Servicios Personalizados
Revista
Articulo
nueva página del texto (beta)
Español (pdf)
Artículo en XML
Referencias del artículo
Traducción automática
Enviar artículo por emailIndicadores
-
Citado por SciELO -
Accesos
Links relacionados
-
Similares en
SciELO
Compartir
Permalink
Salud mental
versión impresa ISSN 0185-3325
Salud Ment vol.29 no.3 México may./jun. 2006
Artículos originales
Conductas alimentarias de riesgo e imagen corporal de acuerdo al índice de masa corporal en una muestra de mujeres adultas de la ciudad de México
1Licenciada en Nutrición. Egresada de la Escuela de Dietética y Nutrición del ISSSTE, México.
2Doctora en Psicología y Profesora investigadora. Instituto de Ciencias de la Salud. Área Académica de Nutrición. Universidad Autónoma del Estado de Hidalgo.
La mujer adulta durante los periodos de embarazo, lactancia y alteraciones menstruales, presenta disminución de la actividad física y alteraciones psicológicas de diversos tipos, entre las cuales sobresale la depresión. Se ha propuesto que muchos de estos episodios depresivos pueden repercutir en su patrón alimentario y en la evaluación de la imagen corporal y desencadenar conductas alimentarias de riesgo, mismas que más tarde pueden transformarse en trastornos de la conducta alimentaria.
El objetivo de este estudio fue analizar la distribución y la relación que existe entre el Índice de Masa Corporal (IMC), las conductas alimentarias de riesgo y la percepción e insatisfacción con la imagen corporal, en una muestra de mujeres adultas de 25 a 45 años de edad, de la Ciudad de México.
Se trabajó con una muestra no probabilística a conveniencia, conformada por 659 mujeres, de 25 a 45 años de edad (X = 38.27; DE = 4.4041).
Para la recopilación de los datos se empleó parte de un instrumento autoaplicable que mide conductas alimentarias de riesgo (Escala de Factores de Riesgo Asociados a Trastornos Alimentarios). La imagen corporal se midió mediante dos dimensiones: a) percepción de la imagen y b) satisfacción/insatisfacción con la imagen corporal. El IMC se obtuvo a partir del autoreporte de peso y talla de los sujetos de estudio. Los puntos de corte empleados fueron los recomendados por el Comité de Expertos (OMS).
Los porcentajes obtenidos en cuanto a la percepción de la imagen corporal, fueron: 0.9% se percibió muy delgada, 15.3% delgadas, 44.4% se percibió normal, 32.6% con sobrepeso y 6.8% con obesidad. De la muestra 78.8% afirmó estar insatisfecha con su imagen corporal; 70.1% quería tener una figura más delgada.
Las conductas que registraron mayores porcentajes, correspondieron a las conductas compensatorias (17.3%) y al comer compulsivamente (12%); la dieta restringida presentó los porcentajes más bajos (5.5%).
De una correlación de Pearson entre el IMC, para conductas alimentarias de riesgo, insatisfacción y percepción de la imagen corporal, los datos mostraron que las variables que mayor correlación significativa alcanzaron con el IMC fueron: comer compulsivamente (r=0.42, p<0.01), insatisfacción con la imagen corporal (r=0.53, p<0.01) y percepción de la imagen corporal (r=0.76, p<0.01).
Los hallazgos permitieron confirmar la presencia de conductas alimentarias de riesgo, en población de mujeres adultas. Si bien dichos datos no ameritan el diagnóstico de un trastorno alimentario, denotan la presencia de ciertos síntomas de estos trastornos y muestran que es común encontrarlos en la población general. Uno de los peligros que representa este grupo de mujeres, recae en el hecho de que todas son madres, puesto que en diversas investigaciones se ha confirmado la relación entre ciertas características alimentarias maternas y el momento en que aparecen los trastornos en la conducta alimentaria en sus hijos.
Asimismo también fue posible observar que el IMC en la muestra estudiada tiende más al sobrepeso (32.3%) y la obesidad (13%). Estos valores son preocupantes no sólo por el hecho de favorecer la aparición de enfermedades crónico degenerativas, sino por la asociación que existe entre el sobrepeso y la obesidad con las conductas alimentarias de riesgo.
Las principales aportaciones de este trabajo las constituyen el haber obtenido la relación entre el IMC y diversas variables asociados a los trastornos alimentarios, en mujeres mexicanas adultas, así como el haber aportado información a partir de una escala mexicana multidimensional, válida y confiable, diseñada específicamente para el estudio de conceptos complejos como las conductas alimentarias de riesgo y la imagen corporal.
Palabras clave: Conductas alimentarias de riesgo; Índice de Masa Corporal; imagen corporal; mujeres adultas; Ciudad de México
Studies conducted in adolescent and young women have showed that body image perception and dissatisfaction are highly related with risk eating behaviors, particularly with compensatory behaviors. It has also been found that these women tend to overestimate their body size, showing more dissatisfaction.
Many studies on eating disorders have been developed in adolescents, but, what happens with adult women?
Adult women show periods of pregnancy, nursing, menstrual disorders and, a decrease in physical activity and, at the psychological level there is a lack of emotional stability and depression.
These episodes in general, have influence in feeding and body image, that could lead to risky eating behaviors (restricted dieting, fasting, skipping meals among others) affecting directly the state of health, because latter they can develop into eating disorders.
Undoubtedly, inadequate feeding can cause malnutrition and nutrimental deficiencies, provoking physiological alterations such as osteoporosis, anemia or hypokaliemia, and also, somatic complications during pregnancy, including abortions and low weight in the new born.
Objective.
To determine the relationship between body mass index (BMI), risky eating behaviours, body perception and body dissatisfaction in Mexican adult women from 25 to 45 years of age in Mexico City.
Methods.
A non probabilistic sample of 659 women from 25 to 45 years of age (X=38.27; SD=4.4) was used.
To collect the sample, an area of the Questionnaire for Health and Feeding called scale of risk factors associated to eating disorders (EFRATA) and body image was used. This is a self-report questionnaire, validated for this population. Its main purpose is to measure risk eating behaviors and body image. Questions refer to risky eating behaviors (binge eating, compensatory behaviors, restricted dieting, preoccupation about weight and figure), with 4 answering options: 1) Never, 2) Sometimes, 3) Frequently, and 4) Always.
Body Image was measured through two dimensions: (a) Body perception was measured through five specific items and (b) Body dissatisfaction was measured with a nine body figure scale, from thin to obese.
The BMI was obtained from weight and height self-report (BMI=kg/m2). Self report measures of weight and height have been found reliable; as there is a high correlation with data taken directly, the difference between them is 1.14 kg/m2, which does not interfere significantly.
The cut points recommended by the Expert Committee (OMS), are: low weight from 15 to 18.5; normal weight from 18.51 to 24.99; overweight from 25 to 29.99; obesity from 30 to 39.99 and morbid obesity higher than 40.
Results.
Body Mass Index distribution of the sample was: 1.1% low weight, 53.6% normal weight, 32.3% overweight, 12.4% obesity, and 0.6% of women were morbidly obese.
Body perception distribution was: 0.9% very thin, 15.3% thin, 44.4% normal, 32.6% overweight and 6.8% obese.
Results related to body dissatisfaction, showed that more than % of the sample was dissatisfied; 70.1% of the women were dissatisfied with their body image and wanted to be thinner and, 8.7% wanted to gain weight.
It was found that a large percentage of women (79%) are dissatisfied with their body image. From this percentage 70.1 wanted to be thinner and, 8.7% wanted to gain weight.
As to the relationship between BMI distribution and body dissatisfaction it was found that 14% of underweight and 54.2% normal weight women want to be even thinner.
The findings of the study showed that women with higher BMI, displayed more risky eating behaviors. Women with overweight and obesity displayed the higher percentages in binge eating.
A Pearson correlation was carried out to look for significant differences between BMI, risky eating behaviors and the two dimensions of body image (perception and dissatisfaction). Results indicated that BMI was significantly correlated with binge eating, body dissatisfaction and body image perception.
Discussion.
This study supported important information about the relation between BMI and risky eating behaviors in Mexican adult women. The most important result was to confirm the presence of disordered eating typical of eating disorders among adult women. Even though the data obtained do not demonstrate the diagnosis of an ED, it shows the presence of some of the characteristic symptoms, which means that these are commonles found among the general population. Although isolated symptoms are not a necessary indicator of the development of the disease, in a way they point out the individuals who are at risk of threatening their physical and mental health. On the other hand, one of the risks that adds to this particular population is the fact that all of them are mothers, as some research findings have confirmed the relationship between the mother's eating behaviors and the appearance of eating disorders in their children.
The results obtained in this research show that the BMI of the sample tends to be in the overweight (32.3%) and obese ranges (13%). These results agree with those of the National Nutrition Survey of 1999, were 52.5% of the women were classified as overweight or obese (30.8% as overweight and 21.7% as obese). These scores are important not just because they favor chronic-degenerative diseases, but also because of the great association between overweight and obesity with risky eating behaviors, something that could be confirmed in this study, as individuals with higher BMI, displayed more risky eating behaviors. The results of this study have consistently supported the positive relationship between BMI, binge eating, body dissatisfaction and body image perception, although group differences attributed to age were not statistically significant.
Finally, another important contribution of this study, is the use of a reliable and valid multidimentional questionnaire developed in Mexico, specifically designed for the study of two very complex issues such as risky eating behaviors and body image.
The main limitations of the study were that the findings were primarily based on self-report data and the use of a non-probabilistic sample of Mexican adult women.
Key words: Risky eating behaviors; body image; Body Mass Index; adult women; México
Referencias
1. Agras SW, Hammer L, Mcnicholas F: A prospective study of the influence of eating-disordered mothers on their children. International J Eating Disorders, 25:253-262, 1999. [ Links ]
2. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. DSM-IV. Cuarta edición. Pergamont Press, Washington, 1994. [ Links ]
3. Barry D, Grilo C, Masheb R: Gender differences in patients with binge eating disorder. International J Eating Disorders, 31(1):63-70, 2002. [ Links ]
4. BundelL JE: The Biology of Apetite. Clinical Applied Nutrición, 1:21-31, 1991. [ Links ]
5. Canovas B, Ruperto M, Mendoza E: Concordancia entre la autopercepción corporal y el IMC calculado en una población_voluntaria captada el IV Día Nacional de la Persona Obesa. Nutrición Hospitalaria, 16(4):116-120, 2001. [ Links ]
6. Casanueva E: Nutrición de la mujer adulta. En: Casanueva E, Kaufer M, Pérez AB, Arroyo P (eds.). Nutriología Médica. Ed. Panamericana, 122-147, México, 2001. [ Links ]
7. Case T, Lemieux S, Kennedy SH, Lewis GF: Elevated plasma lipids in patients with binge eating disorders are found only in those who are anorexic.International J Eating Disorders, 25(2):187-93, 1999. [ Links ]
8. Díaz BM, Rodríguez MF, Martin LC, Hiruela RM: Risk factors related with eating disorders in a community of adolescents. Atención Primaria Salud, 32(7):403-409, 2003. [ Links ]
9. Encuesta Nacional de Nutrición 2001. Cuadernos de Nutrición, 24(2):69-76, 2001. [ Links ]
10. Estrada D, Zuñiga T: Relación que existe entre significado psicológico de imagen corporal y autopercepción de ésta en estudiantes adolescentes de escuelas privadas. Tesis de Licenciatura en Psicología. UNAM, México,1997. [ Links ]
11. Fowles ER: Comparing pregnant women's nutritional knowledge to their actual dietary intake. MCN. Am J Maternal Child Nursing, 27(3):171-7, 2002. [ Links ]
12. Gambacciani M, Ciaponi M, Cappagli B, Benussi C, De Simone L, Genazzani AR: Climateric modifications in body weight and fat tissue distribution. Climateric, 2(1):37-44, 1999. [ Links ]
13. García-García E, Vaquez-Velazquez V, López-Alvarenga J, Arcila-Martínez D: Validez interna y utilidad diagnóstica del Eating Disorders Inventory en mujeres mexicanas. Salud Pública México, 45(3):2003. [ Links ]
14. Gluck ME, Geliebter A: Racial/ethnic differences in body image and eating behaviors. Eating Behaviors, 3(2):143-151, 2002. [ Links ]
15. Gomez Perez-Mitre G. Escala de factores de riesgo asociados a trastornos de la conducta alimentaria. Prevención primaria y factores de riesgo de trastornos alimentarios. IN-305599(PAPIT) UNAM, 34507-H (CONACyT), México. 2000. [ Links ]
16. Gómez Pérez-Mitre G, Saucedo-Molina T, Unikel Santocini C: Psicología social en el campo de la salud: imagen corporal en los trastornos de la alimentación. En: Callejas N, Gómez-Pérez-Mitré G (eds.). Psicología Social: Investigación y Aplicaciones en México. Fondo de Cultura Económica, 267-306, México, 2001. [ Links ]
17. Goodman E: Accuracy of teen and parental reports of obesity and body mass index. Pediatrics, 106:52-8, 2000. [ Links ]
18. Hill A: Pre-adolescent dieting implications for eating disorders. International Review Psychiatry, 5:87-100, 1993. [ Links ]
19. Huon GF: Health promotion and the prevention of dieting induced-disorders. Eating Disorders, 4(1):27-32, 1996. [ Links ]
20. Lora-Cortez C: Conductas alimentarias de riesgo y distribución del índice de masa corporal en mujeres adultas de la ciudad de México. Tesis de Licenciatura en Dietética y Nutrición. Escuela de Dietética y Nutrición ISSSTE, México, 2003. [ Links ]
21. Milos G, Willi J, Hauselmann H: Bilateral osteonecrosis of the talus and «standing obsession» in a patient with anorexia nervosa. International J Eating Disorders, 29(3):363-369, 2001. [ Links ]
22. Nawaz H: Self-reported weight and height: implications for obesity research. Am J Prev Med, 20(4):294-298, 2001. [ Links ]
23. Pfeffer F, Kaufer-Horwitz M: Nutrición del adulto. En: Casanueva E, Kaufer M, Pérez AB, Arroyo P (eds.). Nutriología Médica. Panamericana, 104-117, México, 2001. [ Links ]
24. Pike K, Dohm F, Striegel-Moore R, Wilfley D, Fairburn C: A comparison of black and white women with binge eating disorder. Am J Psychiatry, 158(9):1455-1460, 2001. [ Links ]
25. Resch M, Szendei G: Gynecologic and obstetric complications in eating disorders. Orvosi Hetilap, 143(25):1529-32, 2002. [ Links ]
26. Rieder S, Ruderman A: Cognitive factors associated with binge and purge eating behaviors: The interaction of body dissatisfaction and body image importance. Cognitive Therapy Research, 25(6):801-812, 2001. [ Links ]
27. Saucedo-Molina T: Modelos predictivos de la dieta restringida en púberes y en sus madres. Tesis de doctorado. Universidad Nacional Autónoma de México. México, 2003. [ Links ]
28. Steward LA: The reability and validity of self-reported weight and height. J Chron Dis, 35:295-309, 1982. [ Links ]
29. Stewart T, Williamson D, White M: Rigid vs. flexible dieting: Association with eating disorder symptoms in nonobese women. Appetite, 38(1):39-44, 2002. [ Links ]
30. Stice E, Agras SW, Hammer LD: Risk Factors for the Emergency of Childhood Eating Disturbance. A five-year prospective study. International J Eating Disorders, 25:375-387. 1999. [ Links ]
31. Stice E, Agras WS, Telch C, Halmi K, Mitchell J, Wilson T: Subtyping binge eating-disordered women along dieting and negative affect dimensions, International J Eating Disorders, 30(1):11-27, 2001. [ Links ]
32. Stice E, Shaw HE: Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosomatic Research, 53(5):985-93, 2002. [ Links ]
33. Stunkard JA, Alboium JM: The accurancy of self-reported weight. Am J Clin Nutr, 34:1593-1599, 1981. [ Links ]
34. Toro J: El cuerpo como delito. Anorexia, bulimia, cultura y sociedad. Ariel, Barcelona, 1996. [ Links ]
35. Unikel C: Desórdenes de la alimentación en estudiantes y profesionales del ballet. Tesis de Maestría en Psicología. Universidad Nacional Autónoma de México. México, 1998. [ Links ]
36. Unikel C, Mora J, Gómez-Peresmitre G: Percepción de la gordura en adolescentes y su relación con las conductas inapropiadas del comer. Rev Interam Psicol, 33(1):11-29, 1999. [ Links ]
37. Unikel C, Saucedo T, Villatoro J, Fleiz C: Conductas alimentarias de riesgo y distribución del índice de masa corporal en estudiantes de 13 a 18 años. Salud Mental, 25:49-57, 2002. [ Links ]
38. Unikel C, Villatoro J, Medina-Mora ME: Conductas alimentarias de riesgo en adolescentes mexicanos. Datos de la población infantil del Distrito Federal. Revista Investigación Clínica, 52(2):140-147, 2000. [ Links ]
39. WHO: Expert Committee: Physical Status: The use and Interpretation of Anthropometry. World Health Organisation. Technical Report Series, 854, Ginebra, 1995. [ Links ]
Recibido: 11 de Julio de 2005; Aprobado: 27 de Febrero de 2006
Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons
