Camila Cremonezi Japur

Introduction: From a biomedical perspective, metabolic and bariatric surgery can effectively treat obesity. However, traditional strategies (diet and exercise) to prevent weight regain have not been fully effective, as they may help some individuals maintain postoperative weight loss, but approximately 30% of patients still regain weight after surgery. This highlights the need to explore alternative approaches, including mindfulness-based interventions. This study aims to evaluate the feasibility and describe the effects of a mindfulness-based intervention on behavioral and anthropometric outcomes in women with weight regain after metabolic and bariatric surgery. Methods: A pre-post feasibility pilot study was conducted with 10 women who had regained ≥ 15% of the achieved weight loss. The intervention combined Mindfulness-Based Eating Awareness Training with elements of the Mindful Self-Compassion program. Feasibility outcomes included adherence, attendance (overall and among completers), recruitment rate, data completeness, and informal facilitator feedback. Behavioral (binge eating, self-compassion, mindfulness) and anthropometric measures (weight and BMI) were assessed at three time points: baseline (T1), post-intervention (T2), and 3-month follow-up (T3). Results: Feasibility indicators revealed low adherence (60% dropout), low overall attendance (41.7%), high attendance among completers (87.5%), moderate recruitment rate (38.5%), and low data completeness (40.0%). Challenges in engagement were associated with expectations of diet-based approaches. Among completers, improvements were observed in binge eating (22.7 ± 5.4 to 11.3 ± 2.5), “Isolation” (2.6 ± 0.4 vs. 2.3 ± 0.4), “Over-Identification” (3.3 ± 0.5 vs. 2.8 ± 0.2), and “Mindfulness” (3.1 ± 0.3 vs. 3.5 ± 0.4) subscales of the Self-Compassion Scale. From baseline to the 3-month follow-up, we observed improvement in “Mindfulness” (3.1 ± 0.3 vs. 3.9 ± 0.2), “Over-Identification” (3.3 ± 0.5 vs. 2.8 ± 0.3), and “Nonreactivity to Inner Experience” (19.5 ± 1.6 vs. 22.2 ± 2.2). Body weight remained stable throughout the intervention period (82.1 ± 4.0 vs 81.7 ± 4.0) and reduced at 3-month follow-up (79.8 ± 3.7). Conclusion: Although not feasible in its current format, the intervention showed preliminary benefits, indicating the need for protocol refinement and a new feasibility evaluation before moving to larger trials.

Background: Nutrition students are at greater risk of developing disordered eating attitudes, especially during the COVID‐19 pandemic. Mindfulness‐based interventions (MBIs) have proven to be beneficial in improving mental health outcomes and are also applied to issues related to food through mindful eating. The study aimed to evaluate the effect of a MBI on levels of body dissatisfaction and disordered eating attitudes among nutrition students during the COVID‐19 pandemic.Methods: This randomised clinical trial performed the ‘Mindfulness‐Based Eating Solution’ (MBES) intervention in nutrition students. Seventy‐eight adult women were randomised into the intervention group (n = 38) and control group (n = 40). The intervention group received eleven weekly sessions of MBES and two follow‐up sessions. Body dissatisfaction and appreciation, disordered eating attitudes, intuitive eating and mindfulness were assessed four times (at baseline, post‐intervention, 1‐month follow‐up and 3‐month follow‐up).Results: The intervention group showed decreased levels of body dissatisfaction (from 86.60 ± 6.13 to 64.13 ± 2.82) and disordered eating attitudes (from 1.46 ± 0.08 to 1.15 ± 0.02), and higher levels of reliance on hunger and satiety cues and mindfulness after the MBES intervention. Body dissatisfaction and levels of reliance on hunger and satiety cues were maintained at follow‐up, whereas the disordered eating attitudes and levels of mindfulness increased in the first and third months, respectively. No significant changes were found in the outcomes evaluated in the control group.Conclusions: The results suggest the positive effects of a MBI on the nutrition students’ body image perceptions and eating attitudes. Further research is needed to investigate such benefits and understand the related mechanisms in other populations.

Background Weight stigma is a complex construct formed by various components. This study aimed to compile these components and classify them into the multilevel intervention levels of stigma (structural, interpersonal, and intrapersonal).Methods A non-systematic literature review was conducted to identify the most commonly used definitions of weight stigma components. Subsequently, a proposal was made to classify these components into different intervention levels as proposed (Structural, Interpersonal, Intrapersonal). The components were categorized based on their definitions and specificities at each level. A panel of experts evaluated the proposal, and the degree of agreement was assessed using Fleiss' Kappa coefficient (₭). Values of ₭ between 0.40 and 0.60 indicated moderate agreement; between 0.61 and 0.75, good agreement; and above 0.75, excellent agreement.Results Ten terms were identified and classified in the different levels of stigma, except “Weight stigma” and “Weight bias”. At the structural level were included "fatphobia" and "weight-based stereotypes"; at the interpersonal level, "weight discrimination" and "explicit weight bias"; and at the intrapersonal level, "implicit weight bias", "lipophobia," "fat stigma", and "internalized weight bias". Agreement among the experts' responses for the structural and interpersonal levels was 100% (₭ = 1.0). For the components allocated at the intrapersonal level, there were some disagreements in the classification of the “Fat stigma” component (₭ = 0.4), and “Lipophobia” and “Implicit weight bias” were considered inappropriate by one specialist (₭ = 0.6).Conclusion The proposed classification of weight stigma components across multi-level interventions is novel and deemed appropriate by the experts. In future studies, this classification can help assess associations between weight stigma components across inter- and intra-levels and guide interventions across different levels for more effective outcomes in combating weight stigma.

The Fat Phobia Scale-Short Form (FPS) and the Beliefs About Obese Persons Scale (BAOP) are scales developed to investigate fatphobia and beliefs about obese persons, respectively. The aim of the study was to carry out the cross-cultural adaptation of these scales to Brazilian Portuguese. The methodology was carried out in 5 stages: 1. translation, 2. synthesis of translations, 3. evaluation by the expert committee of semantic, idiomatic, experiential and conceptual equivalences, 4. discussion with the target population (health professionals and other areas), and 5. back-translation. The results of the judgment of equivalences evaluated by the specialists were presented in absolute and relative frequency, and the agreement of the results between the specialists was verified by the Kappa de Fleiss Coefficient (₭). The results showed excellent agreement for all equivalences in both scales, except for BAOP semantics, which was good. (₭ = 0.67). Suggestions from the target population (Brazilian adults) were considered to adapt the final version of the two scales, which were back-translated and approved by the original authors. It is concluded that FPS and BAOP are duly adapted to Brazilian Portuguese and ready to be tested for their psychometric qualities.

Os objetivos deste estudo foram relatar a experiência da utilização de oficinas culinárias como estratégia didático-pedagógica na disciplina de educação nutricional, e analisar as percepções dos estudantes quanto à interdisciplinaridade e aplicabilidade na atuação profissional, pela análise de conteúdo temática. Este é um relato de experiência da utilização de oficinas culinárias durante a disciplina de Educação Nutricional no curso de nutrição de uma universidade pública. Foram quantificados os tipos de receitas selecionadas e seus respectivos princípios dietéticos e/ou dietoterápicos. Identificamos que 80% das receitas selecionadas priorizavam o conteúdo de nutrientes dos ingredientes como princípio dietético/dietoterápico e somente 20% consideraram aspectos sensoriais e culturais. Na análise qualitativa, foram identificados três eixos temáticos: (1) O olhar do estudante sobre a oficina culinária; (2) O aprendizado da oficina culinária para sua prática profissional; (3) A racionalização da alimentação. A oficina foi considerada uma experiência inovadora e enriquecedora para a formação acadêmica, principalmente pela interdisciplinaridade. Conclui-se que o uso de oficinas culinárias como estratégia didático-pedagógica interdisciplinar nos cursos de Nutrição pode trazer benefícios na formação dos futuros nutricionistas.

Objetivou-se retratar consequências e significados das experiências alimentares de pessoas com DCNTs. Trata-se de uma revisão narrativa realizada pela busca em bases de dados, utilizando o referencial teórico de Castellanos (2015). 28 estudos qualitativos ou mistos, publicados entre 2003 e 2022, compuseram o corpus de análise, predominando a população de pessoas com câncer (n=9), doença renal crônica (n=7) e diabetes mellitus (n=5). Emergiram quatro temas associados a essas experiências alimentares: 1- A presença de sintomas como motivador para mudanças alimentares; 2- Perda de autonomia para fazer escolhas alimentares e do prazer em comer; 3- Impacto da interação profissional de saúde-cliente; e 4- A influência do núcleo social nas experiências alimentares. Poucos estudos das Ciências Sociais, Humanas e da Saúde aprofundaram-se em como essas pessoas lidam com as consequências e significados do comer, sendo necessário olhar para a multidimensionalidade da alimentação nos processos terapêuticos visando o cuidado integral ao ser humano.