Vol. 13. Núm. 69.
Páginas 4064-4071 (Diciembre 2022)

Actualización sobre los trastornos de la conducta alimentaria

Update on eating disorders

M.A. Álvarez-MonabF. MoraacA. Rodríguez-QuirogaacJ. Quinteroac
Doi : https://10.1016/j.med.2022.12.004
Opciones
Resumen

Los trastornos de la conducta alimentaria (TCA) (sobre todo la anorexia, la bulimia y el trastorno por atracones) comienzan principalmente en la adolescencia y la juventud, y se caracterizan por: restricción de las calorías, cantidad y/o tipo de alimentos, atracones recurrentes y conductas compensatorias que conducen a un estado de malnutrición. Además, presentan una preocupación exagerada por su peso e imagen corporal. Los TCA tienden a las recaídas. Es fundamental hacer un abordaje terapéutico multidisciplinar. El uso de psicofármacos en la anorexia nerviosa estaría limitado a formas clínicas de intensidad grave o para el tratamiento de los trastornos comórbidos. En la bulimia nerviosa estaría indicado el uso de fluoxetina, sobre todo asociada a la psicoterapia cognitiva conductual y a la intervención familiar. Las comorbilidades psiquiátricas son habituales (trastornos de ansiedad, episodios depresivos, abuso de sustancias o riesgo de suicidio). El diagnóstico es clínico, por lo que la principal herramienta es la entrevista clínica, pero también es necesaria una valoración médico-nutricional.

Palabras clave
Anorexia nerviosa
Bulimia nerviosa
Trastorno por atracón
Trastornos de la conducta alimentaria
Abstract

Eating disorders (ED) (mainly anorexia, bulimia, and binge eating disorder) mainly start in adolescence and youth. They are characterized by restriction of calories and/or food types, recurrent binges, and compensatory behaviors that lead to a state of malnutrition. Patients also present with an exaggerated preoccupation with their weight and body image. ED tend to entail relapses. A multidisciplinary treatment approach is fundamental. The use of psychotropic drugs in anorexia nervosa would be limited to clinical forms of severe intensity or for the treatment of comorbid disorders. In bulimia nervosa, it would be limited to the use of fluoxetine and, most of all, associated with cognitive behavioral psychotherapy and family intervention. Psychiatric comorbidities are common (anxiety disorders, depressive episodes, substance abuse, or risk of suicide). The diagnosis is clinical and thus the main tool is a clinical interview, but a medical-nutritional evaluation is also necessary.

Keywords
Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Eating disorders

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