less, and 74% had psychiatric comorbidities. Anorexia nervosa was the most prevalent diagnosis (43%). Hospitalized patients had lower body mass index, longer ED duration, and more severe scores on the Children's Global Assessment Scale than outpatients (p < 0.05). Conclusions: Our young Brazilian patients with ED present epidemiological and symptomatic characteristics very similar to those found in the scientific literature, including a high prevalence of psychiatric comorbidities. The higher frequency of full syndrome ED, the predominance of cases with an early onset, the delay in beginning specialized treatment, and the more severe state of inpatients provide grounds for concern because these factors differ from what has been reported in reference studies and indicate greater ED severity.