Duygusal, Dışsal ve Kısıtlayıcı Yeme Bozukluklarının Metabolik Sendrom Gelişimi Üzerine Etkisi

Year 2020, , 36 - 43, 31.03.2020

Emel Bayrak , Rüştü Serter , Sedat Işıklı

https://doi.org/10.20492/aeahtd.669570

Cited By: 1

Abstract

Amaç: Aşırı yeme bozuklukları olarak tanımlanan, duygusal, dışsal ve kısıtlayıcı yeme bozuklukları ile metabolik sendrom ve metabolik sendrom parametreleri arasındaki ilişkiyi saptamak.
Gereç ve Yöntemler: İç Hastalıkları Polikliniğine ardışık olarak başvuran 169’u kadın, 58 i erkek, toplam 227 hasta alındı. Okuma yazma bilmeyen, mental geriliği olan, malignitesi bulunan ve herni, assit, karın içi kitle veya gebelik gibi bel çevresi ölçümünü etkileyebilecek faktörleri olan hastalar ile ortopedik anormallikleri olanlar çalışmaya alınmadı. Yeme bozukluklarının değerlendirilmesinde, “Hollanda Yeme Davranışı Anketi” Türkçe geçerlilik ve güvenilirlik çalışması yapılarak kullanıldı. Metabolik Sendrom tanısı için National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) kriterleri baz alındı.
Bulgular: Duygusal ve dışsal yeme bozuklukları açısından, MS olan ve olmayan kadın ve erkekler arasında istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0.05). Aynı durum, hastalar obez olanlar ve olmayanlar olarak ayrıldıklarında da benzerdir. Buna karşın; kadınlarda kısıtlayıcı yeme bozukluğu skorları gerek obez, gerekse MS olanlarda olmayanlara göre istatistiksel olarak anlamlı düzeyde yüksek bulunmuştur.(p<0.05).
Sonuç: Kısıtlayıcı yeme bozukluğu kadınlarda Metabolik Sendrom gelişimi ile ilişkilidir. Obezite ve komplikasyonlarının önlenmesinde karşılaşılan güçlükler, uygulanan benzer tipteki diyet programlarının hastalar tarafından idame ettirilememesi, hastaların aşırı yemeye neden olan yeme bozuklukları açısından değerlendirilmesinin ve öncelikle mevcut yeme bozukluğunun giderilmeye çalışılmasının önemini ortaya koymaktadır.

Purpose: The objective of this study was to evaluate the association between excessive eating behaviours such as emotional, external and restrained eating with the development of metabolic syndrome.
Methods: Study group consisted of 227 individuals consecutively examined at the outpatient clinic of Internal Medicine. Patients with illiteracy, mental retardation, malignancy, factors that may affect waist circumference measurement such as hernia, ascites, intra-abdominal mass or pregnancy, and those with orthopedic abnormalities were excluded from the study. To determine the eating behaviours, Turkish version of Dutch Eating Behaviour Questionnaire (DEBQ) were used after the validity and reliability of the test have been verified. National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) was used to diagnose metabolic syndrome.
Results: No statistically significant difference was found between men and women with and without MS in terms of emotional and exogenous eating disorders (p> 0.05). The same results were obtained when patients were divided into obese and non-obese patients. However, restrictive eating disorder scores were significantly higher in women with metabolic syndrome or obesity than those who non-obese or did not have metabolic syndrome (p <0.05).
Conclusion: In women, restrained eating disorder is associated with the development of metabolic syndrome. The difficulties encountered in the prevention of obesity, metabolic syndrome and its complications as well as the inability of the maintenance of similar diet programs by the patients reveals the importance of the evaluation and elimination of eating disorders that may cause these disorders.
Key words: metabolic syndrome, eating disorders, restrained eating

Keywords

Metabolik Sendrom, Yeme Bozuklukları, Kısıtlayıcı Yeme

Thanks

Dr.Ömer Dönderici'ye çalışma aşamasındaki katkılarından dolayı teşekkür ederim.

References

• 1. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation. 2002 Dec 17; 106(25):3143-421
• 2. Kaplan Hı, Kaplan Hs. The Psychosomatic Concept Of Obesity. J Nerv Ment Dis. 1957 Apr-Jun;125(2):181-201.
• 3. Schachter S, Goldman R, Gordon A. Effects Of Fear, Food Deprivation And Obesity On Eating J Pers Soc Psychol. 1968 Oct;10(2):91-7.
• 4. Herman CP, Mack D. Restrained and unrestrained eating. J Pers.1975;43:647– 660.
• 5. Nisbett Re. Eating Behavior And Obesity İn Men And Animals.Adv Psychosom Med. 1972;7:173-93.
• 6. Van Strien, T., Frijters, J. E. R., Bergers, G. P. A., & Defares, P. B. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders, 5, 295–315.
• 7. METSAR, Türkiye Metabolik Sendrom Sıklığı Araştırması http://www.metsend.org/pdf/Metsar-metsend.pdf Ulaşılma tarihi:02.08.2019
• 8. Herman CP, Polivy J. Restrained eating. In: Stunkard AJ, editor. Obesity. Philadelphia, PA: Saunders; (1980). p. 208–25.
• 9. Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res (1985) 29(1):71–83.10.1016/0022-3999(85)90010-8
• 10. Adams RC, Chambers CD, Lawrence NS. 2019 Do restrained eaters show increased BMI, food craving and disinhibited eating? A comparison of the Restraint Scale and the Restrained Eating scale of the Dutch Eating Behaviour Questionnaire. R. Soc. open sci. 6:190174. http://dx.doi.org/10.1098/rsos.190174
• 11. Sin NLY., Vartanian LR. Is counter-regulation among restrained eaters a result of motivated overeating? Appetite, 59(2), 488–493. https://doi.org/10.1016/j.appet.2012.06.014
• 12. Abnorm J. Restraint, anticipated consumption, and overeating. Psychol.1985;94:547–555.
• 13. Beiseigel JM, Nickols-Richardson SM. Cognitive eating restraint scores are associated with body fatness but not with other measures of dieting in women.Appetite. 2004 Aug;43(1):47-53. 10.1016/j.appet.2004.02.002
• 14. Stice E, Cooper JA, Schoeller DA, Tappe K, Lowe MR. Are dietary restraint scales valid measures of moderate- to long-term dietary restriction? Objective biological and behavioral data suggest not. Psychol Assess 2007; 19: 449–458.
• 15. Savage JS, Hoffman L, Birch LL. Dieting, restraint, and disinhibition predict women's weight change over 6 y.Am J Clin Nutr. 2009 Jul;90(1):33-40. doi: 10.3945/ajcn.2008.26558.
• 16. Tucker LA., Bates L. . Restrained Eating and Risk of Gaining Weight and Body Fat in Middle-Aged Women: A 3-Year Prospective Study. American Journal of Health Promotion, 23(3), 187–194. doi:10.4278/ajhp.07061456
• 17. Lauzon-Guillain B, Basdevant A, Romon M, Karlsson J, Borys JM, Charles MA; FLVS Study Group. Is restrained eating a risk factor for weight gain in a general population?Am J Clin Nutr. 2006 Jan;83(1):132-8.
• 18. Schur EA., Cummings ED, Callahan HS. and Foster-Schubert K.E, Association of Cognitive Restraint with Ghrelin, Leptin, and Insulin Levels in Subjects Who Are Not Weight-ReducedPhysiol Behav. 2008 Mar 18; 93(4-5): 706–712. doi: 10.1016/j.physbeh.2007.11.025
• 19. Myhre R, Kratz M, Goldberg J, Polivy J, Melhorn S, Buchwald D, Cummings DE, Schur EA. A twin study of differences in the response of plasma ghrelin to a milkshake preload in restrained eaters. Physiol Behav. 2014 Apr 22;129:50-6. doi:10.1016/j.physbeh.2014.02.008.
• 20. Crujeiras AB, Goyenechea E, Abete , Lage M, Carreira MC, Martínez JA, Casanueva FF. Weight regain after a diet-induced loss is predicted by higher baseline leptin and lower ghrelin plasma levels. J Clin Endocrinol Metab. 2010 Nov;95(11):5037-44. doi: 10.1210/jc.2009-2566. Epub 2010 Aug 18.
• 21. Strohacker K, McCaffery JM, MacLean PS, Wing RR1. Adaptations of leptin, ghrelin or insulin during weight loss as predictors of weight regain: a review of current literature. Int J Obes (Lond). 2014 Mar;38(3):388-96. doi: 10.1038/ijo.2013.118. Epub 2013 Jun 26.
• 22. Hofbauer, K. Molecular pathways to obesity. International Journal of Obesity, 26(S2), S18–S27. doi:10.1038/sj.ijo.0802124
• 23. Loos RJF, Bouchard C, Obesity - is it a genetic disorder? Journal of Internal Medicine, 254(5), 401–425. doi:10.1046/j.1365-2796.2003.01242.
• 24. Warren MP. Endocrine Manifestations of Eating Disorders. The Journal of Clinical Endocrinology & Metabolism, 96(2), 333–343. doi:10.1210/jc.2009-2304
• 25. Bakan S, Tek A.N. Enerji Harcamasının Düzenlenmesinde Hormonların Etkileri ACU Sağlık Bil Derg 2018; 9(3):207-212
• 26. Vella K.R, Ramadoss P., Lam S.F, Harris J.C, Ye F.D, Same P.D, O’Neill N.F, Flier M.E and Hollenberg N.A NPY and MC4R signaling regulate thyroid hormone levels during fasting through both central and peripheral pathways Cell Metab. 2011 Dec 7; 14(6): 780–790. doi: 10.1016/j.cmet.2011.10.009
• 27. Song YM, Lee K. Eating behavior and metabolic syndrome over time. Eat Weight Disord. 2019 Feb 4. doi: 10.1007/s40519-019-00640-9.
• 28. Polivy J., Herman CP Restrained Eating and Food Cues: Recent Findings and Conclusions Curr Obes Rep March 2017, Volume 6, Issue 1, pp 79–85
• 29. Herman CP, Polivy J. Curr Obes Rep External cues in the control of food intake in humans: the sensory-normative distinction. Physiol Behav.2008;94:722–8