<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg1.png"><div class="t m0 x0 h2 y1 ff1 fs0 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>rastornos de la conducta alimenta<span class="blank _1"> </span>ria</div><div class="t m0 x0 h2 y2 ff1 fs0 fc0 sc0 ls0 ws1">en niños y adolescentes</div><div class="t m0 x0 h3 y3 ff2 fs1 fc1 sc0 ls0 ws0">Resumen<span class="blank"> </span>Summary</div><div class="t m0 x0 h4 y4 ff3 fs2 fc1 sc0 ls0 ws1">Los <span class="blank _1"> </span>tra<span class="blank _2"></span>stor<span class="blank _2"></span>no<span class="blank _2"></span>s <span class="blank _1"> </span>de <span class="blank _3"> </span>la <span class="blank _1"> </span>cond<span class="blank _2"></span>uct<span class="blank _2"></span>a <span class="blank _1"> </span>alimen<span class="blank _2"></span>tar<span class="blank _2"></span>ia <span class="blank _1"> </span>exac<span class="blank _2"></span>er<span class="blank _2"></span>bado<span class="blank _2"></span>s <span class="blank _1"> </span>por <span class="blank _4"> </span>The eating <span class="blank _2"></span>disorders exacerbate <span class="blank _2"></span>by <span class="blank _2"></span>various factors <span class="blank _2"></span>such as </div><div class="t m0 x0 h4 y5 ff3 fs2 fc1 sc0 ls0 ws1">div<span class="blank _2"></span>ers<span class="blank _2"></span>os <span class="blank _2"></span>fac<span class="blank _2"></span>tor<span class="blank _2"></span>es <span class="blank _2"></span>como <span class="blank _2"></span>la <span class="blank _2"></span>in<span class="blank _2"></span>flu<span class="blank _2"></span>en<span class="blank _2"></span>cia <span class="blank _2"></span>cul<span class="blank _2"></span>tur<span class="blank _2"></span>al<span class="blank _2"></span>, há<span class="blank _2"></span>bi<span class="blank _2"></span>tos <span class="blank _2"></span>fam<span class="blank _2"></span>ilia<span class="blank _2"></span>-<span class="blank _5"> </span>cultural <span class="blank _0"></span>influences, <span class="blank _0"></span>family <span class="blank _0"></span>habits <span class="blank _2"></span>and <span class="blank _0"></span>economic <span class="blank _0"></span>status, <span class="blank _0"></span>affect </div><div class="t m0 x0 h4 y6 ff3 fs2 fc1 sc0 ls0 ws1">res y <span class="blank _1"> </span>la <span class="blank _1"> </span>situa<span class="blank _2"></span>ción econ<span class="blank _2"></span>ómic<span class="blank _2"></span>a, afec<span class="blank _2"></span>tan grupos pobl<span class="blank _2"></span>acio<span class="blank _2"></span>na<span class="blank _2"></span>les <span class="blank _4"> </span>population <span class="blank _6"> </span>groups <span class="blank _6"> </span>such <span class="blank _7"> </span>as <span class="blank _6"> </span>Colombians <span class="blank _7"> </span>adolescents <span class="blank _6"> </span>and </div><div class="t m0 x0 h4 y7 ff3 fs2 fc1 sc0 ls0 ws1">com<span class="blank _2"></span>o <span class="blank _8"> </span>los <span class="blank _8"> </span>ad<span class="blank _2"></span>ol<span class="blank _2"></span>esc<span class="blank _2"></span>ent<span class="blank _2"></span>es <span class="blank _8"> </span>y <span class="blank _8"> </span>ni<span class="blank _2"></span>ños <span class="blank _8"> </span>c<span class="blank _2"></span>olom<span class="blank _2"></span>bi<span class="blank _2"></span>anos<span class="blank _2"></span>; <span class="blank _8"> </span>pr<span class="blank _2"></span>oduc<span class="blank _2"></span>en <span class="blank _4"> </span>children <span class="blank _1"> </span>occurring <span class="blank _1"> </span>abnormalities <span class="blank _3"> </span>in <span class="blank _1"> </span>their <span class="blank _3"> </span>patterns <span class="blank _1"> </span>of <span class="blank _3"> </span>growth </div><div class="t m0 x0 h4 y8 ff3 fs2 fc1 sc0 ls0 ws1">anor<span class="blank _2"></span>ma<span class="blank _2"></span>lida<span class="blank _2"></span>de<span class="blank _2"></span>s en s<span class="blank _2"></span>us pa<span class="blank _2"></span>tr<span class="blank _2"></span>ones <span class="blank _2"></span>de c<span class="blank _2"></span>rec<span class="blank _2"></span>imie<span class="blank _2"></span>nt<span class="blank _2"></span>o y de<span class="blank _2"></span>sar<span class="blank _2"></span>roll<span class="blank _2"></span>o, <span class="blank _4"> </span>and <span class="blank _9"> </span>development <span class="blank"> </span>and <span class="blank _7"> </span>creates <span class="blank"> </span>health <span class="blank"> </span>complications <span class="blank _9"> </span>and </div><div class="t m0 x0 h4 y9 ff3 fs2 fc1 sc0 ls0 ws1">lo <span class="blank _6"> </span>qu<span class="blank _2"></span>e <span class="blank _6"> </span>ge<span class="blank _2"></span>ne<span class="blank _2"></span>ra <span class="blank _6"> </span>c<span class="blank _2"></span>ompl<span class="blank _2"></span>ic<span class="blank _2"></span>acio<span class="blank _2"></span>ne<span class="blank _2"></span>s <span class="blank _6"> </span>de <span class="blank _a"> </span>sal<span class="blank _2"></span>ud <span class="blank _a"> </span>y <span class="blank _6"> </span>det<span class="blank _2"></span>erio<span class="blank _2"></span>ro <span class="blank _a"> </span>de <span class="blank _a"> </span>la <span class="blank _4"> </span>deterioration <span class="blank _8"> </span>the <span class="blank"> </span>quality <span class="blank _b"> </span>of <span class="blank _b"> </span>life. <span class="blank"> </span>This <span class="blank _b"> </span>is <span class="blank"> </span>a <span class="blank _b"> </span>public <span class="blank _b"> </span>health </div><div class="t m0 x0 h4 ya ff3 fs2 fc1 sc0 ls0 ws1">cal<span class="blank _2"></span>idad <span class="blank _0"></span>de <span class="blank _2"></span>v<span class="blank _2"></span>ida.<span class="blank _2"></span> <span class="blank _2"></span>Es <span class="blank _0"></span>un <span class="blank _2"></span>ve<span class="blank _2"></span>rdad<span class="blank _2"></span>er<span class="blank _2"></span>o <span class="blank _2"></span>pr<span class="blank _2"></span>oble<span class="blank _2"></span>ma <span class="blank _0"></span>de <span class="blank _2"></span>sal<span class="blank _2"></span>ud <span class="blank _0"></span>públic<span class="blank _2"></span>a; <span class="blank _4"> </span>problem, <span class="blank"> </span>therefore <span class="blank"> </span>it <span class="blank _b"> </span>is <span class="blank"> </span>vital <span class="blank"> </span>to <span class="blank _b"> </span>have <span class="blank"> </span>clarity <span class="blank _b"> </span>on <span class="blank"> </span>how <span class="blank"> </span>to </div><div class="t m0 x0 h4 yb ff3 fs2 fc1 sc0 ls0 ws1">por <span class="blank _3"> </span>tal <span class="blank _1"> </span>motiv<span class="blank _2"></span>o, <span class="blank _3"> </span>es <span class="blank _3"> </span>de <span class="blank _3"> </span>vital <span class="blank _3"> </span>impo<span class="blank _2"></span>rt<span class="blank _2"></span>anc<span class="blank _2"></span>ia <span class="blank _3"> </span>tener <span class="blank _1"> </span>clarid<span class="blank _2"></span>ad <span class="blank _1"> </span>sobre <span class="blank _4"> </span>approach <span class="blank _7"> </span>the <span class="blank _9"> </span>diagnosis <span class="blank _7"> </span>and <span class="blank"> </span>treatment <span class="blank _7"> </span>in <span class="blank _7"> </span>these <span class="blank"> </span>patients </div><div class="t m0 x0 h4 yc ff3 fs2 fc1 sc0 ls0 ws1">cóm<span class="blank _2"></span>o <span class="blank _3"> </span>diag<span class="blank _2"></span>nos<span class="blank _2"></span>tic<span class="blank _2"></span>ar <span class="blank _3"> </span>y <span class="blank _3"> </span>enfoc<span class="blank _2"></span>ar <span class="blank _1"> </span>el <span class="blank _3"> </span>tratam<span class="blank _2"></span>ie<span class="blank _2"></span>nto <span class="blank _1"> </span>en <span class="blank _3"> </span>este <span class="blank _1"> </span>tipo <span class="blank _3"> </span>de <span class="blank _4"> </span>because <span class="blank _6"> </span>they <span class="blank _6"> </span>are <span class="blank _6"> </span>the <span class="blank _6"> </span>social <span class="blank _6"> </span>and <span class="blank _6"> </span>economic <span class="blank _6"> </span>future <span class="blank _6"> </span>of <span class="blank _6"> </span>the </div><div class="t m0 x0 h4 yd ff3 fs2 fc1 sc0 ls0 ws1">paci<span class="blank _2"></span>en<span class="blank _2"></span>tes <span class="blank _c"></span>ya <span class="blank _c"></span>que <span class="blank _c"></span>son <span class="blank _c"></span>el <span class="blank _c"></span>futur<span class="blank _2"></span>o <span class="blank _c"></span>socia<span class="blank _2"></span>l <span class="blank _c"></span>y <span class="blank _0"></span>ec<span class="blank _2"></span>onóm<span class="blank _2"></span>ic<span class="blank _2"></span>o <span class="blank _c"></span>del <span class="blank _c"></span>país <span class="blank _c"></span>y <span class="blank _0"></span>el <span class="blank _4"> </span>country <span class="blank _c"></span>and <span class="blank _0"></span>the <span class="blank _c"></span>world. <span class="blank _c"></span>The <span class="blank _0"></span>objective <span class="blank _0"></span>of <span class="blank _c"></span>this <span class="blank _0"></span>review <span class="blank _c"></span>of <span class="blank _0"></span>national </div><div class="t m0 x0 h4 ye ff3 fs2 fc1 sc0 ls0 ws1">mund<span class="blank _2"></span>o. <span class="blank _0"></span>En <span class="blank _0"></span>este <span class="blank _0"></span>sent<span class="blank _2"></span>ido,<span class="blank _2"></span> <span class="blank _0"></span>el <span class="blank _2"></span>ob<span class="blank _2"></span>jet<span class="blank _2"></span>ivo <span class="blank _0"></span>de <span class="blank _0"></span>esta <span class="blank _0"></span>revis<span class="blank _2"></span>ió<span class="blank _2"></span>n <span class="blank _0"></span>es <span class="blank _2"></span>ha<span class="blank _2"></span>cer <span class="blank _4"> </span>and <span class="blank _0"></span>international literature <span class="blank _0"></span>is <span class="blank _2"></span>a <span class="blank _2"></span>practical <span class="blank _0"></span>approach regarding </div><div class="t m0 x0 h4 yf ff3 fs2 fc1 sc0 ls0 ws1">un <span class="blank _1"> </span>acer<span class="blank _2"></span>cam<span class="blank _2"></span>ient<span class="blank _2"></span>o <span class="blank _1"> </span>prác<span class="blank _2"></span>tic<span class="blank _2"></span>o <span class="blank _1"> </span>al <span class="blank _1"> </span>diag<span class="blank _2"></span>nós<span class="blank _2"></span>tic<span class="blank _2"></span>o <span class="blank _1"> </span>y <span class="blank _3"> </span>la <span class="blank _1"> </span>ter<span class="blank _2"></span>apéu<span class="blank _2"></span>tic<span class="blank _2"></span>a <span class="blank _1"> </span>de <span class="blank _4"> </span>diagnosis <span class="blank _a"> </span>and <span class="blank _a"> </span>treatment <span class="blank _d"> </span>of <span class="blank _d"> </span>Eating <span class="blank _a"> </span>Disorders, <span class="blank _a"> </span>giving <span class="blank _d"> </span>clear </div><div class="t m0 x0 h4 y10 ff3 fs2 fc1 sc0 ls0 ws1">los <span class="blank _c"></span>TCA, <span class="blank _c"></span>con <span class="blank _0"></span>el <span class="blank _0"></span>ob<span class="blank _2"></span>jet<span class="blank _2"></span>o <span class="blank _0"></span>de <span class="blank _0"></span>ex<span class="blank _2"></span>po<span class="blank _2"></span>ner <span class="blank _0"></span>pa<span class="blank _2"></span>ut<span class="blank _2"></span>as <span class="blank _0"></span>cla<span class="blank _2"></span>ra<span class="blank _2"></span>s <span class="blank _0"></span>de <span class="blank _0"></span>ma<span class="blank _2"></span>nejo<span class="blank _2"></span>, <span class="blank _0"></span>y <span class="blank _4"> </span>guidelines <span class="blank _1"> </span>for <span class="blank _3"> </span>handling <span class="blank _1"> </span>and <span class="blank _1"> </span>deepening <span class="blank _3"> </span>in <span class="blank _1"> </span>the <span class="blank _3"> </span>psychothera-</div><div class="t m0 x0 h4 y11 ff3 fs2 fc1 sc0 ls0 ws1">prof<span class="blank _2"></span>un<span class="blank _2"></span>diz<span class="blank _2"></span>ar <span class="blank _2"></span>el <span class="blank _0"></span>enfoq<span class="blank _2"></span>ue <span class="blank _2"></span>ps<span class="blank _2"></span>icot<span class="blank _2"></span>er<span class="blank _2"></span>apéu<span class="blank _2"></span>-t<span class="blank _2"></span>ico,<span class="blank _2"></span> <span class="blank _2"></span>con <span class="blank _0"></span>el <span class="blank _2"></span>fin <span class="blank _0"></span>de di<span class="blank _2"></span>sm<span class="blank _2"></span>i-<span class="blank _5"> </span>peutic <span class="blank _3"> </span>approach, <span class="blank _3"> </span>in <span class="blank _3"> </span>order <span class="blank _3"> </span>to <span class="blank _3"> </span>minimize <span class="blank _d"> </span>complications <span class="blank _1"> </span>in <span class="blank _d"> </span>the </div><div class="t m0 x0 h4 y12 ff3 fs2 fc1 sc0 ls0 ws1">nuir l<span class="blank _2"></span>as com<span class="blank _2"></span>pl<span class="blank _2"></span>icac<span class="blank _2"></span>io<span class="blank _2"></span>nes a co<span class="blank _2"></span>rto y la<span class="blank _2"></span>rgo pl<span class="blank _2"></span>az<span class="blank _2"></span>o. Es imp<span class="blank _2"></span>or<span class="blank _2"></span>tan<span class="blank _2"></span>te <span class="blank _4"> </span>short <span class="blank _d"> </span>and <span class="blank _a"> </span>long <span class="blank _d"> </span>term. <span class="blank _a"> </span>It <span class="blank _d"> </span>is <span class="blank _a"> </span>important <span class="blank _d"> </span>to <span class="blank _a"> </span>remember <span class="blank _d"> </span>that <span class="blank _a"> </span>the </div><div class="t m0 x0 h4 y13 ff3 fs2 fc1 sc0 ls0 ws1">rec<span class="blank _2"></span>orda<span class="blank _2"></span>r <span class="blank _3"> </span>que <span class="blank _3"> </span>somos <span class="blank _1"> </span>nosot<span class="blank _2"></span>ros<span class="blank _2"></span>, <span class="blank _3"> </span>los <span class="blank _3"> </span>entes <span class="blank _1"> </span>de <span class="blank _3"> </span>salud<span class="blank _2"></span>, <span class="blank _3"> </span>quiene<span class="blank _2"></span>s <span class="blank _4"> </span>health <span class="blank _2"></span>authorities <span class="blank _0"></span>are <span class="blank _2"></span>the <span class="blank _2"></span>best <span class="blank _0"></span>able <span class="blank _2"></span>to <span class="blank _2"></span>guide <span class="blank _0"></span>and provide <span class="blank _0"></span>this </div><div class="t m0 x0 h4 y14 ff3 fs2 fc1 sc0 ls0 ws1">est<span class="blank _2"></span>amos <span class="blank"> </span>más <span class="blank"> </span>capac<span class="blank _2"></span>itad<span class="blank _2"></span>os <span class="blank"> </span>para <span class="blank _b"> </span>or<span class="blank _2"></span>ient<span class="blank _2"></span>ar <span class="blank"> </span>e <span class="blank _b"> </span>impa<span class="blank _2"></span>rtir <span class="blank"> </span>est<span class="blank _2"></span>a <span class="blank _4"> </span>information to the affected population group <span class="blank _2"></span>and those who </div><div class="t m0 x0 h4 y15 ff3 fs2 fc1 sc0 ls0 ws1">inf<span class="blank _2"></span>orm<span class="blank _2"></span>ació<span class="blank _2"></span>n <span class="blank _0"></span>a <span class="blank _0"></span>este <span class="blank _0"></span>grup<span class="blank _2"></span>o <span class="blank _0"></span>pobl<span class="blank _2"></span>ac<span class="blank _2"></span>iona<span class="blank _2"></span>l <span class="blank _0"></span>y <span class="blank _0"></span>a <span class="blank _2"></span>qu<span class="blank _2"></span>iene<span class="blank _2"></span>s <span class="blank _0"></span>int<span class="blank _2"></span>erac<span class="blank _2"></span>túa<span class="blank _2"></span>n <span class="blank _4"> </span>interact <span class="blank _3"> </span>with <span class="blank _3"> </span>them <span class="blank _3"> </span>such <span class="blank _3"> </span>as <span class="blank _3"> </span>the <span class="blank _3"> </span>education <span class="blank _3"> </span>sector<span class="blank _2"></span>, <span class="blank _3"> </span>the <span class="blank _3"> </span>mass </div><div class="t m0 x0 h4 y16 ff3 fs2 fc1 sc0 ls0 ws1">con <span class="blank"> </span>ello<span class="blank _2"></span>s <span class="blank"> </span>como <span class="blank"> </span>lo <span class="blank _b"> </span>s<span class="blank _2"></span>on <span class="blank"> </span>el <span class="blank _b"> </span>sec<span class="blank _2"></span>tor <span class="blank"> </span>ed<span class="blank _2"></span>ucat<span class="blank _2"></span>ivo,<span class="blank _2"></span> <span class="blank"> </span>los <span class="blank"> </span>medios <span class="blank _4"> </span>media, <span class="blank _2"></span>among others.<span class="ff4"> <span class="blank _2"></span>[Jurado <span class="blank _2"></span>LP<span class="blank _c"></span>, Correa <span class="blank _2"></span>JM, Delgado <span class="blank _0"></span>AM, </span></div><div class="t m0 x0 h4 y17 ff3 fs2 fc1 sc0 ls0 ws1">masi<span class="blank _2"></span>vos <span class="blank _3"> </span>de <span class="blank _d"> </span>com<span class="blank _2"></span>un<span class="blank _2"></span>icac<span class="blank _2"></span>ió<span class="blank _2"></span>n, <span class="blank _3"> </span>entre <span class="blank _3"> </span>otros<span class="blank _2"></span>. <span class="blank _d"> </span><span class="ff4">[Ju<span class="blank _2"></span>ra<span class="blank _2"></span>do <span class="blank _d"> </span>LP<span class="blank _e"></span>, <span class="blank _d"> </span>Co<span class="blank _2"></span>rrea <span class="blank _4"> </span>Contreras <span class="blank _3"> </span>MA, <span class="blank _3"> </span>Camacho <span class="blank _d"> </span>JF<span class="blank _c"></span>, <span class="blank _3"> </span>Ortiz <span class="blank _d"> </span>DA, <span class="blank _3"> </span>Escobar <span class="blank _d"> </span>M. <span class="blank _3"> </span>Eating </span></div><div class="t m0 x0 h5 y18 ff4 fs2 fc1 sc0 ls0 ws1">JM, <span class="blank _a"> </span>Delgad<span class="blank _2"></span>o <span class="blank _a"> </span>AM,<span class="blank _2"></span> <span class="blank _6"> </span>Cont<span class="blank _2"></span>re<span class="blank _2"></span>ras <span class="blank _a"> </span>MA, <span class="blank _6"> </span>Cama<span class="blank _2"></span>cho <span class="blank _a"> </span>JF<span class="blank _e"></span>, <span class="blank _6"> </span>Ortiz <span class="blank _a"> </span>DA, <span class="blank _4"> </span>disorders <span class="blank _7"> </span>in <span class="blank"> </span>children <span class="blank _7"> </span>and <span class="blank _7"> </span>adolescents. <span class="blank"> </span>MedUNAB <span class="blank _7"> </span>2009; </div><div class="t m0 x0 h4 y19 ff4 fs2 fc1 sc0 ls0 ws1">Esc<span class="blank _2"></span>obar <span class="blank _0"></span>M. <span class="blank _0"></span>T<span class="blank _0"></span>rastor<span class="blank _2"></span>no<span class="blank _2"></span>s <span class="blank _2"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>condu<span class="blank _2"></span>cta <span class="blank _0"></span>alim<span class="blank _2"></span>ent<span class="blank _2"></span>aria <span class="blank _0"></span>en <span class="blank _0"></span>niños <span class="blank _0"></span>y <span class="blank _4"> </span>12:129-143]<span class="ff3">.</span></div><div class="t m0 x0 h4 y1a ff4 fs2 fc1 sc0 ls0 ws1">adol<span class="blank _2"></span>es<span class="blank _2"></span>cen<span class="blank _2"></span>tes<span class="blank _2"></span>. <span class="blank _c"></span>MedUNA<span class="blank _2"></span>B <span class="blank _c"></span>2009<span class="blank _2"></span>; <span class="blank _c"></span>12:12<span class="blank _2"></span>9-14<span class="blank _2"></span>3]<span class="blank _2"></span><span class="ff3">.</span></div><div class="t m0 x0 h4 y1b ff2 fs2 fc1 sc0 ls0 ws1">Palabras <span class="blank"> </span>clave:<span class="ff3"> <span class="blank _9"> </span>Niños, <span class="blank _6"> </span>Adolescentes, <span class="blank"> </span>T<span class="blank _2"></span>rastornos <span class="blank _9"> </span>de <span class="blank"> </span>la <span class="blank _4"> </span><span class="ff2">Key <span class="blank _f"> </span>words</span>: <span class="blank _f"> </span>Children, <span class="blank _10"> </span>Adolescents, <span class="blank _f"> </span>Eating <span class="blank _f"> </span>disorders, </span></div><div class="t m0 x0 h4 y1c ff3 fs2 fc1 sc0 ls0 ws1">conducta <span class="blank _c"></span>alimentaria, <span class="blank _e"></span>Anorexia, <span class="blank _0"></span>Bulimia, <span class="blank _c"></span>Pica, <span class="blank _0"></span>Rumiación<span class="ff4">. <span class="blank _11"> </span></span>Anorexia, <span class="blank _c"></span>Bulimia, <span class="blank _0"></span>Pica, <span class="blank _c"></span>Rumination <span class="blank _0"></span>disorders.</div><div class="t m0 x1 h6 y1d ff3 fs3 fc1 sc0 ls0 ws1">* <span class="blank _0"></span>Estudiante, <span class="blank _0"></span>Programa <span class="blank _0"></span>de <span class="blank _0"></span>Medicina, <span class="blank _0"></span>Facultad <span class="blank _0"></span>de <span class="blank _0"></span>Ciencias <span class="blank _c"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>Salud, <span class="blank _0"></span>Universidad <span class="blank _c"></span>Autónoma <span class="blank _0"></span>de <span class="blank _0"></span>Bucaramanga, <span class="blank _0"></span>Bucaramanga, <span class="blank _0"></span>Colombia.</div><div class="t m0 x1 h6 y1e ff3 fs3 fc1 sc0 ls0 ws1">** <span class="blank _0"></span>Profesor<span class="blank _2"></span>, <span class="blank _0"></span>Facultad <span class="blank _0"></span>de <span class="blank _c"></span>Ciencias <span class="blank _0"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>Salud, <span class="blank _0"></span>Universidad <span class="blank _c"></span>Autónoma <span class="blank _0"></span>de <span class="blank _0"></span>Bucaramanga, <span class="blank _0"></span>Bucaramanga, <span class="blank _0"></span>Colombia.</div><div class="t m0 x1 h6 y1f ff2 fs3 fc1 sc0 ls0 ws1">Correspondencia: <span class="blank _d"> </span><span class="ff3">Sta. <span class="blank _d"> </span>Delgado, <span class="blank _d"> </span>Universidad <span class="blank _3"> </span>Autónoma <span class="blank _d"> </span>de <span class="blank _d"> </span>Bucaramanga, <span class="blank _d"> </span>Facultad <span class="blank _d"> </span>de <span class="blank _d"> </span>Ciencias <span class="blank _d"> </span>de <span class="blank _d"> </span>la <span class="blank _d"> </span>Salud, <span class="blank _d"> </span>Calle <span class="blank _d"> </span>157 <span class="blank _d"> </span>Nº <span class="blank _d"> </span>19-55, <span class="blank _d"> </span>Cañaveral <span class="blank _d"> </span>Parque, </span></div><div class="t m0 x1 h6 y20 ff3 fs3 fc1 sc0 ls0 ws1">Bucaramanga, <span class="blank _0"></span>Colombia. <span class="blank _0"></span>E-mail: <span class="blank _0"></span>adelgado9@unab.edu.co.</div><div class="t m0 x1 h6 y21 ff3 fs3 fc1 sc0 ls0 ws1">Artículo recibido: julio 2 de 2009; aceptado, septiembre 3 de 2009.</div><div class="t m0 x2 h3 y22 ff2 fs1 fc1 sc0 ls0 ws1">Re<span class="blank _1"> </span>vis<span class="blank _1"> </span>ió<span class="blank _1"> </span>n d<span class="blank _1"> </span>e t<span class="blank _1"> </span>em<span class="blank _1"> </span>a</div><div class="t m0 x3 h7 y23 ff3 fs4 fc0 sc0 ls0">129</div><div class="t m0 x0 h8 y24 ff1 fs5 fc1 sc0 ls0 ws1">Liliana Patricia Jurado Salcedo*</div><div class="t m0 x0 h8 y25 ff1 fs5 fc1 sc0 ls0 ws1">Juan Manuel Correa Gómez*</div><div class="t m0 x0 h8 y26 ff1 fs5 fc1 sc0 ls0 ws1">Angélica María Delgado Beltrán*</div><div class="t m0 x0 h8 y27 ff1 fs5 fc1 sc0 ls0 ws1">Mariana <span class="blank _0"></span>Angélica Contreras Gamboa*</div><div class="t m0 x0 h8 y28 ff1 fs5 fc1 sc0 ls0 ws1">Juan Fernando Camacho Ruiz*</div><div class="t m0 x0 h8 y29 ff1 fs5 fc1 sc0 ls0 ws1">Danilo <span class="blank _0"></span>Augusto Ortiz Jerez, MD**</div><div class="t m0 x0 h8 y2a ff1 fs5 fc1 sc0 ls0 ws1">Mauricio Escobar Sánchez, MD**</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x4 y2b w2 h9" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg2.png"><div class="t m0 x4 ha y2c ff5 fs6 fc0 sc0 ls0 ws2">Introducción<span class="blank"> </span>Epidemiología</div><div class="t m0 x4 h8 y2d ff1 fs5 fc0 sc0 ls0 ws1">Lo<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _12"> </span>tr<span class="blank _1"> </span>a<span class="blank _1"> </span>s<span class="blank _1"> </span>to<span class="blank _1"> </span>r<span class="blank _1"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span>s <span class="blank _12"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _f"> </span>l<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>co<span class="blank _1"> </span>n<span class="blank _1"> </span>d<span class="blank _1"> </span>u<span class="blank _1"> </span>ct<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>al<span class="blank _1"> </span>i<span class="blank _1"> </span>m<span class="blank _1"> </span>en<span class="blank _1"> </span>t<span class="blank _1"> </span>a<span class="blank _1"> </span>rí<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>(T<span class="blank _1"> </span>C<span class="blank _1"> </span>A<span class="blank _1"> </span>)<span class="blank _1"> </span> <span class="blank _13"> </span><span class="v1">En <span class="blank _3"> </span>un <span class="blank _3"> </span>trabajo <span class="blank _3"> </span>efectuado <span class="blank _d"> </span>en <span class="blank _3"> </span>Colombia, <span class="blank _3"> </span>en <span class="blank _3"> </span>el <span class="blank _3"> </span>cual <span class="blank _d"> </span>se <span class="blank _3"> </span>tomó </span></div><div class="t m0 x4 h8 y2e ff1 fs5 fc0 sc0 ls0 ws1">constituyen un <span class="blank _3"> </span>grupo <span class="blank _1"> </span>de <span class="blank _3"> </span>patologías de <span class="blank _3"> </span>aparición <span class="blank _1"> </span>cotidiana <span class="blank _13"> </span><span class="v1">como <span class="blank _0"></span>población <span class="blank _2"></span>a <span class="blank _0"></span>un <span class="blank _0"></span>grupo <span class="blank _0"></span>de <span class="blank _0"></span>estudiantes <span class="blank _0"></span>universitarios, <span class="blank _0"></span>se </span></div><div class="t m0 x4 h8 y2f ff1 fs5 fc0 sc0 ls0 ws1">en <span class="blank _6"> </span>nuestra <span class="blank _6"> </span>población, <span class="blank _6"> </span>especial<span class="blank _2"></span>mente <span class="blank _6"> </span>en <span class="blank _6"> </span>la <span class="blank _6"> </span>más <span class="blank _6"> </span>joven, <span class="blank _6"> </span>y <span class="blank _4"> </span><span class="v1">encontró <span class="blank _b"> </span>una <span class="blank"> </span>prevalencia <span class="blank"> </span>de <span class="blank _b"> </span>trastornos <span class="blank"> </span>de <span class="blank"> </span>la <span class="blank _b"> </span>conducta </span></div><div class="t m0 x4 h8 y30 ff1 fs5 fc0 sc0 ls0 ws1">aunque <span class="blank _0"></span>se <span class="blank _0"></span>han <span class="blank _0"></span>estudiado <span class="blank _0"></span>alteraciones <span class="blank _0"></span>biológic<span class="blank _2"></span>as <span class="blank _0"></span>y <span class="blank _0"></span>genéticas <span class="blank _4"> </span><span class="v1">alimentaria <span class="blank _0"></span>en <span class="blank _0"></span>general <span class="blank _0"></span>del <span class="blank _0"></span>19.5%, <span class="blank _0"></span>bulimia <span class="blank _0"></span>nerviosa <span class="blank _0"></span>(BN) <span class="blank _0"></span>de </span></div><div class="t m0 x4 h8 y31 ff1 fs5 fc0 sc0 ls0 ws1">que <span class="blank"> </span>tendrían <span class="blank _9"> </span>parte <span class="blank"> </span>en <span class="blank"> </span>el <span class="blank"> </span>orig<span class="blank _2"></span>en <span class="blank"> </span>de <span class="blank"> </span>estos <span class="blank"> </span>tras<span class="blank _2"></span>tornos, <span class="blank"> </span>se <span class="blank _13"> </span><span class="v1">1.2%, anorexia <span class="blank _1"> </span>nerviosa (AN) <span class="blank _1"> </span>de <span class="blank _1"> </span>0.48% y <span class="blank _1"> </span>trastornos de <span class="blank _1"> </span>la </span></div><div class="t m0 x5 hb y32 ff1 fs7 fc0 sc0 ls0">8</div><div class="t m0 x4 h8 y33 ff1 fs5 fc0 sc0 ls0 ws1">resaltan <span class="blank _d"> </span>factores <span class="blank _3"> </span>precipitantes <span class="blank _d"> </span>como <span class="blank _3"> </span>nuestra <span class="blank _d"> </span>cultura <span class="blank _d"> </span>y <span class="blank _d"> </span>los <span class="blank _4"> </span><span class="v2">conducta alimentaria <span class="blank _1"> </span>no <span class="blank _1"> </span>especificados de <span class="blank _1"> </span>17.5%<span class="blank"> </span>.<span class="ff6 ls1"> </span>Entre <span class="blank _1"> </span>la </span></div><div class="t m0 x4 h8 y34 ff1 fs5 fc0 sc0 ls0 ws1">medios <span class="blank _0"></span>de <span class="blank _2"></span>comunica<span class="blank _2"></span>ción <span class="blank _0"></span>que <span class="blank _2"></span>promueve<span class="blank _2"></span>n <span class="blank _0"></span>prototipos <span class="blank _0"></span>rígidos <span class="blank _4"> </span><span class="v2">población <span class="blank _a"> </span>de <span class="blank _a"> </span>infantes, <span class="blank _a"> </span>1 <span class="blank _a"> </span>de <span class="blank _a"> </span>cada <span class="blank _a"> </span>4 <span class="blank _d"> </span>niños <span class="blank _a"> </span>presentó <span class="blank _a"> </span>algún </span></div><div class="t m0 x4 h8 y35 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _6"> </span>belleza, <span class="blank _6"> </span>lo <span class="blank _7"> </span>cual <span class="blank _7"> </span>contribuye <span class="blank _6"> </span>a <span class="blank _6"> </span>la <span class="blank _7"> </span>construcción <span class="blank _6"> </span>de <span class="blank _7"> </span>una <span class="blank _13"> </span><span class="v2">problema en su alimentación, y la prevalenci<span class="blank _2"></span>a en los niños </span></div><div class="t m0 x4 h8 y36 ff1 fs5 fc0 sc0 ls0 ws1">imagen <span class="blank _6"> </span>corporal <span class="blank _6"> </span>negativa. <span class="blank _a"> </span>Esta <span class="blank _7"> </span>asociación <span class="blank _6"> </span>entre <span class="blank _6"> </span>imagen <span class="blank _13"> </span><span class="v2">con <span class="blank _1"> </span>discapacidades fue <span class="blank _1"> </span>más alta, <span class="blank _1"> </span>se <span class="blank _1"> </span>estima entre <span class="blank _1"> </span>un 40% <span class="blank _1"> </span>-</span></div><div class="t m0 x6 hb y37 ff1 fs7 fc0 sc0 ls0 ws1">1, <span class="blank _14"> </span>2<span class="ff5"> </span></div><div class="t m0 x4 h8 y38 ff1 fs5 fc0 sc0 ls0 ws1">corporal <span class="blank _7"> </span>e <span class="blank _7"> </span>incidencia <span class="blank _7"> </span>de <span class="blank _7"> </span>TCA<span class="blank _2"></span> <span class="blank _7"> </span>ha <span class="blank _7"> </span>sido <span class="blank _9"> </span>evaluada<span class="blank _15"> </span>y <span class="blank _7"> </span>es <span class="blank _4"> </span><span class="v1">70% <span class="blank _7"> </span>en <span class="blank _7"> </span>asociación <span class="blank _7"> </span>con <span class="blank _7"> </span>discapacidades <span class="blank _7"> </span>del <span class="blank _7"> </span>desarrollo <span class="blank _9"> </span>y </span></div><div class="t m0 x4 h8 y39 ff1 fs5 fc0 sc0 ls0 ws1">extrapolable <span class="blank _e"></span>a <span class="blank _0"></span>la <span class="blank _c"></span>población <span class="blank _c"></span>colombiana. <span class="blank _16"> </span><span class="v1">enfermedades <span class="blank _a"> </span>crónicas, <span class="blank _a"> </span>para <span class="blank _a"> </span>llegar <span class="blank _d"> </span>al <span class="blank _a"> </span>89% <span class="blank _a"> </span>en <span class="blank _a"> </span>niños <span class="blank _a"> </span>con </span></div><div class="t m0 x7 hb y3a ff1 fs7 fc0 sc0 ls0">9</div><div class="t m0 x8 h8 y3b ff1 fs5 fc0 sc0 ls0 ws1">deterioro <span class="blank _c"></span>neurológico.</div><div class="t m0 x4 h8 y3c ff1 fs5 fc0 sc0 ls0 ws1">En <span class="blank _6"> </span>Mede<span class="blank _2"></span>llín <span class="blank _a"> </span>se <span class="blank _6"> </span>realiz<span class="blank _2"></span>ó <span class="blank _6"> </span>un <span class="blank _a"> </span>estudio <span class="blank _a"> </span>con <span class="blank _6"> </span>972 <span class="blank _6"> </span>adol<span class="blank _2"></span>escente<span class="blank _2"></span>s </div><div class="t m0 x4 h8 y3d ff1 fs5 fc0 sc0 ls0 ws1">escol<span class="blank _2"></span>arizad<span class="blank _2"></span>as <span class="blank _0"></span>en <span class="blank _0"></span>el <span class="blank _c"></span>que, <span class="blank _0"></span>por <span class="blank _0"></span>medi<span class="blank _2"></span>o <span class="blank _0"></span>de <span class="blank _0"></span>un <span class="blank _c"></span>cuestiona<span class="blank _2"></span>rio <span class="blank _0"></span>para <span class="blank _c"></span>la <span class="blank _4"> </span><span class="v3">Las <span class="blank _1"> </span>tas<span class="blank _1"> </span>as de <span class="blank _1"> </span>mor<span class="blank _1"> </span>talida<span class="blank _1"> </span>d <span class="blank _1"> </span>se <span class="blank _1"> </span>postul<span class="blank _1"> </span>an <span class="blank _1"> </span>entre <span class="blank _1"> </span>las <span class="blank _1"> </span>más <span class="blank _1"> </span>alt<span class="blank _1"> </span>as <span class="blank _1"> </span>de </span></div><div class="t m0 x4 h8 y3e ff1 fs5 fc0 sc0 ls0 ws1">tamiza<span class="blank _2"></span>ción de conduc<span class="blank _2"></span>tas de riesgo, se conoci<span class="blank _2"></span>eron las ideas <span class="blank _13"> </span><span class="v3">los <span class="blank _6"> </span>tra<span class="blank _1"> </span>storno<span class="blank _1"> </span>s <span class="blank _6"> </span>mental<span class="blank _1"> </span>es, <span class="blank _6"> </span>consti<span class="blank _1"> </span>tuyénd<span class="blank _1"> </span>ose <span class="blank _6"> </span>en <span class="blank _6"> </span>la <span class="blank _6"> </span>pri<span class="blank _1"> </span>ncipal </span></div><div class="t m0 x4 h8 y3f ff1 fs5 fc0 sc0 ls0 ws1">más comune<span class="blank _2"></span>s acerca del concepto de bienest<span class="blank _2"></span>ar saludabl<span class="blank _2"></span>e y <span class="blank _4"> </span><span class="v3">cau<span class="blank _1"> </span>sa de muert<span class="blank _1"> </span>e en muje<span class="blank _1"> </span>res jóv<span class="blank _1"> </span>enes entre <span class="blank _1"> </span>15 y 24 años d<span class="blank _1"> </span>e </span></div><div class="t m0 x9 hb y40 ff1 fs7 fc0 sc0 ls0 ws1">4, <span class="blank _d"> </span>10, <span class="blank _d"> </span>11</div><div class="t m0 x4 h8 y41 ff1 fs5 fc0 sc0 ls0 ws1">su <span class="blank _0"></span>relación <span class="blank _0"></span>con <span class="blank _2"></span>el <span class="blank _0"></span>ideal <span class="blank _0"></span>de <span class="blank _2"></span>be<span class="blank _2"></span>lleza, <span class="blank _0"></span>y <span class="blank _2"></span>se <span class="blank _0"></span>encontró <span class="blank _0"></span>que <span class="blank _0"></span>al <span class="blank _2"></span>77% <span class="blank _13"> </span><span class="v4">edad.<span class="blank _17"> </span>La <span class="blank _1"> </span>cro<span class="blank _1"> </span>nicida<span class="blank _1"> </span>d <span class="blank _1"> </span>de <span class="blank _3"> </span>los <span class="blank _1"> </span>TCA<span class="blank _2"></span> <span class="blank _1"> </span>tambié<span class="blank _1"> </span>n <span class="blank _1"> </span>es <span class="blank _3"> </span>causa <span class="blank _3"> </span>de </span></div><div class="t m0 xa hc y42 ff5 fs7 fc0 sc0 ls0 ws1"> </div><div class="t m0 x4 h8 y43 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _1"> </span>las <span class="blank _1"> </span>alumnas <span class="blank _1"> </span>les <span class="blank _1"> </span>aterra <span class="blank _1"> </span>la <span class="blank _3"> </span>idea <span class="blank _1"> </span>de <span class="blank _1"> </span>ganar <span class="blank _1"> </span>peso, <span class="blank _1"> </span>41% <span class="blank _3"> </span>tiene <span class="blank _13"> </span><span class="v4">preocu<span class="blank _1"> </span>pación <span class="blank _1"> </span>pue<span class="blank _1"> </span>s sólo <span class="blank _1"> </span>el 50% <span class="blank _1"> </span>de los <span class="blank _1"> </span>pacien<span class="blank _1"> </span>tes afe<span class="blank _1"> </span>ctados<span class="blank _1"> </span> </span></div><div class="t m0 x4 h8 y44 ff1 fs5 fc0 sc0 ls0 ws1">atraco<span class="blank _2"></span>nes, <span class="blank _0"></span>33% <span class="blank _0"></span>se <span class="blank _0"></span>siente <span class="blank _0"></span>culpable <span class="blank _0"></span>despu<span class="blank _2"></span>és <span class="blank _0"></span>de <span class="blank _0"></span>comer <span class="blank _0"></span>y <span class="blank _2"></span>el <span class="blank _0"></span>8% <span class="blank _13"> </span><span class="v4">se <span class="blank _18"> </span>recupe<span class="blank _1"> </span>ra <span class="blank _8"> </span>totalm<span class="blank _1"> </span>ente, <span class="blank _18"> </span>30% <span class="blank _8"> </span>con<span class="blank _1"> </span>tinúan <span class="blank _18"> </span>con <span class="blank _8"> </span>esp<span class="blank _1"> </span>ectros </span></div><div class="t m0 x4 h8 y45 ff1 fs5 fc0 sc0 ls0 ws1">se <span class="blank _8"> </span>induce <span class="blank _b"> </span>vómito. <span class="blank _b"> </span>El <span class="blank _8"> </span>85% <span class="blank _8"> </span>piensa <span class="blank _b"> </span>que <span class="blank _8"> </span>el <span class="blank _8"> </span>ejercici<span class="blank _2"></span>o <span class="blank _8"> </span>es <span class="blank _4"> </span><span class="v4">subclíni<span class="blank _1"> </span>cos <span class="blank _b"> </span>de <span class="blank _b"> </span>la <span class="blank _8"> </span>enferm<span class="blank _1"> </span>edad <span class="blank _b"> </span>y <span class="blank _b"> </span>20% <span class="blank _8"> </span>presen<span class="blank _1"> </span>tan <span class="blank _b"> </span>ser<span class="blank _1"> </span>ias </span></div><div class="t m0 x4 h8 y46 ff1 fs5 fc0 sc0 ls0 ws1">import<span class="blank _2"></span>ante <span class="blank _a"> </span>para <span class="blank _a"> </span>controlar <span class="blank _a"> </span>el <span class="blank _6"> </span>peso, <span class="blank _a"> </span>45% <span class="blank _a"> </span>realiza <span class="blank _a"> </span>activida<span class="blank _2"></span>d <span class="blank _4"> </span><span class="v4">compli<span class="blank _1"> </span>caciones. De <span class="blank _2"></span>hecho, la <span class="blank _0"></span>AN <span class="blank _2"></span>es <span class="blank _2"></span>la <span class="blank _2"></span>tercera enfermeda<span class="blank _1"> </span>d </span></div><div class="t m0 xb hc y47 ff5 fs7 fc0 sc0 ls2">3<span class="ff1 ls0 v4">12</span></div><div class="t m0 x4 h8 y48 ff1 fs5 fc0 sc0 ls0 ws1">físic<span class="blank _2"></span>a <span class="blank _c"></span>por <span class="blank _0"></span>razo<span class="blank _2"></span>nes <span class="blank _c"></span>estétic<span class="blank _2"></span>as.<span class="blank _19"> </span><span class="v4">crónic<span class="blank _1"> </span>a <span class="blank _3"> </span>más <span class="blank _3"> </span>com<span class="blank _1"> </span>ún <span class="blank _3"> </span>ent<span class="blank _1"> </span>re <span class="blank _3"> </span>los <span class="blank _3"> </span>ado<span class="blank _1"> </span>lescen<span class="blank _1"> </span>tes.<span class="blank _12"> </span> <span class="blank _3"> </span>La <span class="blank _d"> </span>creciente </span></div><div class="t m0 x8 h8 y49 ff1 fs5 fc0 sc0 ls0 ws1">incide<span class="blank _1"> </span>ncia <span class="blank _6"> </span>de <span class="blank _7"> </span>obesid<span class="blank _1"> </span>ad <span class="blank _6"> </span>se <span class="blank _7"> </span>ha <span class="blank _6"> </span>visto <span class="blank _7"> </span>acompa<span class="blank _1"> </span>ñada <span class="blank _7"> </span>de <span class="blank _6"> </span>una </div><div class="t m0 x4 h8 y4a ff1 fs5 fc0 sc0 ls0 ws1">Esto <span class="blank _0"></span>es <span class="blank _2"></span>un <span class="blank _0"></span>problema <span class="blank _2"></span>de <span class="blank _0"></span>salud <span class="blank _2"></span>pública <span class="blank _0"></span>que <span class="blank _2"></span>debemos <span class="blank _0"></span>atender<span class="blank _2"></span>, <span class="blank _4"> </span><span class="v4">incide<span class="blank _1"> </span>ncia <span class="blank _7"> </span>tambié<span class="blank _1"> </span>n <span class="blank _6"> </span>may<span class="blank _1"> </span>or <span class="blank _7"> </span>de <span class="blank _6"> </span>tra<span class="blank _1"> </span>storno<span class="blank _1"> </span>s <span class="blank _7"> </span>de <span class="blank _6"> </span>la <span class="blank _7"> </span>con<span class="blank _1"> </span>ducta </span></div><div class="t m0 xc hb y4b ff1 fs7 fc0 sc0 ls0 ws1">13, <span class="blank _2"></span>14</div><div class="t m0 x4 h8 y4c ff1 fs5 fc0 sc0 ls0 ws1">puesto <span class="blank"> </span>que <span class="blank"> </span>afecta <span class="blank _7"> </span>en <span class="blank"> </span>gran <span class="blank"> </span>medida <span class="blank"> </span>a <span class="blank"> </span>nuestra <span class="blank _9"> </span>población <span class="blank _4"> </span><span class="ws3 v5">alimen<span class="blank"> </span>tar<span class="blank"> </span>ia.</span></div><div class="t m0 x4 h8 y4d ff1 fs5 fc0 sc0 ls0 ws1">adolescente e infantil en que tiene repercusión importante, </div><div class="t m0 x4 h8 y4e ff1 fs5 fc0 sc0 ls0 ws1">dado <span class="blank _2"></span>que <span class="blank _2"></span>la <span class="blank _2"></span>morbilidad <span class="blank _0"></span>de la <span class="blank _0"></span>malnutrición tiene <span class="blank _0"></span>impacto en </div><div class="t m0 x4 h8 y4f ff1 fs5 fc0 sc0 ls0 ws1">los <span class="blank _b"> </span>procesos <span class="blank _b"> </span>fisiológicos <span class="blank _b"> </span>del <span class="blank _b"> </span>crecimiento <span class="blank _b"> </span>y <span class="blank _b"> </span>desarrollo, <span class="blank _4"> </span><span class="ff5 fs6 v6">Genética <span class="blank _c"></span>y <span class="blank _e"></span>Fisiopatología </span></div><div class="t m0 x4 h8 y50 ff1 fs5 fc0 sc0 ls0 ws1">complicaciones <span class="blank _1a"> </span>médicas <span class="blank _1a"> </span>y <span class="blank _1a"> </span>psicológicas <span class="blank _1a"> </span>e, <span class="blank _1a"> </span>incluso, <span class="blank _1a"> </span>la </div><div class="t m0 xd hc y51 ff5 fs7 fc0 sc0 ls0">4</div><div class="t m0 x4 h8 y52 ff1 fs5 fc0 sc0 ls0 ws4">muerte.<span class="blank"> </span><span class="ff5 ls3 ws1"> </span><span class="ws1">Además <span class="blank _1"> </span>del <span class="blank _1"> </span>pobre <span class="blank _1"> </span>pronóstico <span class="blank _1"> </span>de <span class="blank _1"> </span>este <span class="blank _1"> </span>espectro <span class="blank _1"> </span>de </span></div><div class="t m0 x8 h8 y53 ff1 fs5 fc0 sc0 ls0 ws1">Se <span class="blank _d"> </span>han <span class="blank _3"> </span>estudiado <span class="blank _d"> </span>alteraciones <span class="blank _d"> </span>en <span class="blank _d"> </span>la <span class="blank _3"> </span>actividad <span class="blank _d"> </span>neuroendo-</div><div class="t m0 x4 h8 y54 ff1 fs5 fc0 sc0 ls0 ws1">enfermedades <span class="blank _d"> </span>del <span class="blank _d"> </span>comportamiento <span class="blank _d"> </span>alimentario, <span class="blank _a"> </span>con <span class="blank _d"> </span>tasas </div><div class="t m0 x8 h8 y55 ff1 fs5 fc0 sc0 ls0 ws1">crina <span class="blank _7"> </span>que <span class="blank"> </span>podrían <span class="blank _7"> </span>comportar <span class="blank"> </span>factores <span class="blank _7"> </span>de <span class="blank _7"> </span>vulnerabilidad </div><div class="t m0 x4 h8 y56 ff1 fs5 fc0 sc0 ls0 ws1">de recuperación <span class="blank _2"></span>del 50%, constituye <span class="blank _2"></span>una de <span class="blank _2"></span>las principales </div><div class="t m0 x8 h8 y57 ff1 fs5 fc0 sc0 ls0 ws1">biológica <span class="blank _3"> </span>para <span class="blank _3"> </span>el <span class="blank _3"> </span>desarrollo <span class="blank _d"> </span>de <span class="blank _1"> </span>estos <span class="blank _d"> </span>trastornos <span class="blank _3"> </span>y <span class="blank _3"> </span>explicar </div><div class="t m0 x4 h8 y58 ff1 fs5 fc0 sc0 ls0 ws1">morbilidades <span class="blank _0"></span>crónicas, <span class="blank _0"></span>situación <span class="blank _c"></span>que <span class="blank _0"></span>nos <span class="blank _0"></span>compromete <span class="blank _c"></span>en <span class="blank _0"></span>la </div><div class="t m0 x6 hb y59 ff1 fs7 fc0 sc0 ls0 ws1">5, <span class="blank _2"></span>6<span class="blank _1b"> </span><span class="fs5 v7">algunos <span class="blank _0"></span>rasgos <span class="blank _2"></span>clínicos. <span class="blank _2"></span>Desde <span class="blank _0"></span>la <span class="blank _2"></span>neurobiología <span class="blank _0"></span>se <span class="blank _2"></span>propone </span></div><div class="t m0 x4 h8 y5a ff1 fs5 fc0 sc0 ls0 ws1">prevención <span class="blank _c"></span>y <span class="blank _0"></span>pesquisa <span class="blank _c"></span>temprana <span class="blank _0"></span>de <span class="blank _c"></span>estos <span class="blank _c"></span>trastornos.<span class="blank _1c"> </span> </div><div class="t m0 x8 h8 y5b ff1 fs5 fc0 sc0 ls0 ws1">q<span class="blank _1"> </span>u<span class="blank _1"> </span>e<span class="blank _3"> </span> <span class="blank _f"> </span>l<span class="blank _3"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>v<span class="blank _1"> </span>u<span class="blank _1"> </span>l<span class="blank _1"> </span>n<span class="blank _3"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _3"> </span>b<span class="blank _1"> </span>i<span class="blank _1"> </span>l<span class="blank _1"> </span>i<span class="blank _3"> </span>d<span class="blank _1"> </span>a<span class="blank _1"> </span>d<span class="blank _3"> </span> <span class="blank _f"> </span>b<span class="blank _3"> </span>i<span class="blank _1"> </span>o<span class="blank _1"> </span>l<span class="blank _3"> </span>ó<span class="blank _1"> </span>g<span class="blank _1"> </span>i<span class="blank _3"> </span>c<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>n<span class="blank _1"> </span>e<span class="blank _1"> </span>u<span class="blank _3"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>l<span class="blank _1"> </span> <span class="blank _12"> </span>c<span class="blank _1"> </span>r<span class="blank _3"> </span>e<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>u<span class="blank _1"> </span>n<span class="blank _1"> </span>a<span class="blank _3"> </span> </div><div class="t m0 x8 h8 y5c ff1 fs5 fc0 sc0 ls0 ws1">contribución <span class="blank _0"></span>sustancial <span class="blank _2"></span>para <span class="blank _0"></span>la <span class="blank _0"></span>patogénesis <span class="blank _2"></span>de <span class="blank _c"></span>AN <span class="blank _0"></span>y <span class="blank _2"></span>BN. <span class="blank _0"></span>Se </div><div class="t m0 x4 h8 y5d ff1 fs5 fc0 sc0 ls0 ws1">Por <span class="blank _2"></span>otro lado, <span class="blank _0"></span>existen trastornos <span class="blank _2"></span>de <span class="blank _2"></span>la conducta <span class="blank _0"></span>alimentaria </div><div class="t m0 x8 h8 y5e ff1 fs5 fc0 sc0 ls0 ws1">plantea que <span class="blank _2"></span>existen anormalidades <span class="blank _2"></span>en las <span class="blank _2"></span>vías relacionadas </div><div class="t m0 x4 h8 y5f ff1 fs5 fc0 sc0 ls0 ws1">que afectan a la población infantil más joven, entre los 0 y </div><div class="t m0 x8 h8 y60 ff1 fs5 fc0 sc0 ls0 ws1">con <span class="blank _6"> </span>la <span class="blank _7"> </span>modulación <span class="blank _7"> </span>del <span class="blank _7"> </span>comportamiento <span class="blank _7"> </span>alimenticio, <span class="blank _7"> </span>del </div><div class="t m0 x4 h8 y61 ff1 fs5 fc0 sc0 ls0 ws1">los <span class="blank _d"> </span>7 <span class="blank _a"> </span>años. <span class="blank _a"> </span>La <span class="blank _d"> </span>DSM-IV <span class="blank _d"> </span>reconoce <span class="blank _a"> </span>las <span class="blank _d"> </span>categorías <span class="blank _a"> </span>de <span class="blank _a"> </span>pica, </div><div class="t m0 x8 h8 y62 ff1 fs5 fc0 sc0 ls0 ws1">ánimo, <span class="blank _a"> </span>del <span class="blank _a"> </span>temperamento <span class="blank _6"> </span>y <span class="blank _a"> </span>del <span class="blank _a"> </span>control <span class="blank _6"> </span>del <span class="blank _a"> </span>impulso <span class="blank _a"> </span>que </div><div class="t m0 x4 h8 y63 ff1 fs5 fc0 sc0 ls0 ws1">rumiación <span class="blank _6"> </span>y <span class="blank _a"> </span>trastornos <span class="blank _6"> </span>de <span class="blank _6"> </span>la <span class="blank _6"> </span>ingestión <span class="blank _a"> </span>alimentaria <span class="blank _6"> </span>de <span class="blank _6"> </span>la </div><div class="t m0 xe hd y64 ff1 fs7 fc0 sc0 ls0 ws1">4, <span class="blank _2"></span>7<span class="ff5 ls4"> </span><span class="fs5 v8">influyen <span class="blank _0"></span>en <span class="blank _2"></span>la <span class="blank _0"></span>autopercepción <span class="blank _2"></span>corporal <span class="blank _2"></span>y <span class="blank _0"></span>crean <span class="blank _2"></span>distorsiones </span></div><div class="t m0 x4 h8 y65 ff1 fs5 fc0 sc0 ls0 ws1">infancia <span class="blank _c"></span>y <span class="blank _0"></span>la <span class="blank _c"></span>niñez <span class="blank _0"></span>no <span class="blank _c"></span>especificados.</div><div class="t m0 x8 h8 y66 ff1 fs5 fc0 sc0 ls0 ws1">importantes <span class="blank _0"></span>en <span class="blank _2"></span>la <span class="blank _2"></span>autoimagen. <span class="blank _0"></span>Se <span class="blank _2"></span>han <span class="blank _0"></span>evidenciado <span class="blank _2"></span>cambios </div><div class="t m0 x8 h8 y67 ff1 fs5 fc0 sc0 ls0 ws1">en <span class="blank _1"> </span>la <span class="blank _3"> </span>interrelación <span class="blank _3"> </span>compleja <span class="blank _1"> </span>entre <span class="blank _3"> </span>los <span class="blank _1"> </span>sistemas <span class="blank _3"> </span>periféricos </div><div class="t m0 x4 h8 y68 ff1 fs5 fc0 sc0 ls0 ws1">Por todo <span class="blank _2"></span>lo anterior<span class="blank _0"></span>, hemos realizado <span class="blank _2"></span>esta revisión <span class="blank _2"></span>de <span class="blank _2"></span>tema </div><div class="t m0 x8 h8 y69 ff1 fs5 fc0 sc0 ls0 ws1">(incluyendo <span class="blank _10"> </span>la <span class="blank _10"> </span>estimulación <span class="blank _f"> </span>gustatoria, <span class="blank _10"> </span>secreción <span class="blank _10"> </span>del </div><div class="t m0 x4 h8 y6a ff1 fs5 fc0 sc0 ls0 ws1">con <span class="blank _0"></span>el <span class="blank _2"></span>fin <span class="blank _0"></span>de <span class="blank _0"></span>exponer <span class="blank _2"></span>pautas <span class="blank _0"></span>claras <span class="blank _2"></span>de <span class="blank _0"></span>manejo <span class="blank _0"></span>y <span class="blank _2"></span>profundizar </div><div class="t m0 x8 h8 y6b ff1 fs5 fc0 sc0 ls0 ws1">péptido <span class="blank _0"></span>vasoactivo <span class="blank _2"></span>gastrointestinal <span class="blank _2"></span>y <span class="blank _0"></span>las <span class="blank _2"></span>respuestas <span class="blank _0"></span>vagales </div><div class="t m0 x4 h8 y6c ff1 fs5 fc0 sc0 ls0 ws1">el <span class="blank _8"> </span>enfoque <span class="blank _8"> </span>psicoterapéutico, <span class="blank _18"> </span>en <span class="blank _8"> </span>los <span class="blank _18"> </span>pacientes <span class="blank _8"> </span>niños <span class="blank _8"> </span>y </div><div class="t m0 x8 h8 y6d ff1 fs5 fc0 sc0 ls0 ws1">aferentes) <span class="blank"> </span>y <span class="blank"> </span>aquellos <span class="blank"> </span>neuropéptidos <span class="blank"> </span>o <span class="blank _14"> </span>monoaminas <span class="blank"> </span>del </div><div class="t m0 x4 h8 y6e ff1 fs5 fc0 sc0 ls0 ws1">adolescentes que presenten algún trastorno en su conducta </div><div class="t m0 x8 h8 y6f ff1 fs5 fc0 sc0 ls0 ws1">SNC. <span class="blank _2"></span>Se <span class="blank _0"></span>han observado <span class="blank _0"></span>estudios <span class="blank _2"></span>de <span class="blank _2"></span>animales <span class="blank _2"></span>que <span class="blank _0"></span>muestran </div><div class="t m0 x4 h8 y70 ff1 fs5 fc0 sc0 ls0 ws1">alimentaria, <span class="blank"> </span>involucrando <span class="blank"> </span>en <span class="blank"> </span>el <span class="blank"> </span>manejo <span class="blank"> </span>al <span class="blank"> </span>paciente, <span class="blank _9"> </span>su </div><div class="t m0 x8 h8 y71 ff1 fs5 fc0 sc0 ls0 ws1">neuropéptidos <span class="blank _6"> </span>como <span class="blank _6"> </span>CRH, <span class="blank _6"> </span>Leptina, <span class="blank _7"> </span>opioides <span class="blank _6"> </span>endógenos </div><div class="t m0 x4 h8 y72 ff1 fs5 fc0 sc0 ls0 ws1">familia, <span class="blank"> </span>personal <span class="blank _7"> </span>de <span class="blank"> </span>salud <span class="blank _7"> </span>y <span class="blank"> </span>medio <span class="blank"> </span>que <span class="blank _7"> </span>lo <span class="blank"> </span>rodea. <span class="blank _7"> </span>Para </div><div class="t m0 x8 h8 y73 ff1 fs5 fc0 sc0 ls0 ws1">(beta endorfinas) y <span class="blank _1"> </span>neuropéptido <span class="blank _2"></span>Y<span class="blank _e"></span>, <span class="blank _1"> </span>los cuales se <span class="blank _1"> </span>encargan </div><div class="t m0 x4 h8 y74 ff1 fs5 fc0 sc0 ls0 ws1">lograrlo <span class="blank _3"> </span>se <span class="blank _d"> </span>realizó <span class="blank _3"> </span>una <span class="blank _d"> </span>búsqueda <span class="blank _d"> </span>en <span class="blank _3"> </span>bases <span class="blank _d"> </span>de <span class="blank _3"> </span>datos <span class="blank _d"> </span>como </div><div class="t m0 x8 h8 y75 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _6"> </span>modular<span class="blank _2"></span>, <span class="blank _a"> </span>a <span class="blank _6"> </span>través <span class="blank _6"> </span>de <span class="blank _6"> </span>vías <span class="blank _6"> </span>corticales <span class="blank _6"> </span>hacia <span class="blank _6"> </span>el <span class="blank _6"> </span>sistema </div><div class="t m0 x4 h8 y76 ff1 fs5 fc0 sc0 ls0 ws1">Pubmed, Medline <span class="blank _2"></span>y <span class="blank _2"></span>Lilacs, <span class="blank _2"></span>sobre <span class="blank _2"></span>artículos combinando <span class="blank _2"></span>las </div><div class="t m0 x8 h8 y77 ff1 fs5 fc0 sc0 ls0 ws1">lí<span class="blank _1"> </span>m<span class="blank _1"> </span>bi<span class="blank _1"> </span>co<span class="blank _1"> </span> <span class="blank _12"> </span>y <span class="blank _12"> </span>c<span class="blank _1"> </span>or<span class="blank _1"> </span>t<span class="blank _1"> </span>ez<span class="blank _1"> </span>a <span class="blank _12"> </span>p<span class="blank _1"> </span>re<span class="blank _1"> </span>f<span class="blank _1"> </span>ro<span class="blank _1"> </span>nt<span class="blank _1"> </span>a<span class="blank _1"> </span>l,<span class="blank _1"> </span> <span class="blank _12"> </span>lo<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _f"> </span>c<span class="blank _1"> </span>o<span class="blank _1"> </span>mp<span class="blank _1"> </span>o<span class="blank _1"> </span>rt<span class="blank _1"> </span>am<span class="blank _1"> </span>i<span class="blank _1"> </span>en<span class="blank _1"> </span>t<span class="blank _1"> </span>os<span class="blank _1"> </span> </div><div class="t m0 x4 h8 y78 ff1 fs5 fc0 sc0 ls0 ws1">palabras <span class="blank _1a"> </span>en <span class="blank _10"> </span>inglés <span class="blank _1a"> </span>y <span class="blank _1a"> </span>español, <span class="blank _10"> </span>tales <span class="blank _1a"> </span>como: <span class="blank _1a"> </span>trastornos </div><div class="t m0 x8 h8 y79 ff1 fs5 fc0 sc0 ls0 ws1">alimentarios <span class="blank _3"> </span>y <span class="blank _3"> </span>el <span class="blank _3"> </span>metabolismo <span class="blank _3"> </span>energético <span class="blank _3"> </span>que <span class="blank _3"> </span>intervienen </div><div class="t m0 x4 h8 y7a ff1 fs5 fc0 sc0 ls0 ws1">conducta <span class="blank _10"> </span>alimentaria, <span class="blank _10"> </span>niños, <span class="blank _10"> </span>adolescentes, <span class="blank _10"> </span>pronóstico, </div><div class="t m0 x8 h8 y7b ff1 fs5 fc0 sc0 ls0 ws1">para <span class="blank _d"> </span>producir <span class="blank _d"> </span>la <span class="blank _3"> </span>sensación <span class="blank _d"> </span>de <span class="blank _d"> </span>saciedad <span class="blank _d"> </span>o <span class="blank _d"> </span>la <span class="blank _d"> </span>necesidad <span class="blank _d"> </span>de </div><div class="t m0 x4 h8 y7c ff1 fs5 fc0 sc0 ls0 ws1">tratamiento <span class="blank _a"> </span>y <span class="blank _6"> </span>cuadro <span class="blank _a"> </span>clínico, <span class="blank _6"> </span>lo <span class="blank _a"> </span>que <span class="blank _6"> </span>generó <span class="blank _a"> </span>artículos <span class="blank _6"> </span>de </div><div class="t m0 x8 h8 y7d ff1 fs5 fc0 sc0 ls0 ws1">buscar <span class="blank _c"></span>el <span class="blank _0"></span>alimento.</div><div class="t m0 x4 h8 y7e ff1 fs5 fc0 sc0 ls0 ws1">diferentes <span class="blank"> </span>años <span class="blank _b"> </span>y <span class="blank"> </span>tipos <span class="blank _b"> </span>de <span class="blank"> </span>estudio; <span class="blank _b"> </span>además, <span class="blank"> </span>se <span class="blank _b"> </span>realizó </div><div class="t m0 x4 h8 y7f ff1 fs5 fc0 sc0 ls0 ws1">búsqueda <span class="blank _1"> </span>bibliográfica en <span class="blank _1"> </span>libros <span class="blank _1"> </span>como <span class="blank _1"> </span>el <span class="blank _1"> </span>DSM-IV y <span class="blank _1"> </span>otros </div><div class="t m0 x8 h8 y80 ff1 fs5 fc0 sc0 ls0 ws1">Los sistemas monoaminér<span class="blank _2"></span>gicos de serotonina, dopamina <span class="blank _2"></span>y </div><div class="t m0 x4 h8 y81 ff1 fs5 fc0 sc0 ls0 ws1">con <span class="blank _0"></span>el <span class="blank _2"></span>fin <span class="blank _0"></span>de <span class="blank _0"></span>esclarecer <span class="blank _2"></span>algunos <span class="blank _0"></span>conceptos <span class="blank _2"></span>importantes <span class="blank _0"></span>para </div><div class="t m0 x8 h8 y82 ff1 fs5 fc0 sc0 ls0 ws1">norepinefrina <span class="blank _c"></span>son <span class="blank _0"></span>vías <span class="blank _0"></span>nerviosas <span class="blank _c"></span>complejas <span class="blank _0"></span>implicadas <span class="blank _c"></span>en <span class="blank _0"></span>la </div><div class="t m0 x4 h8 y83 ff1 fs5 fc0 sc0 ls0 ws1">esta <span class="blank _c"></span>revisión.</div><div class="t m0 xf h7 y84 ff3 fs4 fc0 sc0 ls0">130</div><div class="t m0 x10 he y85 ff3 fs8 fc2 sc0 ls0 ws1">V<span class="blank _2"></span>ol. 12 Número 3, Diciembre de 2009</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x11 y2b w2 hf" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg3.png"><div class="t m0 x0 h8 y86 ff1 fs5 fc0 sc0 ls0 ws1">génesis <span class="blank _14"> </span>del <span class="blank _b"> </span>trastorno. <span class="blank _b"> </span>Las <span class="blank _b"> </span>anormalidades <span class="blank _b"> </span>dadas <span class="blank _b"> </span>por <span class="blank _b"> </span>la <span class="blank _4"> </span>influencias <span class="blank _18"> </span>familiares <span class="blank _18"> </span>no <span class="blank _8"> </span>necesariamente <span class="blank _18"> </span>deben <span class="blank _18"> </span>seguir </div><div class="t m0 x0 h8 y87 ff1 fs5 fc0 sc0 ls0 ws1">seroto<span class="blank _1"> </span>nina<span class="blank _1"> </span> <span class="blank _f"> </span>pu<span class="blank _1"> </span>eden <span class="blank _12"> </span>cont<span class="blank _1"> </span>ribu<span class="blank _1"> </span>ir <span class="blank _12"> </span>al <span class="blank _12"> </span>desequ<span class="blank _1"> </span>ilibri<span class="blank _1"> </span>o <span class="blank _12"> </span>en <span class="blank _12"> </span>la <span class="blank _4"> </span>patrones <span class="blank _14"> </span>de <span class="blank _14"> </span>herencia <span class="blank _b"> </span>mendelianos, <span class="blank _14"> </span>por <span class="blank _14"> </span>lo <span class="blank _b"> </span>cual <span class="blank _14"> </span>pueden </div><div class="t m0 x0 h8 y88 ff1 fs5 fc0 sc0 ls0 ws1">regulación <span class="blank _1"> </span>del <span class="blank _3"> </span>apetito, <span class="blank _3"> </span>la <span class="blank _1"> </span>ansiedad <span class="blank _3"> </span>y <span class="blank _3"> </span>los <span class="blank _3"> </span>comportamientos <span class="blank _4"> </span>permanecer <span class="blank _c"></span>ausentes <span class="blank _0"></span>en <span class="blank _c"></span>ciertas <span class="blank _0"></span>generaciones. </div><div class="t m0 x0 h8 y89 ff1 fs5 fc0 sc0 ls0 ws1">obsesivos, <span class="blank _d"> </span>además <span class="blank _d"> </span>de <span class="blank _d"> </span>extrema <span class="blank _d"> </span>dificultad <span class="blank _d"> </span>en <span class="blank _d"> </span>el <span class="blank _d"> </span>control <span class="blank _3"> </span>de </div><div class="t m0 x0 h8 y8a ff1 fs5 fc0 sc0 ls0 ws1">impulsos. En este punto, es importante mencionar el papel <span class="blank _4"> </span><span class="v1">Se <span class="blank _1a"> </span>han <span class="blank _1a"> </span>descrito <span class="blank _1a"> </span>tres <span class="blank _18"> </span>tipos <span class="blank _1a"> </span>de <span class="blank _1a"> </span>correlaciones <span class="blank _18"> </span>genético-</span></div><div class="t m0 x0 h8 y8b ff1 fs5 fc0 sc0 ls0 ws1">del triptófano, <span class="blank _1"> </span>un aminoácido esencial <span class="blank _1"> </span>presente en <span class="blank _1"> </span>la dieta <span class="blank _4"> </span><span class="v1">ambientales <span class="blank _6"> </span>en <span class="blank _7"> </span>la <span class="blank _6"> </span>literatura: <span class="blank _6"> </span>pasiva, <span class="blank _6"> </span>evocadora <span class="blank _6"> </span>y <span class="blank _6"> </span>activa. </span></div><div class="t m0 x0 h8 y8c ff1 fs5 fc0 sc0 ls0 ws1">solamente <span class="blank _c"></span>como <span class="blank _0"></span>precursor <span class="blank _c"></span>de <span class="blank _0"></span>la <span class="blank _c"></span>serotonina. <span class="blank _1d"> </span><span class="v1">Pasiva es <span class="blank _2"></span>aquella <span class="blank _2"></span>que ocurre <span class="blank _2"></span>en <span class="blank _2"></span>niños que <span class="blank _2"></span>reciben <span class="blank _2"></span>genes de </span></div><div class="t m0 x12 h8 y8d ff1 fs5 fc0 sc0 ls0 ws1">las <span class="blank _2"></span>mismas <span class="blank _0"></span>personas <span class="blank _2"></span>que <span class="blank _2"></span>hacen <span class="blank _0"></span>parte de <span class="blank _0"></span>su <span class="blank _2"></span>entorno <span class="blank _2"></span>familiar </div><div class="t m0 x0 h8 y8e ff1 fs5 fc0 sc0 ls0 ws1">La <span class="blank _0"></span>evidencia <span class="blank _2"></span>muestra <span class="blank _0"></span>que <span class="blank _2"></span>una <span class="blank _0"></span>dieta <span class="blank _2"></span>restrictiva <span class="blank _0"></span>disminuye <span class="blank _2"></span>la <span class="blank _4"> </span><span class="v1">(a <span class="blank _3"> </span>menos <span class="blank _d"> </span>que <span class="blank _3"> </span>se <span class="blank _3"> </span>adopten). <span class="blank _d"> </span>En <span class="blank _3"> </span>este <span class="blank _d"> </span>tipo <span class="blank _3"> </span>de <span class="blank _3"> </span>interacción, <span class="blank _d"> </span>es </span></div><div class="t m0 x0 h8 y8f ff1 fs5 fc0 sc0 ls0 ws1">c<span class="blank _1"> </span>a<span class="blank _1"> </span>n<span class="blank _1"> </span>t<span class="blank _3"> </span>i<span class="blank _1"> </span>d<span class="blank _1"> </span>a<span class="blank _3"> </span>d<span class="blank _1"> </span> <span class="blank _12"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _12"> </span>t<span class="blank _1"> </span>r<span class="blank _1"> </span>i<span class="blank _1"> </span>p<span class="blank _3"> </span>t<span class="blank _1"> </span>ó<span class="blank _1"> </span>f<span class="blank _1"> </span>a<span class="blank _3"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _12"> </span>p<span class="blank _1"> </span>l<span class="blank _1"> </span>a<span class="blank _3"> </span>s<span class="blank _1"> </span>m<span class="blank _1"> </span>á<span class="blank _3"> </span>t<span class="blank _1"> </span>i<span class="blank _1"> </span>c<span class="blank _1"> </span>o<span class="blank _3"> </span>,<span class="blank _1"> </span> <span class="blank _12"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>d<span class="blank _1"> </span>u<span class="blank _3"> </span>c<span class="blank _1"> </span>i<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _3"> </span>d<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _12"> </span>l<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _13"> </span><span class="v1">como <span class="blank _3"> </span>si <span class="blank _1"> </span>el <span class="blank _3"> </span>niño <span class="blank _1"> </span>recibiera <span class="blank _3"> </span>una <span class="blank _1"> </span>\u201cdosis <span class="blank _3"> </span>doble\u201d <span class="blank _1"> </span>de <span class="blank _3"> </span>influencia, </span></div><div class="t m0 x0 h8 y90 ff1 fs5 fc0 sc0 ls0 ws1">disponibilidad <span class="blank _1"> </span>de <span class="blank _1"> </span>sustrato <span class="blank _1"> </span>para <span class="blank _1"> </span>la <span class="blank _1"> </span>producción <span class="blank _1"> </span>adecuada <span class="blank _1"> </span>de <span class="blank _4"> </span><span class="v1">tanto <span class="blank _8"> </span>genética <span class="blank _b"> </span>como <span class="blank _b"> </span>medioambiental, <span class="blank _8"> </span>con <span class="blank _b"> </span>modelos <span class="blank _8"> </span>de </span></div><div class="t m0 x0 h8 y91 ff1 fs5 fc0 sc0 ls0 ws1">serotonina <span class="blank _a"> </span>y <span class="blank _a"> </span>produciendo <span class="blank _a"> </span>una <span class="blank _a"> </span>regulación <span class="blank _6"> </span>a <span class="blank _a"> </span>la <span class="blank _a"> </span>baja <span class="blank _a"> </span>de <span class="blank _a"> </span>la <span class="blank _4"> </span><span class="v1">insatisfacción <span class="blank _1a"> </span>por <span class="blank _18"> </span>la <span class="blank _18"> </span>imagen <span class="blank _18"> </span>corporal, <span class="blank _18"> </span>dieta, <span class="blank _1a"> </span>ejercicio </span></div><div class="t m0 x0 h8 y92 ff1 fs5 fc0 sc0 ls0 ws1">densidad <span class="blank _1"> </span>de <span class="blank _1"> </span>transportadores <span class="blank _1"> </span>de <span class="blank _1"> </span>serotonina. <span class="blank _1"> </span>De <span class="blank _1"> </span>esta <span class="blank _1"> </span>forma, <span class="blank _4"> </span><span class="v1">compulsivo, <span class="blank _0"></span>etc. </span></div><div class="t m0 x0 h8 y93 ff1 fs5 fc0 sc0 ls0 ws1">se <span class="blank _3"> </span>ha <span class="blank _d"> </span>podido <span class="blank _3"> </span>establecer <span class="blank _d"> </span>que <span class="blank _3"> </span>el <span class="blank _d"> </span>incremento <span class="blank _3"> </span>de <span class="blank _d"> </span>la <span class="blank _d"> </span>ansiedad </div><div class="t m0 x0 h8 y94 ff1 fs5 fc0 sc0 ls0 ws1">producido <span class="blank _a"> </span>por <span class="blank _a"> </span>la <span class="blank _a"> </span>dieta <span class="blank _a"> </span>en <span class="blank _a"> </span>la <span class="blank _3"> </span>AN <span class="blank _a"> </span>está <span class="blank _a"> </span>relacionado <span class="blank _a"> </span>con <span class="blank _a"> </span>la <span class="blank _4"> </span><span class="v3">La correlación evocada es la vista <span class="blank _2"></span>en un individuo con <span class="blank _2"></span>una </span></div><div class="t m0 x0 h8 y95 ff1 fs5 fc0 sc0 ls0 ws1">reducción <span class="blank _c"></span>en <span class="blank _0"></span>la <span class="blank _0"></span>neurotransmisión <span class="blank _c"></span>serotoninérgica <span class="blank _c"></span>y <span class="blank _0"></span>que <span class="blank _0"></span>esto <span class="blank _13"> </span><span class="v3">predisposición <span class="blank _6"> </span>genética <span class="blank _6"> </span>a <span class="blank _7"> </span>un <span class="blank _6"> </span>determinado <span class="blank _6"> </span>trastorno. <span class="blank _6"> </span>Por </span></div><div class="t m0 x0 h8 y96 ff1 fs5 fc0 sc0 ls0 ws1">puede <span class="blank _0"></span>ser <span class="blank _2"></span>revertido <span class="blank _0"></span>con <span class="blank _2"></span>la <span class="blank _0"></span>reintroducción <span class="blank _2"></span>progresiva <span class="blank _0"></span>de <span class="blank _2"></span>una <span class="blank _4"> </span><span class="v3">ejemplo, <span class="blank _6"> </span>el <span class="blank _7"> </span>niño <span class="blank _6"> </span>con <span class="blank _7"> </span>predisposición <span class="blank _6"> </span>genética <span class="blank _7"> </span>que <span class="blank _7"> </span>busca </span></div><div class="t m0 x0 h8 y97 ff1 fs5 fc0 sc0 ls0 ws1">rehabilitación <span class="blank _2"></span>nutricional <span class="blank _0"></span>para <span class="blank _2"></span>contrarestar <span class="blank _0"></span>los <span class="blank _2"></span>efectos <span class="blank _2"></span>de <span class="blank _0"></span>la <span class="blank _4"> </span><span class="v3">comentarios <span class="blank _3"> </span>de <span class="blank _3"> </span>desaprobación <span class="blank _1"> </span>en <span class="blank _3"> </span>sus <span class="blank _3"> </span>pares <span class="blank _1"> </span>y <span class="blank _3"> </span>familiares <span class="blank _3"> </span>y </span></div><div class="t m0 x13 hb y98 ff1 fs7 fc0 sc0 ls0">15</div><div class="t m0 x0 h8 y99 ff1 fs5 fc0 sc0 ls0 ws1">disminución <span class="blank _c"></span>del <span class="blank _0"></span>aporte <span class="blank _c"></span>de <span class="blank _0"></span>triptófano <span class="blank _c"></span>en <span class="blank _c"></span>la <span class="blank _0"></span>dieta.<span class="blank _1e"> </span><span class="v2">encuentra <span class="blank _1"> </span>en <span class="blank _3"> </span>estos <span class="blank _3"> </span>refuerzos <span class="blank _3"> </span>positivos <span class="blank _1"> </span>o <span class="blank _3"> </span>negativos <span class="blank _3"> </span>para <span class="blank _3"> </span>el </span></div><div class="t m0 x0 h8 y9a ff1 fs5 fc0 sc0 ls5 ws1"> <span class="ls0 v2">mantenimiento <span class="blank _1"> </span>y <span class="blank _3"> </span>continuidad <span class="blank _3"> </span>del <span class="blank _3"> </span>trastorno. <span class="blank _3"> </span>Por <span class="blank _3"> </span>último, <span class="blank _1"> </span>la </span></div><div class="t m0 x0 h8 y9b ff1 fs5 fc0 sc0 ls0 ws1">La dopamina también ha jugado un <span class="blank _1"> </span>papel importante en la <span class="blank _4"> </span><span class="v2">correlación activa se produce <span class="blank _2"></span>cuando existe <span class="blank _2"></span>vulnerabilidad </span></div><div class="t m0 x0 h8 y9c ff1 fs5 fc0 sc0 ls0 ws1">fisiopatología, <span class="blank _a"> </span>ya <span class="blank _a"> </span>que <span class="blank _d"> </span>se <span class="blank _a"> </span>ha <span class="blank _a"> </span>encontrado <span class="blank _a"> </span>que <span class="blank _a"> </span>la <span class="blank _a"> </span>secreción <span class="blank _4"> </span><span class="v2">genética y<span class="blank _0"></span>, adicionalmente, el paciente busca entornos que </span></div><div class="t m0 x0 h8 y9d ff1 fs5 fc0 sc0 ls0 ws1">alterada <span class="blank _8"> </span>en <span class="blank _18"> </span>el <span class="blank _18"> </span>cuerpo <span class="blank _8"> </span>estriado <span class="blank _18"> </span>puede <span class="blank _8"> </span>contribuir <span class="blank _18"> </span>a <span class="blank _18"> </span>los <span class="blank _4"> </span><span class="v2">refuercen <span class="blank _10"> </span>la <span class="blank _f"> </span>continuidad <span class="blank _10"> </span>del <span class="blank _10"> </span>trastorno <span class="blank _f"> </span>(por <span class="blank _10"> </span>ejemplo, </span></div><div class="t m0 x0 h8 y9e ff1 fs5 fc0 sc0 ls0 ws1">síntomas <span class="blank _b"> </span>de <span class="blank _b"> </span>anorexia <span class="blank _8"> </span>nerviosa, <span class="blank _b"> </span>que <span class="blank _8"> </span>se <span class="blank _b"> </span>manifiestan <span class="blank _8"> </span>en <span class="blank _4"> </span><span class="v2">actividades <span class="blank _3"> </span>como <span class="blank _3"> </span>la <span class="blank _1"> </span>gimnasia, <span class="blank _3"> </span>el <span class="blank _3"> </span>ballet <span class="blank _3"> </span>y <span class="blank _1"> </span>el <span class="blank _3"> </span>modelaje) <span class="blank _3"> </span>los </span></div><div class="t m0 x14 hb y9f ff1 fs7 fc0 sc0 ls0">19</div><div class="t m0 x0 h8 ya0 ff1 fs5 fc0 sc0 ls0 ws1">alteraciones de <span class="blank _1"> </span>la <span class="blank _1"> </span>sensación <span class="blank _1"> </span>de afecto <span class="blank _1"> </span>y <span class="blank _1"> </span>recompensa, en <span class="blank _1"> </span>la <span class="blank _4"> </span><span class="v3">cuales <span class="blank _0"></span>se <span class="blank _c"></span>comportan <span class="blank _0"></span>como <span class="blank _c"></span>\u201cambientes <span class="blank _c"></span>de <span class="blank _0"></span>alto <span class="blank _c"></span>riesgo\u201d.<span class="blank _12"> </span> </span></div><div class="t m0 x0 h8 ya1 ff1 fs5 fc0 sc0 ls0 ws1">capacidad <span class="blank _0"></span>de <span class="blank _0"></span>tomar <span class="blank _0"></span>decisiones <span class="blank _0"></span>adecuadamente, <span class="blank _0"></span>así <span class="blank _0"></span>como <span class="blank _0"></span>en </div><div class="t m0 x0 h8 ya2 ff1 fs5 fc0 sc0 ls0 ws1">el <span class="blank _0"></span>control <span class="blank _0"></span>ejecutivo, <span class="blank _2"></span>el <span class="blank _0"></span>discernimiento <span class="blank _0"></span>y <span class="blank _2"></span>la <span class="blank _0"></span>actividad <span class="blank _0"></span>motora </div><div class="t m0 x0 h8 ya3 ff1 fs5 fc0 sc0 ls0 ws1">estereotípica, <span class="blank _0"></span>lo <span class="blank _0"></span>que <span class="blank _c"></span>implica <span class="blank _0"></span>cambios <span class="blank _0"></span>en <span class="blank _0"></span>el <span class="blank _c"></span>patrón <span class="blank _0"></span>de <span class="blank _0"></span>ingesta </div><div class="t m0 x15 h10 ya4 ff1 fs7 fc0 sc0 ls0 ws1">16, <span class="blank _0"></span>17<span class="blank _1f"> </span><span class="ff5 fs6 v1">Clínica </span></div><div class="t m0 x0 h8 ya5 ff1 fs5 fc0 sc0 ls0 ws1">alimentaria <span class="blank _c"></span>adecuado.</div><div class="t m0 x12 h8 ya6 ff1 fs5 fc0 sc0 ls0 ws1">En el <span class="blank _1"> </span>manual \u201cDiagnóstico <span class="blank _1"> </span>y Estadística <span class="blank _1"> </span>de los Trastornos </div><div class="t m0 x0 h8 ya7 ff1 fs5 fc0 sc0 ls0 ws1">P<span class="blank _3"> </span>o<span class="blank _1"> </span>r<span class="blank _3"> </span> <span class="blank _12"> </span>o<span class="blank _3"> </span>t<span class="blank _3"> </span>r<span class="blank _1"> </span>o<span class="blank _3"> </span> <span class="blank _12"> </span>l<span class="blank _3"> </span>a<span class="blank _1"> </span>d<span class="blank _3"> </span>o<span class="blank _3"> </span>,<span class="blank _3"> </span> <span class="blank _12"> </span>l<span class="blank _1"> </span>a<span class="blank _3"> </span> <span class="blank _12"> </span>h<span class="blank _3"> </span>i<span class="blank _3"> </span>p<span class="blank _1"> </span>o<span class="blank _3"> </span>l<span class="blank _3"> </span>e<span class="blank _3"> </span>p<span class="blank _3"> </span>t<span class="blank _3"> </span>i<span class="blank _3"> </span>n<span class="blank _1"> </span>e<span class="blank _3"> </span>m<span class="blank _3"> </span>i<span class="blank _3"> </span>a<span class="blank _3"> </span> <span class="blank _12"> </span>(<span class="blank _1"> </span>c<span class="blank _3"> </span>a<span class="blank _3"> </span>r<span class="blank _3"> </span>a<span class="blank _3"> </span>c<span class="blank _1"> </span>t<span class="blank _3"> </span>e<span class="blank _3"> </span>r<span class="blank _3"> </span>í<span class="blank _3"> </span>s<span class="blank _3"> </span>t<span class="blank _1"> </span>i<span class="blank _3"> </span>c<span class="blank _3"> </span>a<span class="blank _3"> </span> <span class="blank _20"> </span><span class="ff5 fs7 v9">7</span></div><div class="t m0 x12 h8 ya8 ff1 fs5 fc0 sc0 ls0 ws1">Mentales <span class="blank _0"></span>DSM-IV\u201d,<span class="blank _18"> </span>se <span class="blank _0"></span>dan <span class="blank _0"></span>tres <span class="blank _0"></span>categorías <span class="blank _2"></span>de <span class="blank _0"></span>los <span class="blank _0"></span>trastornos </div><div class="t m0 x0 h8 ya9 ff1 fs5 fc0 sc0 ls0 ws1">endocrinológica <span class="blank _3"> </span>clave <span class="blank _3"> </span>de <span class="blank _d"> </span>la AN), <span class="blank _3"> </span>resulta <span class="blank _d"> </span>de <span class="blank _3"> </span>la <span class="blank _3"> </span>pérdida <span class="blank _d"> </span>de <span class="blank _21"> </span><span class="ff5 fs7 va"> </span></div><div class="t m0 x12 h8 yaa ff1 fs5 fc0 sc0 ls0 ws1">de la ingestión y <span class="blank _1"> </span>de la <span class="blank _1"> </span>conducta alimentaria de inicio <span class="blank _1"> </span>en la </div><div class="t m0 x0 h8 yab ff1 fs5 fc0 sc0 ls0 ws1">grasa <span class="blank _14"> </span>y <span class="blank _b"> </span>produce <span class="blank _b"> </span>una <span class="blank _b"> </span>regulación <span class="blank _14"> </span>a <span class="blank _b"> </span>la <span class="blank _b"> </span>baja <span class="blank _b"> </span>de <span class="blank _14"> </span>los <span class="blank _b"> </span>ejes </div><div class="t m0 x12 h8 yac ff1 fs5 fc0 sc0 ls0 ws1">infancia <span class="blank"> </span>y <span class="blank _9"> </span>la <span class="blank"> </span>niñez: <span class="blank _9"> </span>pica, <span class="blank"> </span>rumiación <span class="blank _9"> </span>y <span class="blank"> </span>trastornos <span class="blank _9"> </span>de <span class="blank"> </span>la </div><div class="t m0 x0 h8 yad ff1 fs5 fc0 sc0 ls0 ws1">hi<span class="blank _1"> </span>p<span class="blank _1"> </span>ot<span class="blank _1"> </span>á<span class="blank _1"> </span>l<span class="blank _1"> </span>am<span class="blank _1"> </span>o<span class="blank _1"> </span>-h<span class="blank _1"> </span>i<span class="blank _1"> </span>p<span class="blank _1"> </span>óf<span class="blank _1"> </span>i<span class="blank _1"> </span>si<span class="blank _1"> </span>s<span class="blank _1"> </span>-g<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span>ad<span class="blank _1"> </span>a<span class="blank _1"> </span>l <span class="blank _12"> </span>e<span class="blank _1"> </span> <span class="blank _12"> </span>hi<span class="blank _1"> </span>po<span class="blank _1"> </span>t<span class="blank _1"> </span>á<span class="blank _1"> </span>la<span class="blank _1"> </span>m<span class="blank _1"> </span>o-<span class="blank _1"> </span>h<span class="blank _1"> </span>ip<span class="blank _1"> </span>ó<span class="blank _1"> </span>f<span class="blank _1"> </span>is<span class="blank _1"> </span>i<span class="blank _1"> </span>s-</div><div class="t m0 x12 h8 yae ff1 fs5 fc0 sc0 ls0 ws1">ingestión <span class="blank _f"> </span>alimentaria <span class="blank _f"> </span>de <span class="blank _12"> </span>la <span class="blank _f"> </span>infancia <span class="blank _12"> </span>o <span class="blank _f"> </span>la <span class="blank _f"> </span>niñez <span class="blank _12"> </span>no </div><div class="t m0 x0 h8 yaf ff1 fs5 fc0 sc0 ls0 ws1">tiroides, <span class="blank _d"> </span>en <span class="blank _d"> </span>contraste <span class="blank _d"> </span>con <span class="blank _3"> </span>una <span class="blank _d"> </span>regulación <span class="blank _d"> </span>a <span class="blank _d"> </span>la <span class="blank _d"> </span>alta <span class="blank _d"> </span>del <span class="blank _d"> </span>eje </div><div class="t m0 x12 h8 yb0 ff1 fs5 fc0 sc0 ls0 ws1">especificados, <span class="blank _a"> </span>lo <span class="blank _d"> </span>que <span class="blank _a"> </span>permite <span class="blank _a"> </span>categorizar <span class="blank _a"> </span>en <span class="blank _d"> </span>este <span class="blank _a"> </span>último, </div><div class="t m0 x0 h8 yb1 ff1 fs5 fc0 sc0 ls0 ws1">hipotalámico-hipofisario-adrenal, <span class="blank _a"> </span>todo <span class="blank _a"> </span>esto <span class="blank _a"> </span>con <span class="blank _a"> </span>el <span class="blank _a"> </span>fin <span class="blank _a"> </span>de </div><div class="t m0 x12 h8 yb2 ff1 fs5 fc0 sc0 ls0 ws1">trastornos <span class="blank _d"> </span>como <span class="blank _a"> </span>la <span class="blank _a"> </span>neofobia <span class="blank _d"> </span>alimentaria, <span class="blank _a"> </span>el <span class="blank _a"> </span>trastorno <span class="blank _d"> </span>por </div><div class="t m0 x0 h8 yb3 ff1 fs5 fc0 sc0 ls0 ws1">disminuir <span class="blank _0"></span>el <span class="blank _c"></span>metabolismo <span class="blank _0"></span>basal <span class="blank _0"></span>sin <span class="blank _0"></span>sacrificar <span class="blank _0"></span>la <span class="blank _c"></span>energía <span class="blank _0"></span>para </div><div class="t m0 x12 h8 yb4 ff1 fs5 fc0 sc0 ls0 ws1">evitación <span class="blank _2"></span>emocional <span class="blank _2"></span>de <span class="blank _2"></span>la <span class="blank _0"></span>comida, las <span class="blank _2"></span>fobias <span class="blank _0"></span>alimentarias y </div><div class="t m0 x0 h8 yb5 ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _3"> </span>actividad <span class="blank _3"> </span>diaria <span class="blank _3"> </span>y <span class="blank _3"> </span>que, <span class="blank _3"> </span>paralelamente, <span class="blank _3"> </span>explica <span class="blank _3"> </span>síntomas <span class="blank _22"> </span><span class="fs7 vb">20 </span></div><div class="t m0 x12 h8 yb6 ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _c"></span>disfagia <span class="blank _0"></span>funcional.</div><div class="t m0 x0 h8 yb7 ff1 fs5 fc0 sc0 ls0 ws1">como <span class="blank _c"></span>la <span class="blank _0"></span>amenorrea. </div><div class="t m0 x12 h8 yb8 ff1 fs5 fc0 sc0 ls0 ws1">Psicopatológicamente, <span class="blank _1"> </span>estos trastornos <span class="blank _1"> </span>se <span class="blank _1"> </span>caracterizan <span class="blank _1"> </span>por </div><div class="t m0 x0 h8 yb9 ff1 fs5 fc0 sc0 ls0 ws1">Los <span class="blank _8"> </span>cambios <span class="blank _18"> </span>en <span class="blank _18"> </span>la <span class="blank _18"> </span>actividad <span class="blank _8"> </span>neuronal <span class="blank _18"> </span>serotoninérgica </div><div class="t m0 x12 h8 yba ff1 fs5 fc0 sc0 ls0 ws1">presentar <span class="blank _7"> </span>alteraciones <span class="blank _7"> </span>en <span class="blank _7"> </span>la <span class="blank _7"> </span>cantidad <span class="blank"> </span>y <span class="blank _6"> </span>la <span class="blank _7"> </span>calidad <span class="blank _7"> </span>de <span class="blank _9"> </span>la </div><div class="t m0 x0 h8 ybb ff1 fs5 fc0 sc0 ls0 ws1">podrían <span class="blank _0"></span>explicar <span class="blank _c"></span>los <span class="blank _0"></span>rasgos <span class="blank _c"></span>obsesivos <span class="blank _0"></span>como <span class="blank _c"></span>el <span class="blank _0"></span>aumento <span class="blank _0"></span>de <span class="blank _c"></span>la </div><div class="t m0 x12 h8 ybc ff1 fs5 fc0 sc0 ls0 ws1">ingesta, <span class="blank _b"> </span>asociados, <span class="blank _8"> </span>de <span class="blank _b"> </span>manera <span class="blank _8"> </span>frecuente, <span class="blank _b"> </span>a <span class="blank _8"> </span>retraso <span class="blank _b"> </span>del </div><div class="t m0 x0 h8 ybd ff1 fs5 fc0 sc0 ls0 ws1">ansiedad <span class="blank _d"> </span>y <span class="blank _d"> </span>las <span class="blank _d"> </span>dificultades <span class="blank _3"> </span>en <span class="blank _d"> </span>el <span class="blank _d"> </span>control <span class="blank _d"> </span>de <span class="blank _d"> </span>los <span class="blank _d"> </span>impulsos. </div><div class="t m0 x12 h8 ybe ff1 fs5 fc0 sc0 ls0 ws1">crecimiento <span class="blank _1"> </span>y <span class="blank _3"> </span>se <span class="blank _3"> </span>manifiestan <span class="blank _3"> </span>en <span class="blank _1"> </span>general <span class="blank _3"> </span>como: <span class="blank _3"> </span>rechazo <span class="blank _3"> </span>al </div><div class="t m0 x0 h8 ybf ff1 fs5 fc0 sc0 ls0 ws1">Ad<span class="blank _1"> </span>i<span class="blank _1"> </span>ci<span class="blank _1"> </span>on<span class="blank _1"> </span>a<span class="blank _1"> </span>lm<span class="blank _1"> </span>en<span class="blank _1"> </span>t<span class="blank _1"> </span>e,<span class="blank _1"> </span> <span class="blank _12"> </span>es<span class="blank _1"> </span>tu<span class="blank _1"> </span>d<span class="blank _1"> </span>io<span class="blank _1"> </span>s <span class="blank _12"> </span>d<span class="blank _1"> </span>e <span class="blank _12"> </span>im<span class="blank _1"> </span>á<span class="blank _1"> </span>ge<span class="blank _1"> </span>n<span class="blank _1"> </span>es<span class="blank _1"> </span> <span class="blank _12"> </span>co<span class="blank _1"> </span>n <span class="blank _12"> </span>nu<span class="blank _1"> </span>e<span class="blank _1"> </span>va<span class="blank _1"> </span>s<span class="blank _1"> </span> </div><div class="t m0 x12 h8 yc0 ff1 fs5 fc0 sc0 ls0 ws1">alimento, <span class="blank _10"> </span>cólicos <span class="blank _f"> </span>y <span class="blank _10"> </span>vómitos. <span class="blank _f"> </span>Otros <span class="blank _f"> </span>trastornos <span class="blank _10"> </span>de <span class="blank _f"> </span>la </div><div class="t m0 x0 h8 yc1 ff1 fs5 fc0 sc0 ls0 ws1">tecnologías <span class="blank _18"> </span>confirman <span class="blank _8"> </span>que <span class="blank _18"> </span>estas <span class="blank _18"> </span>alteraciones <span class="blank _18"> </span>persisten </div><div class="t m0 x12 h8 yc2 ff1 fs5 fc0 sc0 ls0 ws1">alimentación, <span class="blank _d"> </span>más <span class="blank _a"> </span>comunes <span class="blank _a"> </span>en <span class="blank _a"> </span>la <span class="blank _d"> </span>población <span class="blank _a"> </span>adolescente, </div><div class="t m0 x0 h8 yc3 ff1 fs5 fc0 sc0 ls0 ws1">después de la recupe<span class="blank _2"></span>ración clínica de los <span class="blank _2"></span>pacientes, lo cual </div><div class="t m0 x16 hb yc4 ff1 fs7 fc0 sc0 ls0 ws5">18<span class="blank"> </span><span class="fs5 ws1 vc">son <span class="blank _2"></span>AN, BN y los trastornos de la conducta alimentaria no </span></div><div class="t m0 x0 h8 yc5 ff1 fs5 fc0 sc0 ls0 ws1">podría <span class="blank _c"></span>también <span class="blank _0"></span>explicar <span class="blank _c"></span>la <span class="blank _0"></span>cronicidad <span class="blank _c"></span>vista <span class="blank _c"></span>en <span class="blank _0"></span>los <span class="blank _e"></span>TCA.</div><div class="t m0 x12 h8 yc6 ff1 fs5 fc0 sc0 ls0 ws1">especificados <span class="blank _c"></span>(atracones). </div><div class="t m0 x0 h8 yc7 ff1 fs5 fc0 sc0 ls0 ws1">Por <span class="blank _2"></span>otro <span class="blank _2"></span>lado, <span class="blank _0"></span>el riesgo <span class="blank _0"></span>también <span class="blank _2"></span>se <span class="blank _2"></span>comporta <span class="blank _2"></span>desde <span class="blank _0"></span>el punto </div><div class="t m0 x12 h8 yc8 ff1 fs5 fc0 sc0 ls0 ws1">Su <span class="blank _3"> </span>núcleo <span class="blank _3"> </span>psicopatológico <span class="blank _3"> </span>es <span class="blank _3"> </span>una <span class="blank _3"> </span>constante <span class="blank _3"> </span>preocupación </div><div class="t m0 x0 h8 yc9 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank"> </span>vista <span class="blank _7"> </span>genético. <span class="blank"> </span>Se <span class="blank"> </span>ha <span class="blank _7"> </span>visto <span class="blank"> </span>el <span class="blank _7"> </span>importante <span class="blank"> </span>papel <span class="blank"> </span>que </div><div class="t m0 x12 h8 yca ff1 fs5 fc0 sc0 ls0 ws1">por <span class="blank _0"></span>pensamientos <span class="blank _2"></span>referentes <span class="blank _0"></span>a <span class="blank _2"></span>la <span class="blank _0"></span>comida <span class="blank _0"></span>y <span class="blank _2"></span>su <span class="blank _0"></span>intenso <span class="blank _2"></span>miedo </div><div class="t m0 x0 h8 ycb ff1 fs5 fc0 sc0 ls0 ws1">desempeñan <span class="blank _3"> </span>los <span class="blank _3"> </span>factores <span class="blank _3"> </span>genéticos <span class="blank _3"> </span>en <span class="blank _d"> </span>el <span class="blank _3"> </span>desarrollo <span class="blank _3"> </span>de <span class="blank _3"> </span>los </div><div class="t m0 x12 h8 ycc ff1 fs5 fc0 sc0 ls0 ws1">a <span class="blank _12"> </span>engordar, <span class="blank _f"> </span>por<span class="blank _1"> </span> <span class="blank _f"> </span>lo <span class="blank _12"> </span>que<span class="blank _1"> </span> <span class="blank _12"> </span>frecuente<span class="blank _1"> </span>mente <span class="blank _12"> </span>se <span class="blank _12"> </span>vuelve<span class="blank _1"> </span>n </div><div class="t m0 x0 h8 ycd ff1 fs5 fc0 sc0 ls0 ws1">TCA. <span class="blank _1"> </span>Estudios realizados <span class="blank _1"> </span>con <span class="blank _1"> </span>familiares <span class="blank _1"> </span>en AN y <span class="blank _1"> </span>BN <span class="blank _1"> </span>han </div><div class="t m0 x12 h8 yce ff1 fs5 fc0 sc0 ls0 ws1">vegeta<span class="blank _1"> </span>rian<span class="blank _1"> </span>os, <span class="blank _12"> </span>físi<span class="blank _1"> </span>cament<span class="blank _1"> </span>e <span class="blank _12"> </span>hipera<span class="blank _1"> </span>ctiv<span class="blank _1"> </span>os, <span class="blank _12"> </span>se <span class="blank _12"> </span>salt<span class="blank _1"> </span>an <span class="blank _12"> </span>las </div><div class="t m0 x0 h8 ycf ff1 fs5 fc0 sc0 ls0 ws1">encontrado <span class="blank _a"> </span>una <span class="blank _6"> </span>mayor <span class="blank _a"> </span>prevalencia <span class="blank _6"> </span>familiar <span class="blank _a"> </span>de <span class="blank _a"> </span>TCA<span class="blank _2"></span> <span class="blank _a"> </span>con </div><div class="t m0 x12 h8 yd0 ff1 fs5 fc0 sc0 ls0 ws1">comidas <span class="blank _1"> </span>e <span class="blank _3"> </span>incluso, <span class="blank _1"> </span>se <span class="blank _3"> </span>rehúsan <span class="blank _1"> </span>al <span class="blank _3"> </span>consumo <span class="blank _1"> </span>de <span class="blank _3"> </span>líquidos <span class="blank _1"> </span>por </div><div class="t m0 x0 h8 yd1 ff1 fs5 fc0 sc0 ls0 ws1">respecto <span class="blank _1"> </span>a las <span class="blank _1"> </span>familias <span class="blank _1"> </span>control. <span class="blank _1"> </span>Estudios <span class="blank _1"> </span>con <span class="blank _1"> </span>gemelos <span class="blank _1"> </span>para </div><div class="t m0 x17 hc yd2 ff5 fs7 fc0 sc0 ls0 ws1">8, 21 </div><div class="t m0 x12 h8 yd3 ff1 fs5 fc0 sc0 ls0 ws1">miedo <span class="blank _0"></span>a <span class="blank _0"></span>engordar<span class="blank _2"></span>.<span class="blank _23"> </span>La <span class="blank _0"></span>clínica <span class="blank _0"></span>de <span class="blank _0"></span>los <span class="blank _2"></span>distintos <span class="blank _0"></span>trastornos <span class="blank _0"></span>de </div><div class="t m0 x0 h8 yd4 ff1 fs5 fc0 sc0 ls0 ws1">patologías <span class="blank _0"></span>alimentarias <span class="blank _0"></span>sugieren <span class="blank _0"></span>que <span class="blank _2"></span>hay <span class="blank _0"></span>aproximadamente </div><div class="t m0 x12 h8 yd5 ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _a"> </span>conducta <span class="blank _6"> </span>alimentaria <span class="blank _a"> </span>de <span class="blank _a"> </span>la <span class="blank _6"> </span>infancia <span class="blank _a"> </span>y <span class="blank _a"> </span>adolescencia <span class="blank _6"> </span>se </div><div class="t m0 x0 h8 yd6 ff1 fs5 fc0 sc0 ls0 ws1">un <span class="blank _1"> </span>50 <span class="blank _1"> </span>a <span class="blank _1"> </span>un <span class="blank _1"> </span>80% <span class="blank _1"> </span>de <span class="blank _1"> </span>contribución <span class="blank _1"> </span>por <span class="blank _1"> </span>parte <span class="blank _1"> </span>de <span class="blank _1"> </span>la <span class="blank _1"> </span>influencia </div><div class="t m0 x18 hb yd7 ff1 fs7 fc0 sc0 ls0 ws1">4, <span class="blank _2"></span>5, <span class="blank _0"></span>7-11, <span class="blank _0"></span>13, <span class="blank _2"></span>22, <span class="blank _0"></span>23</div><div class="t m0 x0 h8 yd8 ff1 fs5 fc0 sc0 ls0 ws1">genética <span class="blank _3"> </span>para <span class="blank _d"> </span>determinar <span class="blank _3"> </span>la <span class="blank _d"> </span>aparición <span class="blank _3"> </span>de <span class="blank _1"> </span>AN <span class="blank _3"> </span>o <span class="blank _d"> </span>BN. <span class="blank _3"> </span>Estas <span class="blank _4"> </span><span class="va">encuentra <span class="blank _0"></span>resumida <span class="blank _c"></span>en <span class="blank _0"></span>las <span class="blank _c"></span>tablas <span class="blank _c"></span>1 <span class="blank _0"></span>y <span class="blank _c"></span>2.</span></div><div class="t m0 x19 h7 yd9 ff3 fs4 fc0 sc0 ls0">131</div><div class="t m0 x0 h6 yda ff3 fs3 fc2 sc0 ls0 ws1">T<span class="blank _2"></span>rastornos de la conducta alimentaria en niños y adolescentes</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x4 ydb w3 h11" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg4.png"><div class="t m0 x4 h4 ydc ff2 fs2 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>abla <span class="blank _0"></span>1. <span class="blank _c"></span><span class="ff3">Presentación <span class="blank _c"></span>clínica <span class="blank _0"></span>y <span class="blank _c"></span>epidemiología <span class="blank _0"></span>de <span class="blank _c"></span>la <span class="blank _0"></span>pica <span class="blank _c"></span>y <span class="blank _c"></span>la <span class="blank _0"></span>rumiación.</span></div><div class="t m0 x0 h12 ydd ff7 fs9 fc3 sc0 ls0 ws6">TRASTORNO<span class="blank"> </span><span class="ws1 vd">CRITERIOS </span></div><div class="t m0 x15 h13 yde ff7 fs9 fc3 sc0 ls0 ws7">DIAGNÓSTICOS<span class="blank"> </span><span class="ws1 ve">OTROS <span class="blank _2"></span>ASPECTOS CLÍNICOS<span class="blank _24"> </span>EPIDEMIOLOGÍA</span></div><div class="t m0 x1a h14 ydf ff7 fsa fc3 sc0 ls0 ws1"> </div><div class="t m0 x1b h15 ye0 ff7 fs9 fc0 sc0 ls0">PICA</div><div class="t m0 x1 h15 ye1 ff7 fs9 fc0 sc0 ls0">RUMIACIÓN</div><div class="t m0 x1c h16 ye2 ff8 fsb fc0 sc0 ls0 ws1">In<span class="blank _1"> </span>ge<span class="blank _1"> </span>s<span class="blank _1"> </span>ta<span class="blank _1"> </span> <span class="blank _10"> </span>d<span class="blank _1"> </span>e <span class="blank _10"> </span>s<span class="blank _1"> </span>us<span class="blank _1"> </span>t<span class="blank _1"> </span>an<span class="blank _1"> </span>ci<span class="blank _1"> </span>a<span class="blank _1"> </span>s <span class="blank _10"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span> </div><div class="t m0 x1c h16 ye3 ff8 fsb fc0 sc0 ls0 ws1">nu<span class="blank _1"> </span>t<span class="blank _1"> </span>r<span class="blank _1"> </span>i<span class="blank _1"> </span>ti<span class="blank _1"> </span>v<span class="blank _1"> </span>a<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _10"> </span>o<span class="blank _1"> </span> <span class="blank _10"> </span>de<span class="blank _1"> </span> <span class="blank _10"> </span>p<span class="blank _1"> </span>r<span class="blank _1"> </span>od<span class="blank _1"> </span>u<span class="blank _1"> </span>c<span class="blank _1"> </span>t<span class="blank _1"> </span>os<span class="blank _1"> </span> </div><div class="t m0 x1c h16 ye4 ff8 fsb fc0 sc0 ls0 ws1">alim<span class="blank _2"></span>enti<span class="blank _2"></span>ci<span class="blank _2"></span>os <span class="blank"> </span>en <span class="blank _14"> </span>form<span class="blank _2"></span>a <span class="blank"> </span>cruda, </div><div class="t m0 x1c h16 ye5 ff8 fsb fc0 sc0 ls0 ws1">por <span class="blank _d"> </span>perí<span class="blank _2"></span>odos <span class="blank _d"> </span>supe<span class="blank _2"></span>rior<span class="blank _2"></span>es <span class="blank _d"> </span>a <span class="blank _a"> </span>un </div><div class="t m0 x1c h16 ye6 ff8 fsb fc0 sc0 ls0 ws1">mes. </div><div class="t m0 x1c h16 ye7 ff8 fsb fc0 sc0 ls0 ws1">Este <span class="blank _1a"> </span>pa<span class="blank _2"></span>trón <span class="blank _1a"> </span>de <span class="blank _1a"> </span>inge<span class="blank _2"></span>sta <span class="blank _1a"> </span>es </div><div class="t m0 x1c h16 ye8 ff8 fsb fc0 sc0 ls0 ws1">inap<span class="blank _2"></span>ropi<span class="blank _2"></span>ad<span class="blank _2"></span>o <span class="blank"> </span>para <span class="blank"> </span>el <span class="blank"> </span>ni<span class="blank _2"></span>vel <span class="blank"> </span>de </div><div class="t m0 x1c h16 ye9 ff8 fsb fc0 sc0 ls0 ws1">desa<span class="blank _2"></span>rrol<span class="blank _2"></span>lo <span class="blank _3"> </span>(est<span class="blank _2"></span>udia<span class="blank _2"></span>r <span class="blank _3"> </span>todo <span class="blank _3"> </span>caso </div><div class="t m0 x1c h16 yea ff8 fsb fc0 sc0 ls0 ws1">mayo<span class="blank _2"></span>r <span class="blank _0"></span>a <span class="blank _c"></span>dos <span class="blank _0"></span>añ<span class="blank _2"></span>os <span class="blank _c"></span>de <span class="blank _0"></span>edad<span class="blank _2"></span>).</div><div class="t m0 x1c h16 yeb ff8 fsb fc0 sc0 ls0 ws1">La<span class="blank _1"> </span> <span class="blank _10"> </span>c<span class="blank _1"> </span>on<span class="blank _1"> </span>du<span class="blank _1"> </span>c<span class="blank _1"> </span>ta<span class="blank _1"> </span> <span class="blank _10"> </span>in<span class="blank _1"> </span>g<span class="blank _1"> </span>es<span class="blank _1"> </span>ti<span class="blank _1"> </span>v<span class="blank _1"> </span>a <span class="blank _10"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span> </div><div class="t m0 x1c h16 yec ff8 fsb fc0 sc0 ls0 ws1">f<span class="blank _1"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>m<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _10"> </span>p<span class="blank _1"> </span>a<span class="blank _1"> </span>rt<span class="blank _1"> </span>e<span class="blank _3"> </span> <span class="blank _10"> </span>de<span class="blank _3"> </span> <span class="blank _10"> </span>pr<span class="blank _1"> </span>á<span class="blank _1"> </span>c<span class="blank _1"> </span>t<span class="blank _1"> </span>i<span class="blank _1"> </span>c<span class="blank _1"> </span>a<span class="blank _1"> </span>s<span class="blank _3"> </span> </div><div class="t m0 x1c h16 yed ff8 fsb fc0 sc0 ls0 ws1">sanc<span class="blank _2"></span>iona<span class="blank _2"></span>da<span class="blank _2"></span>s <span class="blank _0"></span>cult<span class="blank _2"></span>ur<span class="blank _2"></span>alme<span class="blank _2"></span>nte.</div><div class="t m0 x1d h16 ye2 ff8 fsb fc0 sc0 ls0 ws1">Com<span class="blank _1"> </span>pli<span class="blank _1"> </span>cac<span class="blank _1"> </span>ion<span class="blank _1"> </span>es:<span class="blank _1"> </span> <span class="blank _10"> </span>ac<span class="blank _1"> </span>cid<span class="blank _1"> </span>ent<span class="blank _1"> </span>es<span class="blank _1"> </span> <span class="blank _10"> </span>por<span class="blank _1"> </span> <span class="blank _10"> </span>env<span class="blank _1"> </span>ene<span class="blank _1"> </span>na-</div><div class="t m0 x1d h16 ye3 ff8 fsb fc0 sc0 ls0 ws1">mien<span class="blank _1"> </span>to,<span class="blank _1"> </span> <span class="blank _10"> </span>infe<span class="blank _1"> </span>st<span class="blank _1"> </span>ació<span class="blank _1"> </span>n <span class="blank _10"> </span>pa<span class="blank _1"> </span>rasi<span class="blank _1"> </span>ta<span class="blank _1"> </span>ria,<span class="blank _1"> </span> <span class="blank _10"> </span>in<span class="blank _1"> </span>fecc<span class="blank _1"> </span>ione<span class="blank _1"> </span>s,<span class="blank _1"> </span> </div><div class="t m0 x1d h16 ye4 ff8 fsb fc0 sc0 ls0 ws1">ob<span class="blank _1"> </span>st<span class="blank _1"> </span>ru<span class="blank _1"> </span>cc<span class="blank _1"> </span>i<span class="blank _1"> </span>ón<span class="blank _1"> </span> <span class="blank _10"> </span>ga<span class="blank _1"> </span>st<span class="blank _1"> </span>ro<span class="blank _1"> </span>i<span class="blank _1"> </span>nt<span class="blank _1"> </span>es<span class="blank _1"> </span>ti<span class="blank _1"> </span>na<span class="blank _1"> </span>l<span class="blank _1"> </span> <span class="blank _10"> </span>y <span class="blank _10"> </span>l<span class="blank _1"> </span>ac<span class="blank _1"> </span>er<span class="blank _1"> </span>ac<span class="blank _1"> </span>i<span class="blank _1"> </span>on<span class="blank _1"> </span>es<span class="blank _1"> </span> </div><div class="t m0 x1d h16 ye5 ff8 fsb fc0 sc0 ls0 ws8">gast<span class="blank _2"></span>roin<span class="blank _2"></span>te<span class="blank _2"></span>stin<span class="blank _2"></span>ales<span class="blank _2"></span>.</div><div class="t m0 x1d h16 yee ff8 fsb fc0 sc0 ls0 ws1">Asoc<span class="blank _2"></span>iada <span class="blank _c"></span>con <span class="blank _c"></span>sonamb<span class="blank _2"></span>ulis<span class="blank _2"></span>mo, <span class="blank _c"></span>pesadi<span class="blank _2"></span>llas <span class="blank _c"></span>y <span class="blank _0"></span>terr<span class="blank _2"></span>ores </div><div class="t m0 x1d h16 ye7 ff8 fsb fc0 sc0 ls0 ws1">noct<span class="blank _2"></span>urno<span class="blank _2"></span>s; <span class="blank _1"> </span>tras<span class="blank _2"></span>torn<span class="blank _2"></span>os <span class="blank _1"> </span>del <span class="blank _1"> </span>desarr<span class="blank _2"></span>ollo<span class="blank _2"></span>, <span class="blank _1"> </span>(autis<span class="blank _2"></span>mo, T<span class="blank _0"></span>. </div><div class="t m0 x1d h16 ye8 ff8 fsb fc0 sc0 ls0 ws1">de <span class="blank _c"></span>aprend<span class="blank _2"></span>izaj<span class="blank _2"></span>e <span class="blank _0"></span>y <span class="blank _c"></span>del <span class="blank _0"></span>desa<span class="blank _2"></span>rr<span class="blank _2"></span>ollo <span class="blank _c"></span>genera<span class="blank _2"></span>li<span class="blank _2"></span>zado <span class="blank _c"></span>como </div><div class="t m0 x1d h16 ye9 ff8 fsb fc0 sc0 ls0 ws1">el <span class="blank _c"></span>síndro<span class="blank _2"></span>me <span class="blank _0"></span>de <span class="blank _c"></span>Klei<span class="blank _2"></span>ne-L<span class="blank _2"></span>evin<span class="blank _2"></span>). </div><div class="t m0 x1d h16 yef ff8 fsb fc0 sc0 ls0 ws1">Se <span class="blank _0"></span>aument<span class="blank _2"></span>a <span class="blank _0"></span>el <span class="blank _2"></span>ri<span class="blank _2"></span>esgo <span class="blank _0"></span>con <span class="blank _0"></span>la <span class="blank _0"></span>pobrez<span class="blank _2"></span>a, <span class="blank _0"></span>la <span class="blank _2"></span>pr<span class="blank _2"></span>ivac<span class="blank _2"></span>ión, </div><div class="t m0 x1d h16 yeb ff8 fsb fc0 sc0 ls0 ws1">el <span class="blank _9"> </span>abando<span class="blank _2"></span>no, <span class="blank"> </span>las <span class="blank _14"> </span>de<span class="blank _2"></span>fici<span class="blank _2"></span>enci<span class="blank _2"></span>as <span class="blank"> </span>nutric<span class="blank _2"></span>iona<span class="blank _2"></span>les, <span class="blank"> </span>la </div><div class="t m0 x1d h16 yec ff8 fsb fc0 sc0 ls0 ws1">anem<span class="blank _2"></span>ia <span class="blank _c"></span>y <span class="blank _0"></span>la <span class="blank _0"></span>fa<span class="blank _2"></span>lta <span class="blank _c"></span>de <span class="blank _0"></span>supe<span class="blank _2"></span>rv<span class="blank _2"></span>isió<span class="blank _2"></span>n. </div><div class="t m0 x1d h16 yf0 ff8 fsb fc0 sc0 ls0 ws1">Descartar <span class="blank _10"> </span>siempre<span class="blank _1"> </span>: <span class="blank _10"> </span>intoxicación<span class="blank _1"> </span> <span class="blank _10"> </span>por <span class="blank _10"> </span>plomo, </div><div class="t m0 x1d h16 yf1 ff8 fsb fc0 sc0 ls0 ws1">anem<span class="blank _2"></span>ia, <span class="blank _c"></span>infest<span class="blank _2"></span>ac<span class="blank _2"></span>ión <span class="blank _c"></span>parasi<span class="blank _2"></span>tari<span class="blank _2"></span>a.</div><div class="t m0 x1e h16 yf2 ff8 fsb fc0 sc0 ls0 ws1">Cifr<span class="blank _2"></span>as <span class="blank _6"> </span>de <span class="blank"> </span>prev<span class="blank _2"></span>al<span class="blank _2"></span>enci<span class="blank _2"></span>a <span class="blank"> </span>no </div><div class="t m0 x1e h16 yf3 ff8 fsb fc0 sc0 ls0 ws1">son <span class="blank _18"> </span>clar<span class="blank _2"></span>as. <span class="blank _18"> </span>Se <span class="blank _18"> </span>estima<span class="blank _2"></span>n </div><div class="t m0 x1e h16 yf4 ff8 fsb fc0 sc0 ls0 ws1">rang<span class="blank _2"></span>os <span class="blank _c"></span>entre <span class="blank _c"></span>9% <span class="blank _0"></span>y <span class="blank _0"></span>25<span class="blank _2"></span>%.</div><div class="t m0 x1e h16 yf5 ff8 fsb fc0 sc0 ls0 ws1">Más <span class="blank _1"> </span>preval<span class="blank _2"></span>en<span class="blank _2"></span>te <span class="blank _1"> </span>en <span class="blank _3"> </span>clases </div><div class="t m0 x1e h16 yf6 ff8 fsb fc0 sc0 ls0 ws1">soci<span class="blank _2"></span>oeco<span class="blank _2"></span>nó<span class="blank _2"></span>mica<span class="blank _2"></span>s <span class="blank _0"></span>ba<span class="blank _2"></span>jas. </div><div class="t m0 x1e h16 yf7 ff8 fsb fc0 sc0 ls0 ws1">Edad <span class="blank _a"> </span>media <span class="blank _6"> </span>de <span class="blank _6"> </span>diag<span class="blank _2"></span>nó<span class="blank _2"></span>s-</div><div class="t m0 x1e h16 yf8 ff8 fsb fc0 sc0 ls0 ws1">tico <span class="blank _c"></span>de <span class="blank _0"></span>18 <span class="blank _c"></span>mese<span class="blank _2"></span>s. </div><div class="t m0 x1e h16 yf9 ff8 fsb fc0 sc0 ls0 ws1">M<span class="blank _1"> </span>or<span class="blank _1"> </span>t<span class="blank _1"> </span>a<span class="blank _1"> </span>l<span class="blank _1"> </span>i<span class="blank _1"> </span>d<span class="blank _1"> </span>a<span class="blank _1"> </span>d<span class="blank _1"> </span> <span class="blank _10"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>l<span class="blank _1"> </span>a<span class="blank _1"> </span>ci<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span>a<span class="blank _1"> </span>d<span class="blank _1"> </span>a<span class="blank _1"> </span> </div><div class="t m0 x1e h16 yfa ff8 fsb fc0 sc0 ls0 ws1">con inge<span class="blank _2"></span>sta de susta<span class="blank _2"></span>nc<span class="blank _2"></span>ias <span class="blank _d"> </span> </div><div class="t m0 x1e h16 yfb ff8 fsb fc0 sc0 ls0 ws8">tóxi<span class="blank _2"></span>cas.</div><div class="t m0 x1c h16 yfc ff8 fsb fc0 sc0 ls0 ws1">Reg<span class="blank _1"> </span>ur<span class="blank _1"> </span>git<span class="blank _1"> </span>ac<span class="blank _1"> </span>ió<span class="blank _1"> </span>n <span class="blank _10"> </span>de<span class="blank _1"> </span> <span class="blank _10"> </span>al<span class="blank _1"> </span>im<span class="blank _1"> </span>ent<span class="blank _1"> </span>os<span class="blank _1"> </span> </div><div class="t m0 x1c h16 yfd ff8 fsb fc0 sc0 ls0 ws1">inge<span class="blank _2"></span>rido<span class="blank _2"></span>s, <span class="blank _b"> </span>que <span class="blank _b"> </span>se <span class="blank _8"> </span>vuel<span class="blank _2"></span>ven <span class="blank _b"> </span>a </div><div class="t m0 x1c h16 yfe ff8 fsb fc0 sc0 ls0 ws1">mast<span class="blank _2"></span>icar<span class="blank _0"></span>, se <span class="blank _1"> </span>trag<span class="blank _2"></span>an de nuevo o </div><div class="t m0 x1c h16 yff ff8 fsb fc0 sc0 ls0 ws1">son <span class="blank _0"></span>escu<span class="blank _2"></span>pido<span class="blank _2"></span>s. <span class="blank _0"></span>Este <span class="blank _0"></span>proc<span class="blank _2"></span>eso <span class="blank _0"></span>se </div><div class="t m0 x1c h16 y100 ff8 fsb fc0 sc0 ls0 ws1">repi<span class="blank _2"></span>te <span class="blank _c"></span>varias <span class="blank _c"></span>vece<span class="blank _2"></span>s. </div><div class="t m0 x1c h16 y101 ff8 fsb fc0 sc0 ls0 ws1">La <span class="blank _3"> </span>regu<span class="blank _2"></span>rgit<span class="blank _2"></span>ació<span class="blank _2"></span>n <span class="blank _3"> </span>se <span class="blank _3"> </span>efectú<span class="blank _2"></span>a <span class="blank _3"> </span>en </div><div class="t m0 x1c h16 y102 ff8 fsb fc0 sc0 ls0 ws1">a<span class="blank _3"> </span>u<span class="blank _d"> </span>s<span class="blank _3"> </span>e<span class="blank _3"> </span>n<span class="blank _d"> </span>c<span class="blank _3"> </span>i<span class="blank _3"> </span>a<span class="blank _d"> </span> <span class="blank _10"> </span>d<span class="blank _3"> </span>e<span class="blank _d"> </span> <span class="blank _10"> </span>n<span class="blank _3"> </span>á<span class="blank _d"> </span>u<span class="blank _3"> </span>s<span class="blank _3"> </span>e<span class="blank _d"> </span>a<span class="blank _3"> </span>s<span class="blank _d"> </span> <span class="blank _10"> </span>o<span class="blank _3"> </span> </div><div class="t m0 x1c h16 y103 ff8 fsb fc0 sc0 ls0 ws1">en<span class="blank _1"> </span>f<span class="blank _1"> </span>e<span class="blank _1"> </span>rm<span class="blank _1"> </span>e<span class="blank _1"> </span>d<span class="blank _1"> </span>ad<span class="blank _1"> </span> <span class="blank _10"> </span>g<span class="blank _1"> </span>a<span class="blank _1"> </span>st<span class="blank _1"> </span>r<span class="blank _1"> </span>o<span class="blank _1"> </span>in<span class="blank _1"> </span>t<span class="blank _1"> </span>e<span class="blank _1"> </span>st<span class="blank _1"> </span>i<span class="blank _1"> </span>na<span class="blank _1"> </span>l<span class="blank _1"> </span> </div><div class="t m0 x1c h16 y104 ff8 fsb fc0 sc0 ls0 ws1">asoc<span class="blank _2"></span>iada<span class="blank _2"></span>. </div><div class="t m0 x1c h16 y105 ff8 fsb fc0 sc0 ls0 ws1">Esta <span class="blank _3"> </span>cond<span class="blank _2"></span>ucta <span class="blank _3"> </span>tiene <span class="blank _3"> </span>una <span class="blank _d"> </span>dura<span class="blank _2"></span>-</div><div class="t m0 x1c h16 y106 ff8 fsb fc0 sc0 ls0 ws1">ción <span class="blank _6"> </span>míni<span class="blank _2"></span>ma <span class="blank _6"> </span>de <span class="blank"> </span>un <span class="blank _6"> </span>mes, <span class="blank _6"> </span>con </div><div class="t m0 x1c h16 y107 ff8 fsb fc0 sc0 ls0 ws1">ante<span class="blank _2"></span>cede<span class="blank _2"></span>nt<span class="blank _2"></span>e <span class="blank _2"></span>de <span class="blank _2"></span>fu<span class="blank _2"></span>ncio<span class="blank _2"></span>nami<span class="blank _2"></span>ento </div><div class="t m0 x1c h16 y108 ff8 fsb fc0 sc0 ls0 ws1">norm<span class="blank _2"></span>al. </div><div class="t m0 x1c h16 y109 ff8 fsb fc0 sc0 ls0 ws1">Pérd<span class="blank _2"></span>ida de peso o incapa<span class="blank _2"></span>cida<span class="blank _2"></span>d </div><div class="t m0 x1c h16 y10a ff8 fsb fc0 sc0 ls0 ws1">para <span class="blank _a"> </span>alcanz<span class="blank _2"></span>ar <span class="blank _6"> </span>el <span class="blank _6"> </span>peso <span class="blank _a"> </span>normal </div><div class="t m0 x1c h16 y10b ff8 fsb fc0 sc0 ls0 ws1">segú<span class="blank _2"></span>n <span class="blank _0"></span>ed<span class="blank _2"></span>ad <span class="blank _c"></span>y <span class="blank _0"></span>géne<span class="blank _2"></span>ro.</div><div class="t m0 x6 h16 yfc ff8 fsb fc0 sc0 ls0 ws1">En <span class="blank _6"> </span>los <span class="blank"> </span>lactantes, <span class="blank _6"> </span>a <span class="blank _6"> </span>menudo <span class="blank _6"> </span>constituye <span class="blank _14"> </span> <span class="blank"> </span>una </div><div class="t m0 x6 h16 yfd ff8 fsb fc0 sc0 ls0 ws1">forma <span class="blank _0"></span>de <span class="blank _c"></span>auto-estimulación. </div><div class="t m0 x6 h16 y10c ff8 fsb fc0 sc0 ls0 ws1">Se <span class="blank _d"> </span>ha <span class="blank _3"> </span>descrito <span class="blank _d"> </span>una <span class="blank _d"> </span>postura <span class="blank _d"> </span>típica: <span class="blank _d"> </span>un <span class="blank _3"> </span>arco <span class="blank _d"> </span>de </div><div class="t m0 x6 h16 y10d ff8 fsb fc0 sc0 ls0 ws1">espalda, inclinación <span class="blank _1"> </span>hacia <span class="blank _1"> </span>atrás <span class="blank _1"> </span>de la <span class="blank _1"> </span>cabeza <span class="blank _1"> </span>y </div><div class="t m0 x6 h16 y10e ff8 fsb fc0 sc0 ls0 ws1">contracción <span class="blank _10"> </span>de <span class="blank _10"> </span>los <span class="blank _10"> </span>múscu<span class="blank _1"> </span>los <span class="blank _10"> </span>abdominales </div><div class="t m0 x6 h16 y101 ff8 fsb fc0 sc0 ls0 ws1">(representa <span class="blank _1a"> </span>los <span class="blank _1a"> </span>intentos <span class="blank _1a"> </span>para <span class="blank _1a"> </span>regurgitar <span class="blank _1a"> </span>la </div><div class="t m0 x6 h16 y102 ff8 fsb fc0 sc0 ls0 ws1">comida <span class="blank _0"></span>digerida).</div><div class="t m0 x6 h16 y10f ff8 fsb fc0 sc0 ls0 ws1">Se <span class="blank _1"> </span>deben descartar <span class="blank _1"> </span>otras <span class="blank _1"> </span>causas <span class="blank _1"> </span>de <span class="blank _1"> </span>regurgita-</div><div class="t m0 x6 h16 y110 ff8 fsb fc0 sc0 ls0 ws1">ción <span class="blank"> </span>como <span class="blank"> </span>reflujo <span class="blank"> </span>gastroesofágico, <span class="blank _9"> </span>estenosis </div><div class="t m0 x6 h16 y111 ff8 fsb fc0 sc0 ls0 ws1">pilórica <span class="blank _0"></span>o <span class="blank _c"></span>infecciones <span class="blank _0"></span>gastrointestinales. </div><div class="t m0 x6 h16 y112 ff8 fsb fc0 sc0 ls0 ws1">Asociado <span class="blank _14"> </span>a <span class="blank _14"> </span>privación <span class="blank _14"> </span>sensorial <span class="blank _14"> </span>y <span class="blank _14"> </span>emocional </div><div class="t m0 x6 h16 y113 ff8 fsb fc0 sc0 ls0 ws1">(explica <span class="blank _6"> </span>mayor <span class="blank _a"> </span>incidencia <span class="blank _6"> </span>en <span class="blank _6"> </span>niños <span class="blank _a"> </span>institucio-</div><div class="t m0 x6 h16 y114 ff8 fsb fc0 sc0 ls0 ws1">nalizados). </div><div class="t m0 x1f h16 yfc ff8 fsb fc0 sc0 ls0 ws1">M<span class="blank _1"> </span>a<span class="blank _3"> </span>y<span class="blank _3"> </span>o<span class="blank _1"> </span>r<span class="blank _3"> </span> <span class="blank _10"> </span>f<span class="blank _3"> </span>r<span class="blank _1"> </span>e<span class="blank _3"> </span>c<span class="blank _3"> </span>u<span class="blank _1"> </span>e<span class="blank _3"> </span>n<span class="blank _1"> </span>c<span class="blank _3"> </span>i<span class="blank _3"> </span>a<span class="blank _3"> </span> <span class="blank _10"> </span>e<span class="blank _1"> </span>n<span class="blank _3"> </span> </div><div class="t m0 x1f h16 yfd ff8 fsb fc0 sc0 ls0 ws8">homb<span class="blank _2"></span>res.</div><div class="t m0 x1f h16 y10c ff8 fsb fc0 sc0 ls0 ws1">En <span class="blank _1"> </span>estudi<span class="blank _2"></span>os <span class="blank _1"> </span>de <span class="blank _3"> </span>paci<span class="blank _2"></span>ente<span class="blank _2"></span>s </div><div class="t m0 x1f h16 y10d ff8 fsb fc0 sc0 ls0 ws1">inst<span class="blank _2"></span>ituc<span class="blank _2"></span>io<span class="blank _2"></span>nali<span class="blank _2"></span>zado<span class="blank _2"></span>s, <span class="blank _d"> </span>se <span class="blank _a"> </span>ha </div><div class="t m0 x1f h16 y10e ff8 fsb fc0 sc0 ls0 ws1">enco<span class="blank _2"></span>ntra<span class="blank _2"></span>do una p<span class="blank _2"></span>reva<span class="blank _2"></span>le<span class="blank _2"></span>n-</div><div class="t m0 x1f h16 y101 ff8 fsb fc0 sc0 ls0 ws1">cia <span class="blank _2"></span>co<span class="blank _2"></span>n <span class="blank _2"></span>ra<span class="blank _2"></span>ngos <span class="blank _0"></span>entre <span class="blank _2"></span>6% <span class="blank _0"></span>y </div><div class="t m0 x1f h16 y102 ff8 fsb fc0 sc0 ls0 ws1">10%. </div><div class="t m0 x1f h16 y10f ff8 fsb fc0 sc0 ls0 ws1">Diag<span class="blank _2"></span>nóst<span class="blank _2"></span>ic<span class="blank _2"></span>o <span class="blank _1"> </span>más frecue<span class="blank _2"></span>n-</div><div class="t m0 x1f h16 y110 ff8 fsb fc0 sc0 ls0 ws1">te entre los 3 y <span class="blank _1"> </span>14 meses </div><div class="t m0 x1f h16 y111 ff8 fsb fc0 sc0 ls0 ws1">de <span class="blank _c"></span>edad.</div><div class="t m0 x1f h16 y112 ff8 fsb fc0 sc0 ls0 ws1">Mort<span class="blank _2"></span>alid<span class="blank _2"></span>ad <span class="blank _2"></span>en <span class="blank _0"></span>1 de <span class="blank _0"></span>cada <span class="blank _2"></span>4 </div><div class="t m0 x1f h16 y113 ff8 fsb fc0 sc0 ls0 ws1">niño<span class="blank _2"></span>s <span class="blank _0"></span>af<span class="blank _2"></span>ecta<span class="blank _2"></span>dos.</div><div class="t m0 x20 h16 y115 ff8 fsb fc0 sc0 ls0 ws1">F<span class="blank _3"> </span>a<span class="blank _3"> </span>l<span class="blank _3"> </span>l<span class="blank _3"> </span>a<span class="blank _d"> </span> <span class="blank _10"> </span>p<span class="blank _1"> </span>e<span class="blank _3"> </span>r<span class="blank _d"> </span>s<span class="blank _1"> </span>i<span class="blank _d"> </span>s<span class="blank _1"> </span>t<span class="blank _3"> </span>e<span class="blank _d"> </span>n<span class="blank _1"> </span>t<span class="blank _d"> </span>e<span class="blank _3"> </span> <span class="blank _10"> </span>e<span class="blank _3"> </span>n<span class="blank _3"> </span> <span class="blank _10"> </span>l<span class="blank _3"> </span>a<span class="blank _3"> </span> </div><div class="t m0 x20 h16 y116 ff8 fsb fc0 sc0 ls0 ws1">alimen<span class="blank _1"> </span>taci<span class="blank _1"> </span>ón <span class="blank _10"> </span>con<span class="blank _1"> </span> <span class="blank _10"> </span>dificu<span class="blank _1"> </span>ltad<span class="blank _1"> </span> </div><div class="t m0 x20 h16 y117 ff8 fsb fc0 sc0 ls0 ws1">para ga<span class="blank _2"></span>nar peso o pérd<span class="blank _2"></span>ida de </div><div class="t m0 x20 h16 y118 ff8 fsb fc0 sc0 ls0 ws1">peso <span class="blank _c"></span>en <span class="blank _0"></span>el <span class="blank _c"></span>últi<span class="blank _2"></span>mo <span class="blank _0"></span>me<span class="blank _2"></span>s. </div><div class="t m0 x20 h16 y119 ff8 fsb fc0 sc0 ls0 ws1">Pert<span class="blank _2"></span>urba<span class="blank _2"></span>ci<span class="blank _2"></span>ón <span class="blank _14"> </span>no <span class="blank _14"> </span>asocia<span class="blank _2"></span>da <span class="blank _14"> </span>a </div><div class="t m0 x20 h16 y11a ff8 fsb fc0 sc0 ls0 ws1">e<span class="blank _d"> </span>n<span class="blank _d"> </span>f<span class="blank _d"> </span>e<span class="blank _3"> </span>r<span class="blank _d"> </span>m<span class="blank _d"> </span>e<span class="blank _d"> </span>d<span class="blank _d"> </span>a<span class="blank _d"> </span>d<span class="blank _d"> </span> <span class="blank _10"> </span>d<span class="blank _d"> </span>e<span class="blank _d"> </span>l<span class="blank _d"> </span> <span class="blank _10"> </span>t<span class="blank _3"> </span>r<span class="blank _d"> </span>a<span class="blank _d"> </span>c<span class="blank _d"> </span>t<span class="blank _d"> </span>o<span class="blank _d"> </span> </div><div class="t m0 x20 h16 y11b ff8 fsb fc0 sc0 ls0 ws1">gastro<span class="blank _2"></span>intest<span class="blank _2"></span>inal <span class="blank _10"> </span>o <span class="blank _10"> </span>co<span class="blank _2"></span>ndició<span class="blank _2"></span>n </div><div class="t m0 x20 h16 y11c ff8 fsb fc0 sc0 ls0 ws1">médi<span class="blank _2"></span>ca <span class="blank _c"></span>asocia<span class="blank _2"></span>da.</div><div class="t m0 x20 h16 y11d ff8 fsb fc0 sc0 ls0 ws1">No <span class="blank _0"></span>es <span class="blank _0"></span>mejor <span class="blank _0"></span>expl<span class="blank _2"></span>icad<span class="blank _2"></span>a <span class="blank _0"></span>por <span class="blank _0"></span>otro </div><div class="t m0 x20 h16 y11e ff8 fsb fc0 sc0 ls0 ws1">tras<span class="blank _2"></span>torn<span class="blank _2"></span>o <span class="blank _0"></span>o <span class="blank _2"></span>por <span class="blank _0"></span>falta <span class="blank _0"></span>de <span class="blank _0"></span>comida </div><div class="t m0 x20 h16 y11f ff8 fsb fc0 sc0 ls0 ws1">disp<span class="blank _2"></span>onib<span class="blank _2"></span>le<span class="blank _2"></span>. </div><div class="t m0 x20 h16 y120 ff8 fsb fc0 sc0 ls0 ws1">Inic<span class="blank _2"></span>io <span class="blank _6"> </span>del <span class="blank _6"> </span>tras<span class="blank _2"></span>torn<span class="blank _2"></span>o <span class="blank _6"> </span>antes <span class="blank _6"> </span>de </div><div class="t m0 x20 h16 y121 ff8 fsb fc0 sc0 ls0 ws1">los <span class="blank _c"></span>6 <span class="blank _0"></span>años <span class="blank _c"></span>de <span class="blank _0"></span>ed<span class="blank _2"></span>ad.</div><div class="t m0 x21 h16 y115 ff8 fsb fc0 sc0 ls0 ws1">NEOF<span class="blank _2"></span>OBIA<span class="blank _0"></span> <span class="blank _2"></span>AL<span class="blank _2"></span>IMEN<span class="blank _2"></span>T<span class="blank _0"></span>ARIA<span class="blank _0"></span> </div><div class="t m0 x22 h16 y122 ff8 fsb fc0 sc0 ls0 ws1"> Ing<span class="blank _2"></span>esta <span class="blank _2"></span>de un<span class="blank _2"></span>a gam<span class="blank _2"></span>a l<span class="blank _2"></span>imit<span class="blank _2"></span>ada d<span class="blank _2"></span>e ali<span class="blank _2"></span>ment<span class="blank _2"></span>os co<span class="blank _2"></span>n </div><div class="t m0 x22 h16 y123 ff8 fsb fc0 sc0 ls0 ws1">extr<span class="blank _2"></span>ema <span class="blank _c"></span>resist<span class="blank _2"></span>en<span class="blank _2"></span>cia <span class="blank _c"></span>a <span class="blank _0"></span>prob<span class="blank _2"></span>ar <span class="blank _c"></span>nuevos<span class="blank _2"></span>. </div><div class="t m0 x22 h16 y124 ff8 fsb fc0 sc0 ls0 ws1">P<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>f<span class="blank _3"> </span>i<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _3"> </span>n<span class="blank _1"> </span> <span class="blank _10"> </span>c<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _3"> </span>s<span class="blank _1"> </span>u<span class="blank _1"> </span>m<span class="blank _1"> </span>i<span class="blank _3"> </span>r<span class="blank _1"> </span> <span class="blank _10"> </span>a<span class="blank _1"> </span>l<span class="blank _3"> </span>i<span class="blank _1"> </span>m<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span>t<span class="blank _3"> </span>o<span class="blank _1"> </span>s<span class="blank _3"> </span> <span class="blank _12"> </span> <span class="blank _10"> </span>s<span class="blank _1"> </span>u<span class="blank _1"> </span>a<span class="blank _1"> </span>v<span class="blank _3"> </span>e<span class="blank _1"> </span>s<span class="blank _1"> </span>,<span class="blank _3"> </span> </div><div class="t m0 x22 h16 y125 ff8 fsb fc0 sc0 ls0 ws1">prep<span class="blank _2"></span>arac<span class="blank _2"></span>io<span class="blank _2"></span>nes <span class="blank _c"></span>a <span class="blank _0"></span>base <span class="blank _c"></span>de <span class="blank _0"></span>hidr<span class="blank _2"></span>at<span class="blank _2"></span>os <span class="blank _0"></span>de <span class="blank _c"></span>carb<span class="blank _2"></span>ono.</div><div class="t m0 x23 h16 y126 ff8 fsb fc0 sc0 ls0 ws1">TRAS<span class="blank _2"></span>T<span class="blank _2"></span>ORNO P<span class="blank _2"></span>OR EVI<span class="blank _2"></span>T<span class="blank _0"></span>ACIÓ<span class="blank _2"></span>N EMOC<span class="blank _2"></span>IONA<span class="blank _2"></span>L<span class="blank _2"></span> </div><div class="t m0 x24 h16 y127 ff8 fsb fc0 sc0 ls0 ws1">DE LOS <span class="blank _0"></span>ALIM<span class="blank _2"></span>ENT<span class="blank _2"></span>OS</div><div class="t m0 x22 h16 y128 ff8 fsb fc0 sc0 ls0 ws1">Pérd<span class="blank _2"></span>ida <span class="blank _c"></span>notabl<span class="blank _2"></span>e <span class="blank _c"></span>del <span class="blank _0"></span>ap<span class="blank _2"></span>etit<span class="blank _2"></span>o. </div><div class="t m0 x22 h16 y129 ff8 fsb fc0 sc0 ls0 ws1"> <span class="blank _d"> </span>Los <span class="blank _d"> </span>niños <span class="blank _d"> </span>sabe<span class="blank _2"></span>n <span class="blank _d"> </span>que <span class="blank _d"> </span>está<span class="blank _2"></span>n <span class="blank _d"> </span>bajos <span class="blank _d"> </span>de <span class="blank _d"> </span>peso<span class="blank _2"></span>, <span class="blank _d"> </span>y </div><div class="t m0 x22 h16 y12a ff8 fsb fc0 sc0 ls0 ws1">quis<span class="blank _2"></span>iera<span class="blank _2"></span>n <span class="blank _c"></span>ser <span class="blank _0"></span>más <span class="blank _c"></span>pesado<span class="blank _2"></span>s.</div><div class="t m0 x22 h16 y12b ff8 fsb fc0 sc0 ls0 ws1"> <span class="blank"> </span>La<span class="blank _2"></span>s <span class="blank"> </span>ra<span class="blank _2"></span>zo<span class="blank _2"></span>nes <span class="blank _6"> </span>para <span class="blank _6"> </span>no <span class="blank"> </span>co<span class="blank _2"></span>mer: <span class="blank _6"> </span>mied<span class="blank _2"></span>o <span class="blank"> </span>a <span class="blank _6"> </span>estar </div><div class="t m0 x22 h16 y12c ff8 fsb fc0 sc0 ls0 ws1">enfe<span class="blank _2"></span>rmo, <span class="blank _1"> </span>no <span class="blank _3"> </span>tiene <span class="blank _1"> </span>hambre<span class="blank _2"></span>, <span class="blank _3"> </span>no <span class="blank _3"> </span>puede <span class="blank _1"> </span>comer<span class="blank _0"></span>, <span class="blank _3"> </span>le </div><div class="t m0 x22 h16 y12d ff8 fsb fc0 sc0 ls0 ws1">duel<span class="blank _2"></span>e <span class="blank _0"></span>el <span class="blank _c"></span>estó<span class="blank _2"></span>mago<span class="blank _2"></span>. </div><div class="t m0 x1e h16 y115 ff8 fsb fc0 sc0 ls0 ws1">E<span class="blank _d"> </span>l<span class="blank _d"> </span> <span class="blank _10"> </span>t<span class="blank _d"> </span>r<span class="blank _3"> </span>a<span class="blank _d"> </span>s<span class="blank _d"> </span>t<span class="blank _d"> </span>o<span class="blank _d"> </span>r<span class="blank _d"> </span>n<span class="blank _3"> </span>o<span class="blank _a"> </span> <span class="blank _10"> </span>p<span class="blank _3"> </span>u<span class="blank _d"> </span>e<span class="blank _d"> </span>d<span class="blank _d"> </span>e<span class="blank _d"> </span> </div><div class="t m0 x1e h16 y116 ff8 fsb fc0 sc0 ls0 ws1">pers<span class="blank _2"></span>isti<span class="blank _2"></span>r <span class="blank _9"> </span>más <span class="blank _14"> </span>allá <span class="blank"> </span>de <span class="blank _14"> </span>la </div><div class="t m0 x1e h16 y117 ff8 fsb fc0 sc0 ls0 ws1">infa<span class="blank _2"></span>ncia<span class="blank _2"></span>. </div><div class="t m0 x1e h16 y12e ff8 fsb fc0 sc0 ls0 ws1">El <span class="blank _1"> </span>trasto<span class="blank _2"></span>rno <span class="blank _1"> </span>por <span class="blank _3"> </span>evit<span class="blank _2"></span>ació<span class="blank _2"></span>n </div><div class="t m0 x1e h16 y119 ff8 fsb fc0 sc0 ls0 ws1">emoc<span class="blank _2"></span>iona<span class="blank _2"></span>l <span class="blank _6"> </span>de <span class="blank"> </span>la <span class="blank _6"> </span>comi<span class="blank _2"></span>da </div><div class="t m0 x1e h16 y11a ff8 fsb fc0 sc0 ls0 ws1">p<span class="blank _3"> </span>u<span class="blank _d"> </span>e<span class="blank _3"> </span>d<span class="blank _3"> </span>e<span class="blank _d"> </span> <span class="blank _10"> </span>c<span class="blank _3"> </span>o<span class="blank _3"> </span>n<span class="blank _d"> </span>s<span class="blank _3"> </span>t<span class="blank _d"> </span>i<span class="blank _3"> </span>t<span class="blank _3"> </span>u<span class="blank _d"> </span>i<span class="blank _3"> </span>r<span class="blank _d"> </span> <span class="blank _10"> </span>u<span class="blank _3"> </span>n<span class="blank _3"> </span> </div><div class="t m0 x1e h16 y11b ff8 fsb fc0 sc0 ls0 ws1">prec<span class="blank _2"></span>urso<span class="blank _2"></span>r <span class="blank _c"></span>de <span class="blank _0"></span>otro<span class="blank _2"></span>s <span class="blank _c"></span>TCA.</div><div class="t m0 x25 h15 y12f ff7 fs9 fc0 sc0 ls0 ws1">TRASTORNOS </div><div class="t m0 x26 h15 y130 ff7 fs9 fc0 sc0 ls0 ws1">DE LA<span class="blank _2"></span> </div><div class="t m0 x1 h15 y131 ff7 fs9 fc0 sc0 ls0">INGESTIÓN</div><div class="t m0 x27 h15 y132 ff7 fs9 fc0 sc0 ls0 ws1">Y DE LA<span class="blank _2"></span> </div><div class="t m0 x1 h15 y133 ff7 fs9 fc0 sc0 ls0 ws1">CONDUCT<span class="blank _0"></span>A </div><div class="t m0 x25 h15 y134 ff7 fs9 fc0 sc0 ls0 ws1">ALIMENT<span class="blank _0"></span>ARIA </div><div class="t m0 x0 h15 y135 ff7 fs9 fc0 sc0 ls0 ws1">DE INICIO EN </div><div class="t m0 x0 h15 y136 ff7 fs9 fc0 sc0 ls0 ws1">LA<span class="blank _2"></span> INF<span class="blank _2"></span>ANCIA</div><div class="t m0 x16 h7 y84 ff3 fs4 fc0 sc0 ls0">132</div><div class="t m0 x10 he y85 ff3 fs8 fc2 sc0 ls0 ws1">V<span class="blank _2"></span>ol. 12 Número 3, Diciembre de 2009</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x28 y137 w4 h17" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg5.png"><div class="t m0 x29 h4 ydc ff2 fs2 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>abla <span class="blank _0"></span>2. <span class="blank _c"></span><span class="ff3">Presentación <span class="blank _c"></span>clínica, <span class="blank _0"></span>clasificación <span class="blank _c"></span>y <span class="blank _0"></span>epidemiología <span class="blank _c"></span>de <span class="blank _0"></span>la <span class="blank _c"></span>anorexia <span class="blank _c"></span>nerviosa <span class="blank _0"></span>y <span class="blank _c"></span>la <span class="blank _0"></span>bulimia <span class="blank _c"></span>nerviosa</span></div><div class="t m0 x2a h14 ydf ff7 fsa fc3 sc0 ls0 ws1"> </div><div class="t m0 xb h16 ye2 ff8 fsb fc0 sc0 ls0 ws1">Sínd<span class="blank _2"></span>rome <span class="blank _a"> </span>cl<span class="blank _2"></span>ínic<span class="blank _2"></span>o <span class="blank _a"> </span>en <span class="blank _6"> </span>que <span class="blank _a"> </span>se <span class="blank _a"> </span>mant<span class="blank _2"></span>iene <span class="blank _a"> </span>un </div><div class="t m0 xb h16 ye3 ff8 fsb fc0 sc0 ls0 ws1">peso <span class="blank _14"> </span>al <span class="blank _8"> </span>meno<span class="blank _2"></span>s <span class="blank _b"> </span>15% <span class="blank _b"> </span>por <span class="blank _b"> </span>debajo <span class="blank _b"> </span>de <span class="blank _b"> </span>lo </div><div class="t m0 xb h16 ye4 ff8 fsb fc0 sc0 ls0 ws1">espe<span class="blank _2"></span>rado <span class="blank _c"></span>para <span class="blank _c"></span>la <span class="blank _0"></span>ed<span class="blank _2"></span>ad, <span class="blank _c"></span>talla <span class="blank _c"></span>y <span class="blank _0"></span>géne<span class="blank _2"></span>ro.</div><div class="t m0 xb h16 y138 ff8 fsb fc0 sc0 ls0 ws1">Dese<span class="blank _2"></span>o <span class="blank _0"></span>ob<span class="blank _2"></span>sesi<span class="blank _2"></span>vo <span class="blank _c"></span>de <span class="blank _0"></span>esta<span class="blank _2"></span>r <span class="blank _c"></span>delgad<span class="blank _2"></span>o.</div><div class="t m0 xb h16 y139 ff8 fsb fc0 sc0 ls0 ws1"> </div><div class="t m0 xb h16 y13a ff8 fsb fc0 sc0 ls0 ws1">Frac<span class="blank _2"></span>aso <span class="blank _1a"> </span>en <span class="blank _10"> </span>las <span class="blank _10"> </span>me<span class="blank _2"></span>ta<span class="blank _2"></span>s <span class="blank _10"> </span>de <span class="blank _25"> </span>crec<span class="blank _2"></span>imie<span class="blank _2"></span>nt<span class="blank _2"></span>o </div><div class="t m0 x2b h16 y13b ff8 fsb fc0 sc0 ls0 ws1">espe<span class="blank _2"></span>rada<span class="blank _2"></span>s para el <span class="blank _1"> </span>género y <span class="blank _1"> </span>edad y <span class="blank _1"> </span>retr<span class="blank _2"></span>aso </div><div class="t m0 x2b h16 y13c ff8 fsb fc0 sc0 ls0 ws1">de <span class="blank _c"></span>la <span class="blank _0"></span>pube<span class="blank _2"></span>rtad<span class="blank _2"></span>.</div><div class="t m0 x2b h16 y13d ff8 fsb fc0 sc0 ls0 ws1"> </div><div class="t m0 x2b h16 y13e ff8 fsb fc0 sc0 ls0 ws1">Amen<span class="blank _2"></span>orre<span class="blank _2"></span>a <span class="blank _c"></span>(al <span class="blank _0"></span>meno<span class="blank _2"></span>s <span class="blank _c"></span>3 <span class="blank _0"></span>ciclos <span class="blank _c"></span>mens<span class="blank _2"></span>trua<span class="blank _2"></span>le<span class="blank _2"></span>s).</div><div class="t m0 x2b h16 y13f ff8 fsb fc0 sc0 ls0 ws1">Comp<span class="blank _2"></span>orta<span class="blank _2"></span>mi<span class="blank _2"></span>ento<span class="blank _2"></span>s <span class="blank _3"> </span>ritu<span class="blank _2"></span>ales <span class="blank _1"> </span>alrede<span class="blank _2"></span>do<span class="blank _2"></span>r <span class="blank _3"> </span>de <span class="blank _3"> </span>las </div><div class="t m0 x2b h16 y140 ff8 fsb fc0 sc0 ls0 ws1">comi<span class="blank _2"></span>das <span class="blank"> </span>(corta<span class="blank _2"></span>r <span class="blank"> </span>la <span class="blank _14"> </span>comi<span class="blank _2"></span>da <span class="blank"> </span>en <span class="blank _14"> </span>pequ<span class="blank _2"></span>eñ<span class="blank _2"></span>os </div><div class="t m0 x2b h16 y141 ff8 fsb fc0 sc0 ls0 ws1">peda<span class="blank _2"></span>zos, <span class="blank _c"></span>reor<span class="blank _2"></span>dena<span class="blank _2"></span>rlas <span class="blank _c"></span>en <span class="blank _c"></span>el <span class="blank _0"></span>plat<span class="blank _2"></span>o, <span class="blank _c"></span>etc). </div><div class="t m0 x2c h18 y142 ff7 fsb fc0 sc0 ls0 ws1">1. <span class="blank _c"></span>Tipo <span class="blank _c"></span>restri<span class="blank _2"></span>ctiv<span class="blank _2"></span>o</div><div class="t m0 x2c h16 y143 ff8 fsb fc0 sc0 ls0 ws1">Dism<span class="blank _2"></span>inuc<span class="blank _2"></span>ió<span class="blank _2"></span>n <span class="blank _18"> </span>drásti<span class="blank _2"></span>ca <span class="blank _8"> </span>de <span class="blank _18"> </span>la </div><div class="t m0 x2c h16 y144 ff8 fsb fc0 sc0 ls0 ws1">inge<span class="blank _2"></span>sta <span class="blank _c"></span>o <span class="blank _0"></span>ejer<span class="blank _2"></span>cici<span class="blank _2"></span>o <span class="blank _c"></span>exhaus<span class="blank _2"></span>tivo</div><div class="t m0 x2c h18 y145 ff7 fsb fc0 sc0 ls0 ws1">2<span class="blank _a"> </span>.<span class="blank _a"> </span> <span class="blank _10"> </span>T<span class="blank _a"> </span>i<span class="blank _a"> </span>p<span class="blank _a"> </span>o<span class="blank _a"> </span> <span class="blank _10"> </span>c<span class="blank _a"> </span>o<span class="blank _a"> </span>m<span class="blank _a"> </span>p<span class="blank _a"> </span>u<span class="blank _a"> </span>l<span class="blank _a"> </span>s<span class="blank _a"> </span>i<span class="blank _a"> </span>v<span class="blank _a"> </span>o<span class="blank _6"> </span> </div><div class="t m0 x2c h18 y146 ff7 fsb fc0 sc0 ls0 ws8">purg<span class="blank _2"></span>ativ<span class="blank _2"></span>o<span class="ff8 ws1"> </span></div><div class="t m0 x2c h16 y147 ff8 fsb fc0 sc0 ls0 ws1">Acciones <span class="blank _10"> </span>purgativas <span class="blank _10"> </span>como<span class="blank _1"> </span> </div><div class="t m0 x2c h16 y148 ff8 fsb fc0 sc0 ls0 ws1">indu<span class="blank _2"></span>cció<span class="blank _2"></span>n <span class="blank _2"></span>del <span class="blank _2"></span>vó<span class="blank _2"></span>mito <span class="blank _2"></span>o <span class="blank _2"></span>us<span class="blank _2"></span>o de </div><div class="t m0 x2c h16 y149 ff8 fsb fc0 sc0 ls0 ws8">laxa<span class="blank _2"></span>ntes<span class="blank _2"></span>.</div><div class="t m0 x2d h16 yf2 ff8 fsb fc0 sc0 ls0 ws1">Inci<span class="blank _2"></span>denc<span class="blank _2"></span>ia <span class="blank _b"> </span>de <span class="blank _18"> </span>8.1 <span class="blank _b"> </span>/ <span class="blank _18"> </span>100,<span class="blank _2"></span>000 </div><div class="t m0 x2d h16 yf3 ff8 fsb fc0 sc0 ls0 ws1">habi<span class="blank _2"></span>tant<span class="blank _2"></span>es <span class="blank _c"></span>año.</div><div class="t m0 x2d h16 y14a ff8 fsb fc0 sc0 ls0 ws1">Edad <span class="blank _0"></span>me<span class="blank _2"></span>dia <span class="blank _0"></span>de <span class="blank _0"></span>inic<span class="blank _2"></span>io <span class="blank _0"></span>es <span class="blank _0"></span>de <span class="blank _0"></span>16 <span class="blank _0"></span>a </div><div class="t m0 x2d h16 yf5 ff8 fsb fc0 sc0 ls0 ws1">17 <span class="blank _c"></span>años.</div><div class="t m0 x2d h16 y14b ff8 fsb fc0 sc0 ls0 ws1">Mort<span class="blank _2"></span>alid<span class="blank _2"></span>ad <span class="blank _1"> </span> <span class="blank _2"></span>6% <span class="blank _0"></span>- <span class="blank _2"></span>10% <span class="blank _0"></span>(princ<span class="blank _2"></span>ipal </div><div class="t m0 x2d h16 y14c ff8 fsb fc0 sc0 ls0 ws1">caus<span class="blank _2"></span>a <span class="blank"> </span>de <span class="blank _6"> </span>muer<span class="blank _2"></span>te <span class="blank _6"> </span>en <span class="blank"> </span>mu<span class="blank _2"></span>jere<span class="blank _2"></span>s </div><div class="t m0 x2d h16 y14d ff8 fsb fc0 sc0 ls0 ws1">entr<span class="blank _2"></span>e <span class="blank _0"></span>15 <span class="blank _c"></span>a <span class="blank _0"></span>24 <span class="blank _c"></span>años <span class="blank _c"></span>de <span class="blank _0"></span>edad<span class="blank _2"></span>).</div><div class="t m0 x2d h16 y14e ff8 fsb fc0 sc0 ls0 ws1">Entr<span class="blank _2"></span>e <span class="blank _2"></span>el <span class="blank _2"></span>8% <span class="blank _0"></span>y el <span class="blank _0"></span>62% <span class="blank _2"></span>desa<span class="blank _2"></span>rrol<span class="blank _2"></span>la </div><div class="t m0 x2d h16 y14f ff8 fsb fc0 sc0 ls0 ws1">sínt<span class="blank _2"></span>omas <span class="blank _0"></span>de <span class="blank _1"> </span> <span class="blank _2"></span>BN <span class="blank _0"></span>en <span class="blank _2"></span>el <span class="blank _0"></span>curso <span class="blank _0"></span>de </div><div class="t m0 x2d h16 y150 ff8 fsb fc0 sc0 ls0 ws1">su <span class="blank _3"> </span>enferm<span class="blank _2"></span>edad<span class="blank _2"></span>, <span class="blank _3"> </span>la <span class="blank _d"> </span>ma<span class="blank _2"></span>yorí<span class="blank _2"></span>a <span class="blank _d"> </span>en </div><div class="t m0 x2d h16 y151 ff8 fsb fc0 sc0 ls0 ws1">los <span class="blank _0"></span>primer<span class="blank _2"></span>os <span class="blank _2"></span>5 <span class="blank _0"></span>años <span class="blank _2"></span>po<span class="blank _2"></span>ster<span class="blank _2"></span>io<span class="blank _2"></span>res </div><div class="t m0 x2d h16 y152 ff8 fsb fc0 sc0 ls0 ws1">al <span class="blank _c"></span>diagnó<span class="blank _2"></span>stic<span class="blank _2"></span>o.</div><div class="t m0 x2b h16 y153 ff8 fsb fc0 sc0 ls0 ws1">Preocupación <span class="blank _0"></span>por <span class="blank _c"></span>la <span class="blank _0"></span>forma <span class="blank _0"></span>y <span class="blank _0"></span>peso <span class="blank _c"></span>corporal.</div><div class="t m0 x2b h16 y154 ff8 fsb fc0 sc0 ls0 ws1">Períodos <span class="blank _d"> </span>de <span class="blank _d"> </span>dieta <span class="blank _a"> </span>y <span class="blank _d"> </span>ayuno <span class="blank _d"> </span>interrumpidos </div><div class="t m0 x2b h16 y155 ff8 fsb fc0 sc0 ls0 ws1">por episodios <span class="blank _1"> </span>de <span class="blank _1"> </span>atracones acompañados </div><div class="t m0 x2b h16 y156 ff8 fsb fc0 sc0 ls0 ws1">por <span class="blank _0"></span>\u201csensación <span class="blank _c"></span>de <span class="blank _0"></span>pérdida <span class="blank _0"></span>de <span class="blank _0"></span>control\u201d.</div><div class="t m0 x2b h16 y157 ff8 fsb fc0 sc0 ls0 ws1">El <span class="blank _2"></span>episodio <span class="blank _2"></span>de <span class="blank _0"></span>atracón es <span class="blank _0"></span>compensado por </div><div class="t m0 x2b h16 y158 ff8 fsb fc0 sc0 ls0 ws1">estrategias <span class="blank _0"></span>Purgativas <span class="blank _c"></span>o <span class="blank _0"></span>NO <span class="blank _0"></span>purgativas. </div><div class="t m0 x2b h16 y159 ff8 fsb fc0 sc0 ls0 ws1">Frecuencia <span class="blank _d"> </span>de <span class="blank _a"> </span>los <span class="blank _a"> </span>atracones <span class="blank _d"> </span>al <span class="blank _a"> </span>menos <span class="blank _a"> </span>2 </div><div class="t m0 x2b h16 y15a ff8 fsb fc0 sc0 ls0 ws1">veces <span class="blank _0"></span>a <span class="blank _c"></span>la <span class="blank _0"></span>semana <span class="blank _0"></span>/ <span class="blank _0"></span>3 <span class="blank _c"></span>meses. </div><div class="t m0 x2b h16 y15b ff8 fsb fc0 sc0 ls0 ws1">Los <span class="blank _14"> </span>pacientes <span class="blank _14"> </span>tienden <span class="blank _9"> </span>a <span class="blank _14"> </span>perder <span class="blank _14"> </span>menos </div><div class="t m0 x2b h16 y15c ff8 fsb fc0 sc0 ls0 ws1">peso <span class="blank _2"></span>que <span class="blank _2"></span>aquellos <span class="blank _2"></span>afectados <span class="blank _2"></span>por <span class="blank _2"></span>la <span class="blank _0"></span>AN, <span class="blank _2"></span>sin </div><div class="t m0 x2b h16 y15d ff8 fsb fc0 sc0 ls0 ws1">descender <span class="blank _a"> </span>por <span class="blank _a"> </span>debajo <span class="blank _a"> </span>del <span class="blank _a"> </span>85% <span class="blank _a"> </span>del <span class="blank _a"> </span>peso </div><div class="t m0 x2b h16 y15e ff8 fsb fc0 sc0 ls0 ws1">e<span class="blank _3"> </span>s<span class="blank _d"> </span>p<span class="blank _3"> </span>e<span class="blank _d"> </span>r<span class="blank _3"> </span>a<span class="blank _3"> </span>d<span class="blank _d"> </span>o<span class="blank _3"> </span> <span class="blank _10"> </span>(<span class="blank _d"> </span>a<span class="blank _3"> </span>l<span class="blank _3"> </span>g<span class="blank _d"> </span>u<span class="blank _3"> </span>n<span class="blank _d"> </span>o<span class="blank _3"> </span>s<span class="blank _d"> </span> <span class="blank _25"> </span>p<span class="blank _d"> </span>u<span class="blank _3"> </span>e<span class="blank _3"> </span>d<span class="blank _d"> </span>e<span class="blank _3"> </span>n<span class="blank _d"> </span> <span class="blank _25"> </span>t<span class="blank _d"> </span>e<span class="blank _3"> </span>n<span class="blank _d"> </span>e<span class="blank _3"> </span>r<span class="blank _3"> </span> </div><div class="t m0 x2b h16 y15f ff8 fsb fc0 sc0 ls0">sobrepeso).</div><div class="t m0 x2e h18 y160 ff7 fsb fc0 sc0 ls0 ws1">1<span class="blank _d"> </span>.<span class="blank _d"> </span> <span class="blank _25"> </span>B<span class="blank _d"> </span>u<span class="blank _d"> </span>l<span class="blank _d"> </span>i<span class="blank _d"> </span>m<span class="blank _d"> </span>i<span class="blank _d"> </span>a<span class="blank _d"> </span> <span class="blank _25"> </span>n<span class="blank _d"> </span>e<span class="blank _d"> </span>r<span class="blank _d"> </span>v<span class="blank _d"> </span>i<span class="blank _d"> </span>o<span class="blank _d"> </span>s<span class="blank _3"> </span>a<span class="blank _d"> </span> </div><div class="t m0 x2e h18 y161 ff7 fsb fc0 sc0 ls0 ws1">purgativa </div><div class="t m0 x2e h16 y162 ff8 fsb fc0 sc0 ls0 ws1">Vómito <span class="blank _0"></span>autoinducido, <span class="blank _0"></span>abuso </div><div class="t m0 x2e h16 y163 ff8 fsb fc0 sc0 ls0 ws1">de <span class="blank _10"> </span>medi<span class="blank _1"> </span>came<span class="blank _1"> </span>ntos<span class="blank _1"> </span>, <span class="blank _10"> </span>como<span class="blank _1"> </span> </div><div class="t m0 x2e h16 y164 ff8 fsb fc0 sc0 ls0 ws1">l<span class="blank _3"> </span>a<span class="blank _3"> </span>x<span class="blank _d"> </span>a<span class="blank _3"> </span>n<span class="blank _3"> </span>t<span class="blank _3"> </span>e<span class="blank _3"> </span>s<span class="blank _d"> </span>,<span class="blank _3"> </span> <span class="blank _25"> </span>d<span class="blank _d"> </span>i<span class="blank _3"> </span>u<span class="blank _3"> </span>r<span class="blank _3"> </span>é<span class="blank _d"> </span>t<span class="blank _3"> </span>i<span class="blank _3"> </span>c<span class="blank _3"> </span>o<span class="blank _3"> </span>s<span class="blank _d"> </span> <span class="blank _25"> </span>e<span class="blank _d"> </span> </div><div class="t m0 x2e h16 y165 ff8 fsb fc0 sc0 ls0 ws1">i<span class="blank _6"> </span>n<span class="blank"> </span>c<span class="blank _6"> </span>l<span class="blank"> </span>u<span class="blank _6"> </span>s<span class="blank"> </span>o<span class="blank _6"> </span> <span class="blank _25"> </span>t<span class="blank"> </span>i<span class="blank _6"> </span>r<span class="blank"> </span>o<span class="blank _6"> </span>x<span class="blank"> </span>i<span class="blank _6"> </span>n<span class="blank _6"> </span>a<span class="blank"> </span> <span class="blank _25"> </span>y<span class="blank"> </span> </div><div class="t m0 x2e h16 y166 ff8 fsb fc0 sc0 ls0">anfetaminas.</div><div class="t m0 x2e h18 y167 ff7 fsb fc0 sc0 ls0 ws1">2. <span class="blank"> </span>Bulimia <span class="blank _8"> </span> <span class="blank"> </span>nerviosa <span class="blank _9"> </span>no </div><div class="t m0 x2e h18 y168 ff7 fsb fc0 sc0 ls0">purgativa</div><div class="t m0 x2e h16 y169 ff8 fsb fc0 sc0 ls0 ws1">Estrategias <span class="blank _18"> </span>no <span class="blank _8"> </span>purgativas </div><div class="t m0 x2e h16 y16a ff8 fsb fc0 sc0 ls0 ws1">como <span class="blank"> </span>ejercicio <span class="blank"> </span>excesivo <span class="blank"> </span>y </div><div class="t m0 x2e h16 y16b ff8 fsb fc0 sc0 ls0">dieta.</div><div class="t m0 x2d h16 y153 ff8 fsb fc0 sc0 ls0 ws1">Incidencia <span class="blank"> </span>de <span class="blank _6"> </span>12.0 <span class="blank"> </span>/ <span class="blank _6"> </span>100,000 </div><div class="t m0 x2d h16 y16c ff8 fsb fc0 sc0 ls0 ws1">habitantes <span class="blank _0"></span>año.</div><div class="t m0 x2d h16 y155 ff8 fsb fc0 sc0 ls0 ws1">Edad <span class="blank _d"> </span> media edad de inicio es </div><div class="t m0 x2d h16 y156 ff8 fsb fc0 sc0 ls0 ws1">de <span class="blank _0"></span>18 <span class="blank _c"></span>a <span class="blank _0"></span>19 <span class="blank _0"></span>años.</div><div class="t m0 x2d h16 y157 ff8 fsb fc0 sc0 ls0 ws1">Mortalidad <span class="blank _0"></span>y <span class="blank _c"></span>un <span class="blank _0"></span>1% <span class="blank _0"></span>a <span class="blank _0"></span>un <span class="blank _c"></span>3%. </div><div class="t m0 x2d h16 y16d ff8 fsb fc0 sc0 ls0 ws1">En <span class="blank _8"> </span>muchos <span class="blank _18"> </span>casos <span class="blank _8"> </span>existe <span class="blank _18"> </span>el </div><div class="t m0 x2d h16 y159 ff8 fsb fc0 sc0 ls0 ws1">antecedente <span class="blank _0"></span>de <span class="blank _c"></span>una <span class="blank _c"></span>AN.</div><div class="t m0 x2d h16 y16e ff8 fsb fc0 sc0 ls0 ws1">Se <span class="blank _6"> </span>ha <span class="blank _6"> </span>encontrado <span class="blank _6"> </span>asociación </div><div class="t m0 x2d h16 y15b ff8 fsb fc0 sc0 ls0 ws1">c<span class="blank _d"> </span>o<span class="blank _d"> </span>n<span class="blank _d"> </span> <span class="blank _25"> </span>e<span class="blank _d"> </span>l<span class="blank _d"> </span> <span class="blank _25"> </span>a<span class="blank _d"> </span>n<span class="blank _d"> </span>t<span class="blank _d"> </span>e<span class="blank _d"> </span>c<span class="blank _d"> </span>e<span class="blank _d"> </span>d<span class="blank _d"> </span>e<span class="blank _d"> </span>n<span class="blank _3"> </span>t<span class="blank _d"> </span>e<span class="blank _d"> </span> <span class="blank _10"> </span>d<span class="blank _d"> </span>e<span class="blank _d"> </span> </div><div class="t m0 x2d h16 y15c ff8 fsb fc0 sc0 ls0 ws1">obesidad en la infancia <span class="blank _1"> </span>o en el </div><div class="t m0 x2d h16 y15d ff8 fsb fc0 sc0 ls0 ws1">grupo <span class="blank _0"></span>familiar.</div><div class="t m0 x2f h14 y16f ff7 fsa fc0 sc0 ls0 ws1">ANOREXIA<span class="blank _2"></span> </div><div class="t m0 x2f h14 y170 ff7 fsa fc0 sc0 ls0 ws9">NERVIOSA</div><div class="t m0 x30 h14 y171 ff7 fsa fc0 sc0 ls0 ws1">BULIMIA<span class="blank _2"></span> </div><div class="t m0 x2f h14 y172 ff7 fsa fc0 sc0 ls0 ws1">NERVIOSA<span class="blank _2"></span> </div><div class="t m0 x31 h19 ydd ff7 fs9 fc3 sc0 ls0 wsa">TRASTORNO<span class="blank"> </span><span class="vf">CLÍNICA</span></div><div class="t m0 x32 h15 y173 ff7 fs9 fc3 sc0 ls6 ws1"> <span class="ls0 wsb v10">CLASIFICACIÓN<span class="blank"> </span>EPIDEMIOLOGÍA</span></div><div class="t m0 x25 h8 y174 ff1 fs5 fc0 sc0 ls0 ws1">En <span class="blank _0"></span>Colombia <span class="blank _c"></span>se <span class="blank _0"></span>han <span class="blank _0"></span>realizado <span class="blank _0"></span>validaciones <span class="blank _c"></span>de <span class="blank _0"></span>cuestionarios <span class="blank _4"> </span>como <span class="blank _d"> </span>un <span class="blank _d"> </span>logro <span class="blank _d"> </span>y <span class="blank _d"> </span>por <span class="blank _d"> </span>tanto, <span class="blank _d"> </span>puede <span class="blank _d"> </span>comportar <span class="blank _d"> </span>un <span class="blank _d"> </span>refuerzo </div><div class="t m0 x25 h8 y175 ff1 fs5 fc0 sc0 ls0 ws1">como <span class="blank _1"> </span><span class="ff6 wsc">Scoff</span> <span class="blank _3"> </span>y <span class="blank _3"> </span><span class="ff6 wsc">Bite</span>. <span class="blank _3"> </span>El <span class="blank _3"> </span>primero <span class="blank _1"> </span>muestra <span class="blank _3"> </span>ser <span class="blank _3"> </span>una <span class="blank _3"> </span>alternativa <span class="blank _4"> </span>positivo <span class="blank _8"> </span>en <span class="blank _8"> </span>individuos <span class="blank _8"> </span>con <span class="blank _8"> </span>poca <span class="blank _8"> </span>confianza <span class="blank _b"> </span>y <span class="blank _8"> </span>falta <span class="blank _8"> </span>de </div><div class="t m0 x25 h8 y176 ff1 fs5 fc0 sc0 ls0 ws1">para <span class="blank _2"></span>el <span class="blank _2"></span>tamizaje <span class="blank _2"></span>de <span class="blank _0"></span>trastornos de <span class="blank _2"></span>la <span class="blank _0"></span>conducta alimentaria <span class="blank _0"></span>en <span class="blank _26"> </span>autoestima. <span class="blank _d"> </span>Como <span class="blank _a"> </span>resultado, <span class="blank _a"> </span>la <span class="blank _d"> </span>mayoría <span class="blank _a"> </span>de <span class="blank _d"> </span>los <span class="blank _a"> </span>pacientes </div><div class="t m0 x2a hb y177 ff1 fs7 fc0 sc0 ls0 ws1">8, <span class="blank _2"></span>29</div><div class="t m0 x25 h8 y178 ff1 fs5 fc0 sc0 ls0 ws1">mujeres <span class="blank _18"> </span>adolescentes <span class="blank _18"> </span>y <span class="blank _18"> </span>universitarias; <span class="blank _18"> </span>en <span class="blank _1a"> </span>hombres, <span class="blank _18"> </span>la <span class="blank _4"> </span><span class="va">experimentan <span class="blank _c"></span>los <span class="blank _0"></span>síntomas <span class="blank _c"></span>como <span class="blank _0"></span>egosintónicos.</span></div><div class="t m0 x25 h8 y179 ff1 fs5 fc0 sc0 ls0 ws1">validación <span class="blank _0"></span>de <span class="blank _0"></span>dicho <span class="blank _0"></span>cuestionario <span class="blank _0"></span>requiere <span class="blank _c"></span>otros <span class="blank _0"></span>estudios <span class="blank _0"></span>y <span class="blank _0"></span>el </div><div class="t m0 x25 h8 y17a ff1 fs5 fc0 sc0 ls0 ws1">segundo <span class="blank _d"> </span>es <span class="blank _d"> </span>una <span class="blank _d"> </span>alternativa <span class="blank _3"> </span>para <span class="blank _d"> </span>el <span class="blank _d"> </span>tamizaje <span class="blank _d"> </span>de <span class="blank _d"> </span>conductas <span class="blank _4"> </span><span class="va">Por otro lado, se han estudiado <span class="blank _2"></span>alteraciones en la actividad </span></div><div class="t m0 x25 h8 y17b ff1 fs5 fc0 sc0 ls0 ws1">impulsivas alimentarias <span class="blank _2"></span>en mujeres <span class="blank _2"></span>universitarias. <span class="blank _2"></span>Estos se <span class="blank _13"> </span><span class="va">n<span class="blank _1"> </span>eu<span class="blank _1"> </span>ro<span class="blank _1"> </span>en<span class="blank _1"> </span>d<span class="blank _1"> </span>oc<span class="blank _1"> </span>ri<span class="blank _1"> </span>na<span class="blank _1"> </span> <span class="blank _12"> </span>qu<span class="blank _1"> </span>e <span class="blank _12"> </span>po<span class="blank _1"> </span>dr<span class="blank _1"> </span>ía<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _f"> </span>c<span class="blank _1"> </span>om<span class="blank _1"> </span>p<span class="blank _1"> </span>or<span class="blank _1"> </span>ta<span class="blank _1"> </span>r <span class="blank _12"> </span>fa<span class="blank _1"> </span>ct<span class="blank _1"> </span>o<span class="blank _1"> </span>re<span class="blank _1"> </span>s <span class="blank _12"> </span>de<span class="blank _1"> </span> </span></div><div class="t m0 x25 h8 y17c ff1 fs5 fc0 sc0 ls0 ws1">convierten <span class="blank _7"> </span>en <span class="blank _7"> </span>una <span class="blank _7"> </span>opción <span class="blank"> </span>a <span class="blank _6"> </span>la <span class="blank _7"> </span>hora <span class="blank _7"> </span>de <span class="blank"> </span>diagnosticar <span class="blank _6"> </span>los <span class="blank _4"> </span><span class="va">vulnerabilidad <span class="blank _12"> </span>biológica <span class="blank _f"> </span>para <span class="blank _12"> </span>el <span class="blank _f"> </span>desarrollo <span class="blank _12"> </span>de <span class="blank _12"> </span>estos </span></div><div class="t m0 x25 h8 y17d ff1 fs5 fc0 sc0 ls0 ws1">trastornos de <span class="blank _1"> </span>la conducta <span class="blank _1"> </span>alimentaria <span class="blank _1"> </span>en nuestra <span class="blank _1"> </span>población <span class="blank _4"> </span><span class="va">t<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _3"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _12"> </span>y<span class="blank _1"> </span> <span class="blank _12"> </span>e<span class="blank _1"> </span>x<span class="blank _1"> </span>p<span class="blank _1"> </span>l<span class="blank _1"> </span>i<span class="blank _1"> </span>c<span class="blank _1"> </span>a<span class="blank _3"> </span>r<span class="blank _1"> </span> <span class="blank _12"> </span>a<span class="blank _1"> </span>l<span class="blank _1"> </span>g<span class="blank _1"> </span>u<span class="blank _1"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _12"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>s<span class="blank _1"> </span>g<span class="blank _3"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _12"> </span>c<span class="blank _1"> </span>l<span class="blank _1"> </span>í<span class="blank _1"> </span>n<span class="blank _1"> </span>i<span class="blank _1"> </span>c<span class="blank _1"> </span>o<span class="blank _3"> </span>s<span class="blank _1"> </span>:<span class="blank _1"> </span> <span class="blank _12"> </span>l<span class="blank _1"> </span>a<span class="blank _1"> </span> </span></div><div class="t m0 x33 hb y17e ff1 fs7 fc0 sc0 ls0">24-26</div><div class="t m0 x25 h8 y17f ff1 fs5 fc0 sc0 ls0 ws1">adolescente.<span class="blank _27"> </span>hipoleptinemia <span class="blank _2"></span>(característica <span class="blank _0"></span>de <span class="blank _2"></span>la <span class="blank _c"></span>AN) <span class="blank _2"></span>genera <span class="blank _2"></span>cambios <span class="blank _0"></span>en </div><div class="t m0 x9 h8 y180 ff1 fs5 fc0 sc0 ls0 ws1">el eje <span class="blank _2"></span>hipotálamo-hipofisiario que explican <span class="blank _2"></span>síntomas como </div><div class="t m0 x25 h8 y181 ff1 fs5 fc0 sc0 ls0 ws1">Por <span class="blank _3"> </span>su <span class="blank _d"> </span>parte, <span class="blank _3"> </span>los <span class="blank _d"> </span>trastornos <span class="blank _3"> </span>de <span class="blank _d"> </span>la <span class="blank _3"> </span>conducta <span class="blank _d"> </span>alimentaria <span class="blank _3"> </span>no <span class="blank _4"> </span>la <span class="blank _3"> </span>amenorrea, <span class="blank _3"> </span>la <span class="blank _3"> </span>falta <span class="blank _d"> </span>de <span class="blank _1"> </span>interés <span class="blank _d"> </span>o <span class="blank _3"> </span>de <span class="blank _3"> </span>potencia <span class="blank _3"> </span>sexual <span class="blank _3"> </span>y <span class="blank _3"> </span>la </div><div class="t m0 x25 h8 y182 ff1 fs5 fc0 sc0 ls0 ws1">especificados <span class="blank _1"> </span>son <span class="blank _1"> </span>por <span class="blank _3"> </span>definición <span class="blank _1"> </span>diagnósticos <span class="blank _1"> </span>de <span class="blank _1"> </span>descarte, <span class="blank _26"> </span>hiperactividad <span class="blank _6"> </span>inducida <span class="blank _6"> </span>por <span class="blank _a"> </span>inanición, <span class="blank _6"> </span>síntomas <span class="blank _6"> </span>que <span class="blank _6"> </span>son </div><div class="t m0 x25 h8 y183 ff1 fs5 fc0 sc0 ls0 ws1">pero <span class="blank _0"></span>no <span class="blank _0"></span>de <span class="blank _0"></span>menos <span class="blank _2"></span>importancia <span class="blank _0"></span>puesto <span class="blank _0"></span>que <span class="blank _0"></span>corresponden <span class="blank _0"></span>a <span class="blank _2"></span>la <span class="blank _13"> </span>revertidos con el <span class="blank _2"></span>aumento <span class="blank _2"></span>de peso <span class="blank _2"></span>y de <span class="blank _2"></span>porcentaje <span class="blank _2"></span>de grasa </div><div class="t m0 x34 hc y184 ff5 fs7 fc0 sc0 ls0 ws1">30, <span class="blank _0"></span>31</div><div class="t m0 x25 h8 y185 ff1 fs5 fc0 sc0 ls0 ws1">categoría <span class="blank _d"> </span>más <span class="blank _a"> </span>común <span class="blank _a"> </span>entre <span class="blank _d"> </span>los <span class="blank _a"> </span>trastornos <span class="blank _a"> </span>de <span class="blank _d"> </span>la <span class="blank _a"> </span>conducta <span class="blank _4"> </span><span class="va">corporal.</span></div><div class="t m0 x25 h8 y186 ff1 fs5 fc0 sc0 ls0 ws1">alimentaria <span class="blank _8"> </span>encontrada <span class="blank _8"> </span>en <span class="blank _18"> </span>la <span class="blank _8"> </span>práctica <span class="blank _8"> </span>clínica <span class="blank _8"> </span>tanto <span class="blank _18"> </span>en </div><div class="t m0 x35 hb y187 ff1 fs7 fc0 sc0 ls0 ws1">27, <span class="blank _3"> </span>28</div><div class="t m0 x25 h8 y188 ff1 fs5 fc0 sc0 ls0 ws1">adultos como en <span class="blank _1"> </span>adolescentes.<span class="blank _28"> </span> En distintos <span class="blank _1"> </span>estudios, se <span class="blank _4"> </span>En <span class="blank"> </span>la <span class="blank"> </span>parte <span class="blank"> </span>cognitiva, <span class="blank"> </span>la <span class="blank"> </span>literatura <span class="blank"> </span>señala <span class="blank _14"> </span>un <span class="blank"> </span>síndrome </div><div class="t m0 x25 h8 y189 ff1 fs5 fc0 sc0 ls0 ws1">ha <span class="blank _d"> </span>encontrado <span class="blank _d"> </span>que <span class="blank _d"> </span>más <span class="blank _d"> </span>del <span class="blank _d"> </span>50% <span class="blank _d"> </span>del <span class="blank _d"> </span>diagnóstico <span class="blank _d"> </span>de <span class="blank _d"> </span>TCA<span class="blank _2"></span> <span class="blank _13"> </span>cognitivo conductual, asociado <span class="blank _2"></span>a los <span class="blank _0"></span>TCA. En el <span class="blank _2"></span>caso de <span class="blank _2"></span>la </div><div class="t m0 x25 h8 y18a ff1 fs5 fc0 sc0 ls0 ws1">hace <span class="blank _a"> </span>referencia <span class="blank _a"> </span>a <span class="blank _6"> </span>esta <span class="blank _a"> </span>categoría, <span class="blank _a"> </span>con <span class="blank _6"> </span>edades <span class="blank _a"> </span>que <span class="blank _a"> </span>oscilan <span class="blank _26"> </span>A<span class="blank _3"> </span>N<span class="blank _3"> </span>,<span class="blank _3"> </span> <span class="blank _12"> </span>s<span class="blank _3"> </span>e<span class="blank _3"> </span> <span class="blank _12"> </span>c<span class="blank _3"> </span>a<span class="blank _3"> </span>r<span class="blank _3"> </span>a<span class="blank _3"> </span>c<span class="blank _3"> </span>t<span class="blank _3"> </span>e<span class="blank _3"> </span>r<span class="blank _d"> </span>i<span class="blank _1"> </span>z<span class="blank _d"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>p<span class="blank _3"> </span>o<span class="blank _3"> </span>r<span class="blank _3"> </span> <span class="blank _12"> </span>r<span class="blank _3"> </span>i<span class="blank _3"> </span>g<span class="blank _3"> </span>i<span class="blank _d"> </span>d<span class="blank _1"> </span>e<span class="blank _3"> </span>z<span class="blank _d"> </span>,<span class="blank _1"> </span> <span class="blank _12"> </span>m<span class="blank _3"> </span>e<span class="blank _3"> </span>t<span class="blank _3"> </span>i<span class="blank _d"> </span>c<span class="blank _1"> </span>u<span class="blank _d"> </span>l<span class="blank _1"> </span>o<span class="blank _3"> </span>s<span class="blank _d"> </span>i<span class="blank _1"> </span>d<span class="blank _d"> </span>a<span class="blank _1"> </span>d<span class="blank _d"> </span>,<span class="blank _1"> </span> </div><div class="t m0 x15 hb y18b ff1 fs7 fc0 sc0 ls0 ws1">28 <span class="blank _29"> </span><span class="fs5 v9">perfeccionismo, <span class="blank _2"></span>comportamientos <span class="blank _0"></span>obsesivos, <span class="blank _2"></span>dependencia, </span></div><div class="t m0 x25 h8 y18c ff1 fs5 fc0 sc0 ls0 ws1">entre <span class="blank _10"> </span>7 <span class="blank _f"> </span>y <span class="blank _10"> </span>19 <span class="blank _10"> </span>años.<span class="blank _2a"> </span>Ahora <span class="blank _10"> </span>bien, <span class="blank _f"> </span>en <span class="blank _10"> </span>los <span class="blank _10"> </span>trastornos </div><div class="t m0 x9 h8 y18d ff1 fs5 fc0 sc0 ls0 ws1">inhibición <span class="blank _10"> </span>social <span class="blank _f"> </span>e <span class="blank _f"> </span>internalización <span class="blank _10"> </span>de <span class="blank _f"> </span>los <span class="blank _10"> </span>estilos <span class="blank _f"> </span>de </div><div class="t m0 x25 h8 y18e ff1 fs5 fc0 sc0 ls0 ws1">anteriormente <span class="blank _6"> </span>mencionados, <span class="blank _7"> </span>la <span class="blank _6"> </span>pérdida <span class="blank _7"> </span>de <span class="blank _7"> </span>peso <span class="blank _6"> </span>es <span class="blank _7"> </span>vista </div><div class="t m0 x36 h7 yd9 ff3 fs4 fc0 sc0 ls0">133</div><div class="t m0 x0 h6 yda ff3 fs3 fc2 sc0 ls0 ws1">T<span class="blank _2"></span>rastornos de la conducta alimentaria en niños y adolescentes</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x4 y2b w2 h9" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg6.png"><div class="t m0 x4 h8 y18f ff1 fs5 fc0 sc0 ls0 ws1">afrontamiento, <span class="blank _6"> </span>para <span class="blank _7"> </span>cursar <span class="blank _7"> </span>con <span class="blank _7"> </span>comorbilidades <span class="blank _7"> </span>como <span class="blank _7"> </span>la <span class="blank _2b"> </span>triptófano <span class="blank _b"> </span>y <span class="blank _8"> </span>restablecer <span class="blank _8"> </span>la <span class="blank _8"> </span>densidad <span class="blank _8"> </span>de <span class="blank _8"> </span>los <span class="blank _8"> </span>receptores </div><div class="t m0 x4 h8 y190 ff1 fs5 fc0 sc0 ls0 ws1">depresión <span class="blank _0"></span>y <span class="blank _2"></span>el <span class="blank _0"></span>TOC. <span class="blank _0"></span>Se <span class="blank _0"></span>ha <span class="blank _2"></span>visto <span class="blank _0"></span>comúnmente <span class="blank _2"></span>una <span class="blank _0"></span>dinámica <span class="blank _2b"> </span>serotoninérgicos <span class="blank _c"></span>en <span class="blank _0"></span>el <span class="blank _c"></span>cerebro <span class="blank _0"></span>(que <span class="blank _c"></span>se <span class="blank _0"></span>encuentran <span class="blank _0"></span>regulados </div><div class="t m0 x37 hb y191 ff1 fs7 fc0 sc0 ls0 ws1">54, <span class="blank _0"></span>55</div><div class="t m0 x4 h8 y192 ff1 fs5 fc0 sc0 ls0 ws1">familiar <span class="blank _0"></span>que <span class="blank _0"></span>incluye <span class="blank _0"></span>evitación <span class="blank _2"></span>de <span class="blank _0"></span>conflictos, <span class="blank _0"></span>baja <span class="blank _0"></span>tolerancia <span class="blank _2b"> </span><span class="va">a <span class="blank _c"></span>la <span class="blank _0"></span>baja <span class="blank _c"></span>en <span class="blank _0"></span>el <span class="blank _c"></span>curso <span class="blank _c"></span>de <span class="blank _0"></span>la <span class="blank _c"></span>restricción <span class="blank _0"></span>dietaria).</span></div><div class="t m0 x4 h8 y193 ff1 fs5 fc0 sc0 ls0 ws1">y <span class="blank _a"> </span>padres <span class="blank _a"> </span>sobreprotectores <span class="blank _6"> </span>y <span class="blank _a"> </span>rígidos <span class="blank _a"> </span>en <span class="blank _6"> </span>la <span class="blank _a"> </span>crianza <span class="blank _a"> </span>de <span class="blank _6"> </span>los </div><div class="t m0 x0 hb y194 ff1 fs7 fc0 sc0 ls0 wsd">32<span class="blank"> </span><span class="fs5 ws1 v9">Durante <span class="blank _7"> </span>el <span class="blank"> </span>tratamiento <span class="blank _7"> </span>adjunto <span class="blank"> </span>que <span class="blank _6"> </span>se <span class="blank"> </span>propone <span class="blank _7"> </span>para <span class="blank"> </span>la </span></div><div class="t m0 x4 h8 y195 ff1 fs5 fc0 sc0 ls0 wse">hijos.<span class="blank"> </span><span class="ff5 ls7 ws1"> </span><span class="ws1">Las <span class="blank _1"> </span>pacientes <span class="blank _3"> </span>con <span class="blank _1"> </span>BN <span class="blank _3"> </span>presentan <span class="blank _3"> </span>rasgos <span class="blank _1"> </span>de <span class="blank _3"> </span><span class="ff6">acting-</span></span></div><div class="t m0 x38 hb y196 ff1 fs7 fc0 sc0 ls0 wsf">33<span class="blank"> </span><span class="fs5 ws1 vc">anorex<span class="blank _1"> </span>ia <span class="blank _12"> </span>nervio<span class="blank _1"> </span>sa <span class="blank _12"> </span>se <span class="blank _12"> </span>descri<span class="blank _1"> </span>ben <span class="blank _12"> </span>otros<span class="blank _1"> </span> <span class="blank _f"> </span>med<span class="blank _1"> </span>icamen<span class="blank _1"> </span>tos </span></div><div class="t m0 x4 h8 y197 ff6 fs5 fc0 sc0 ls0 wsc">out,<span class="ff1 ws1"> <span class="blank _0"></span>poco <span class="blank _0"></span>control <span class="blank _2"></span>de <span class="blank _0"></span>los <span class="blank _0"></span>impulsos, <span class="blank _2"></span>con <span class="blank _0"></span>abuso <span class="blank _0"></span>de <span class="blank _0"></span>sustancias<span class="blank _12"> </span><span class="ff5"> </span></span></div><div class="t m0 x8 h8 y198 ff1 fs5 fc0 sc0 ls0 ws1">dirigidos hacia <span class="blank _2"></span>la <span class="blank _2"></span>modulación <span class="blank _2"></span>sintomática, entre <span class="blank _2"></span>los <span class="blank _2"></span>que se </div><div class="t m0 x4 h8 y199 ff1 fs5 fc0 sc0 ls0 ws1">y <span class="blank _0"></span>promiscuidad, <span class="blank _0"></span>excesiva <span class="blank _0"></span>necesidad <span class="blank _0"></span>de <span class="blank _0"></span>aprobación, <span class="blank _2"></span>déficits </div><div class="t m0 x39 h1a y19a ff1 fs7 fc0 sc0 ls0 ws10">34<span class="blank"> </span><span class="fs5 ws1 v7">encuentran <span class="blank _0"></span>la <span class="blank _0"></span>metoclopramida <span class="blank _0"></span>(para <span class="blank _c"></span>el <span class="blank _0"></span>manejo <span class="blank _0"></span>de <span class="blank _0"></span>náuseas <span class="blank _0"></span>y </span></div><div class="t m0 x4 h8 y19b ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _c"></span>autoestima <span class="blank _0"></span>y <span class="blank _c"></span>rasgos <span class="blank _0"></span>de <span class="blank _c"></span>personalidad <span class="blank _c"></span>limítrofe.<span class="blank _12"> </span> <span class="blank _2c"> </span><span class="ff5 fs7 ls8 vb"> </span><span class="fs7 vb">56</span></div><div class="t m0 x8 h8 y19c ff1 fs5 fc0 sc0 ls0 ws1">el <span class="blank _10"> </span>reflujo <span class="blank _10"> </span>secundarios <span class="blank _f"> </span>a <span class="blank _10"> </span>la <span class="blank _10"> </span>realimentación)<span class="blank _2a"> </span> <span class="blank _10"> </span>y <span class="blank _10"> </span>los </div><div class="t m0 x8 h8 y19d ff1 fs5 fc0 sc0 ls0 ws1">suplementos <span class="blank _3"> </span>de <span class="blank _3"> </span>calcio <span class="blank _3"> </span>y <span class="blank _3"> </span>vitamina <span class="blank _3"> </span>D <span class="blank _3"> </span>para <span class="blank _d"> </span>el <span class="blank _1"> </span>manejo <span class="blank _3"> </span>de <span class="blank _d"> </span>la </div><div class="t m0 x3a hb y19e ff1 fs7 fc0 sc0 ls0 ws1">57, <span class="blank _0"></span>58</div><div class="t m0 x8 h8 y19f ff1 fs5 fc0 sc0 ls0 ws1">baja <span class="blank _c"></span>densidad <span class="blank _0"></span>ósea <span class="blank _c"></span>desarrollada <span class="blank _0"></span>en <span class="blank _c"></span>excurso <span class="blank _c"></span>de <span class="blank _0"></span>trastorno.</div><div class="t m0 x4 ha y1a0 ff5 fs6 fc0 sc0 ls0 ws1">T<span class="blank _c"></span>ratamiento <span class="blank _e"></span>farmacológico</div><div class="t m0 x8 h8 y1a1 ff5 fs5 fc0 sc0 ls0 ws1">Bulimia <span class="blank _c"></span>nerviosa<span class="ff1">. <span class="blank _e"></span>A<span class="blank _2"></span> <span class="blank _c"></span>diferencia <span class="blank _c"></span>de <span class="blank _0"></span>la <span class="blank _e"></span>AN, <span class="blank _c"></span>se <span class="blank _0"></span>han <span class="blank _c"></span>encontrado </span></div><div class="t m0 x4 h8 y1a2 ff5 fs5 fc0 sc0 ls0 ws1">Anorexia <span class="blank _0"></span>nerviosa<span class="ff1 wsc">.</span> <span class="ff1">El <span class="blank _2"></span>tratamiento <span class="blank _2"></span>de <span class="blank _0"></span>la anorexia <span class="blank _2"></span>nerviosa <span class="blank _28"> </span><span class="v11">varios <span class="blank"> </span>medicamentos <span class="blank _7"> </span>que <span class="blank"> </span>tienen <span class="blank _7"> </span>mayor <span class="blank"> </span>eficacia <span class="blank _7"> </span>que <span class="blank"> </span>el </span></span></div><div class="t m0 x4 h8 y1a3 ff1 fs5 fc0 sc0 ls0 ws1">debe <span class="blank _2"></span>buscar la <span class="blank _2"></span>funcionalidad <span class="blank _2"></span>física <span class="blank _2"></span>y <span class="blank _2"></span>mental <span class="blank _2"></span>del individuo: <span class="blank _28"> </span><span class="v11">placebo <span class="blank _1"> </span>en <span class="blank _1"> </span>el tratamiento <span class="blank _1"> </span>de <span class="blank _1"> </span>BN, como <span class="blank _1"> </span>los <span class="blank _1"> </span>antidepresivos </span></div><div class="t m0 x4 h8 y1a4 ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _0"></span>restauración <span class="blank _0"></span>del <span class="blank _0"></span>peso <span class="blank _c"></span>corporal <span class="blank _0"></span>con <span class="blank _0"></span>todas <span class="blank _0"></span>sus <span class="blank _0"></span>correcciones <span class="blank _2b"> </span><span class="v11">triciclitos (ADT), los ISRS, los inhibidores de recaptación </span></div><div class="t m0 x4 h8 y1a5 ff1 fs5 fc0 sc0 ls0 ws1">sistémicas, <span class="blank _7"> </span>disminución <span class="blank _7"> </span>de <span class="blank _7"> </span>los <span class="blank _7"> </span>sentimientos <span class="blank _6"> </span>de <span class="blank _9"> </span>tristeza, <span class="blank _2b"> </span><span class="v11">d<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _12"> </span>s<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>o<span class="blank _1"> </span>t<span class="blank _3"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span>i<span class="blank _1"> </span>n<span class="blank _1"> </span>a<span class="blank _3"> </span> <span class="blank _f"> </span>y<span class="blank _3"> </span> <span class="blank _f"> </span>n<span class="blank _3"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>d<span class="blank _1"> </span>r<span class="blank _3"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span>a<span class="blank _1"> </span>l<span class="blank _1"> </span>i<span class="blank _1"> </span>n<span class="blank _3"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>(<span class="blank _1"> </span>I<span class="blank _1"> </span>S<span class="blank _1"> </span>R<span class="blank _1"> </span>S<span class="blank _1"> </span>N<span class="blank _3"> </span>)<span class="blank _1"> </span>,<span class="blank _1"> </span> <span class="blank _12"> </span>y<span class="blank _1"> </span> <span class="blank _12"> </span>o<span class="blank _1"> </span>t<span class="blank _1"> </span>r<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _3"> </span> </span></div><div class="t m0 x4 h8 y1a6 ff1 fs5 fc0 sc0 ls0 ws1">ansiedad <span class="blank"> </span>e <span class="blank"> </span>impulsividad, <span class="blank"> </span>la <span class="blank"> </span>alteración <span class="blank"> </span>de <span class="blank"> </span>los <span class="blank"> </span>síntomas <span class="blank _2d"> </span><span class="fs7 v2">59, <span class="blank _f"> </span>60</span></div><div class="t m0 x8 h8 y1a7 ff1 fs5 fc0 sc0 ls0 ws1">medicamentos <span class="blank _25"> </span>antidepresivos.<span class="blank _2e"> </span> <span class="blank _10"> </span>La <span class="blank _25"> </span>eficacia <span class="blank _10"> </span>de <span class="blank _10"> </span>los </div><div class="t m0 x4 h8 y1a8 ff1 fs5 fc0 sc0 ls0 ws1">afectivos y motores <span class="blank _1"> </span>y hacer <span class="blank _1"> </span>remisión total de <span class="blank _1"> </span>la distorsión <span class="blank _2b"> </span><span class="v10">antidepresivos en la BN es atribuible a la reducción de los </span></div><div class="t m0 x4 h8 y1a9 ff1 fs5 fc0 sc0 ls0 ws1">de la <span class="blank _1"> </span>imagen corporal. <span class="blank _2"></span>Actualmente, ningún medicamento <span class="blank _2b"> </span><span class="v10">síntomas <span class="blank _2"></span>principales <span class="blank _0"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>ingesta <span class="blank _0"></span>y <span class="blank _2"></span>el <span class="blank _0"></span>vómito <span class="blank _0"></span>y <span class="blank _0"></span>a <span class="blank _0"></span>la <span class="blank _0"></span>mejoría </span></div><div class="t m0 x4 h8 y1aa ff1 fs5 fc0 sc0 ls0 ws1">está <span class="blank _0"></span>aprobado <span class="blank _0"></span>por <span class="blank _2"></span>la <span class="blank _0"></span>FDA<span class="blank _0"></span> <span class="blank _2"></span>para <span class="blank _0"></span>el <span class="blank _0"></span>tratamiento <span class="blank _0"></span>de <span class="blank _2"></span>la <span class="blank _0"></span>anorexia <span class="blank _2b"> </span><span class="v10">del <span class="blank _c"></span>humor <span class="blank _0"></span>y <span class="blank _c"></span>la <span class="blank _0"></span>ansiedad. <span class="blank _c"></span>La <span class="blank _0"></span>eficacia <span class="blank _c"></span>de <span class="blank _0"></span>los <span class="blank _0"></span>antidepresivos <span class="blank _c"></span>se </span></div><div class="t m0 x4 h8 y1ab ff1 fs5 fc0 sc0 ls0 ws1">nerviosa <span class="blank _d"> </span>por <span class="blank _3"> </span>sí <span class="blank _d"> </span>misma. <span class="blank _d"> </span>Se <span class="blank _d"> </span>ha <span class="blank _3"> </span>descrito <span class="blank _d"> </span>que <span class="blank _d"> </span>las <span class="blank _d"> </span>evidencias <span class="blank _2b"> </span><span class="v10">ha<span class="blank _1"> </span> <span class="blank _12"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span>m<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>d<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _12"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _12"> </span>d<span class="blank _1"> </span>i<span class="blank _1"> </span>v<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>s<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _12"> </span>es<span class="blank _1"> </span>t<span class="blank _1"> </span>u<span class="blank _1"> </span>d<span class="blank _1"> </span>i<span class="blank _3"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _f"> </span>d<span class="blank _1"> </span>o<span class="blank _1"> </span>b<span class="blank _3"> </span>l<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _f"> </span>c<span class="blank _1"> </span>i<span class="blank _1"> </span>e<span class="blank _1"> </span>g<span class="blank _1"> </span>o<span class="blank _3"> </span> </span></div><div class="t m0 x4 h8 y1ac ff1 fs5 fc0 sc0 ls0 ws1">médica <span class="blank _6"> </span>y <span class="blank _6"> </span>epidemiológica <span class="blank _6"> </span>acerca <span class="blank _6"> </span>de <span class="blank _6"> </span>la <span class="blank _a"> </span>efectividad <span class="blank _6"> </span>de <span class="blank _6"> </span>la <span class="blank _2f"> </span><span class="fs7 v3">61</span></div><div class="t m0 x8 h8 y1ad ff1 fs5 fc0 sc0 ls0 ws1">aleatorizados <span class="blank _3"> </span>controlados <span class="blank _3"> </span>con <span class="blank _d"> </span>placebo.<span class="blank _f"> </span> <span class="blank _d"> </span>Es <span class="blank _3"> </span>recomendado </div><div class="t m0 x4 h8 y1ae ff1 fs5 fc0 sc0 ls0 ws1">farmacoterapia <span class="blank _1"> </span>como <span class="blank _1"> </span>primera <span class="blank _3"> </span>línea <span class="blank _1"> </span>para <span class="blank _1"> </span>el <span class="blank _3"> </span>tratamiento <span class="blank _1"> </span>de <span class="blank _2b"> </span><span class="v12">que <span class="blank _0"></span>los <span class="blank _c"></span>pacientes <span class="blank _0"></span>sigan <span class="blank _0"></span>el <span class="blank _0"></span>tratamiento <span class="blank _c"></span>antidepresivo <span class="blank _0"></span>durante </span></div><div class="t m0 x4 h8 y1af ff1 fs5 fc0 sc0 ls0 ws1">restauración <span class="blank _d"> </span>del <span class="blank _3"> </span>peso <span class="blank _d"> </span>en <span class="blank _d"> </span>pacientes <span class="blank _3"> </span>con <span class="blank _d"> </span>anorexia <span class="blank _d"> </span>nerviosa </div><div class="t m0 x3b h1b y1b0 ff1 fs7 fc0 sc0 ls0 ws1">35, <span class="blank _0"></span>36<span class="ff5 ls9"> </span><span class="fs5 va">al <span class="blank _0"></span>menos <span class="blank _c"></span>9 <span class="blank _0"></span>meses <span class="blank _c"></span>a <span class="blank _0"></span>1 <span class="blank _c"></span>año. </span></div><div class="t m0 x4 h8 y1b1 ff1 fs5 fc0 sc0 ls0 ws1">son <span class="blank _c"></span>muy <span class="blank _0"></span>escasas.</div><div class="t m0 x8 h8 y1b2 ff1 fs5 fc0 sc0 ls0 ws1">Los <span class="blank _0"></span>ISRS <span class="blank _c"></span>han <span class="blank _0"></span>demostrado <span class="blank _0"></span>su <span class="blank _0"></span>eficacia <span class="blank _c"></span>en <span class="blank _0"></span>el <span class="blank _0"></span>tratamiento <span class="blank _c"></span>de <span class="blank _0"></span>la </div><div class="t m0 x4 h8 y1b3 ff1 fs5 fc0 sc0 ls0 ws1">En <span class="blank _25"> </span>estudios <span class="blank _25"> </span>realizados <span class="blank _25"> </span>sobre <span class="blank _25"> </span>la <span class="blank _25"> </span>eficacia <span class="blank _25"> </span>del <span class="blank _25"> </span>manejo <span class="blank _2b"> </span><span class="v10">BN, <span class="blank _0"></span>y <span class="blank _2"></span>la <span class="blank _0"></span>FDA<span class="blank _0"></span> <span class="blank _2"></span>aprueba <span class="blank _0"></span>la <span class="blank _0"></span>indicación <span class="blank _0"></span>del <span class="blank _2"></span>uso <span class="blank _0"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>fluoxetina </span></div><div class="t m0 x4 h8 y1b4 ff1 fs5 fc0 sc0 ls0 ws1">p<span class="blank _d"> </span>s<span class="blank _d"> </span>i<span class="blank _a"> </span>c<span class="blank _d"> </span>o<span class="blank _d"> </span>f<span class="blank _a"> </span>a<span class="blank _d"> </span>r<span class="blank _d"> </span>m<span class="blank _a"> </span>a<span class="blank _d"> </span>c<span class="blank _d"> </span>o<span class="blank _a"> </span>l<span class="blank _d"> </span>ó<span class="blank _d"> </span>g<span class="blank _a"> </span>i<span class="blank _d"> </span>c<span class="blank _d"> </span>o<span class="blank _d"> </span>,<span class="blank _a"> </span> <span class="blank _f"> </span>c<span class="blank _a"> </span>o<span class="blank _d"> </span>n<span class="blank _d"> </span> <span class="blank _12"> </span>m<span class="blank _d"> </span>e<span class="blank _a"> </span>d<span class="blank _d"> </span>i<span class="blank _d"> </span>c<span class="blank _a"> </span>a<span class="blank _d"> </span>m<span class="blank _d"> </span>e<span class="blank _a"> </span>n<span class="blank _d"> </span>t<span class="blank _d"> </span>o<span class="blank _a"> </span>s<span class="blank _d"> </span> <span class="blank _f"> </span>t<span class="blank _a"> </span>i<span class="blank _d"> </span>p<span class="blank _d"> </span>o<span class="blank _a"> </span> <span class="blank _26"> </span><span class="v10">en <span class="blank _3"> </span>este <span class="blank _3"> </span>trastorno <span class="blank _1"> </span>pues <span class="blank _3"> </span>goza <span class="blank _3"> </span>de <span class="blank _3"> </span>un <span class="blank _3"> </span>buen <span class="blank _3"> </span>perfil <span class="blank _3"> </span>en <span class="blank _1"> </span>cuanto <span class="blank _3"> </span>a </span></div><div class="t m0 x4 h8 y1b5 ff1 fs5 fc0 sc0 ls0 ws1">antipsicóticos, <span class="blank _2"></span>benzodiacepinas <span class="blank _2"></span>(lorazepam <span class="blank _2"></span>y <span class="blank _0"></span>clonazepam, <span class="blank _30"> </span><span class="fs7 v3">62-65</span></div><div class="t m0 x8 h8 y1b6 ff1 fs5 fc0 sc0 ls0 ws1">efectos <span class="blank _0"></span>secundarios<span class="blank _2a"> </span> <span class="blank _0"></span>y <span class="blank _0"></span>ha <span class="blank _0"></span>demostrado <span class="blank _0"></span>interrumpir <span class="blank _0"></span>el <span class="blank _c"></span>ciclo </div><div class="t m0 x4 h8 y1b7 ff1 fs5 fc0 sc0 ls0 ws1">principalmente) <span class="blank _f"> </span>y <span class="blank _12"> </span>otros <span class="blank _12"> </span>medicamentos <span class="blank _f"> </span>derivados <span class="blank _12"> </span>no <span class="blank _2b"> </span><span class="v12">compulsivo/purgativo; <span class="blank _7"> </span>además, <span class="blank"> </span>es <span class="blank"> </span>el <span class="blank _7"> </span>medicamento <span class="blank"> </span>más </span></div><div class="t m0 x4 h8 y1b8 ff1 fs5 fc0 sc0 ls0 ws1">anfetamínicos <span class="blank _0"></span>(pimozide <span class="blank _2"></span>y <span class="blank _0"></span>sulpiride), <span class="blank _0"></span>se <span class="blank _2"></span>ha <span class="blank _0"></span>encontrado <span class="blank _0"></span>que <span class="blank _2b"> </span><span class="v12">rigurosamente <span class="blank _1"> </span>estudiado <span class="blank _1"> </span>para <span class="blank _1"> </span>el <span class="blank _1"> </span>tratamiento <span class="blank _1"> </span>de <span class="blank _1"> </span>la <span class="blank _1"> </span>bulimia </span></div><div class="t m0 x4 h8 y1b9 ff1 fs5 fc0 sc0 ls0 ws1">estos, <span class="blank _3"> </span>en <span class="blank _1"> </span>primera <span class="blank _3"> </span>instancia, <span class="blank _3"> </span>pueden <span class="blank _3"> </span>contribuir <span class="blank _3"> </span>al <span class="blank _3"> </span>aumento <span class="blank _31"> </span><span class="fs7 v4">65</span></div><div class="t m0 x8 h8 y1ba ff1 fs5 fc0 sc0 ls0 ws1">nervosa.<span class="blank _f"> </span> La <span class="blank _0"></span>dosis <span class="blank _2"></span>de <span class="blank _2"></span>fluoxetina <span class="blank _0"></span>que demostró <span class="blank _0"></span>ser <span class="blank _2"></span>superior </div><div class="t m0 x4 h8 y1bb ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _d"> </span>peso <span class="blank _d"> </span>de <span class="blank _d"> </span>los <span class="blank _d"> </span>pacientes <span class="blank _d"> </span>y <span class="blank _d"> </span>al <span class="blank _d"> </span>alivio <span class="blank _a"> </span>de <span class="blank _d"> </span>la <span class="blank _d"> </span>sintomatología <span class="blank _2b"> </span><span class="v13">al <span class="blank _18"> </span>placebo <span class="blank _1a"> </span>y <span class="blank _18"> </span>mejor <span class="blank _1a"> </span>tolerado <span class="blank _18"> </span>con <span class="blank _18"> </span>efectos <span class="blank _1a"> </span>secundarios </span></div><div class="t m0 x4 h8 y1bc ff1 fs5 fc0 sc0 ls0 ws1">ansiosa <span class="blank _2"></span>e impulsiva, <span class="blank _2"></span>pero <span class="blank _2"></span>a <span class="blank _2"></span>lar<span class="blank _2"></span>go <span class="blank _2"></span>plazo no <span class="blank _2"></span>contribuyen <span class="blank _2"></span>con <span class="blank _2b"> </span><span class="v13">mínimos (en un ensayo controlado con <span class="blank _1"> </span>la participación <span class="blank _1"> </span>de </span></div><div class="t m0 x4 h8 y1bd ff1 fs5 fc0 sc0 ls0 ws1">u<span class="blank _1"> </span>n<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>me<span class="blank _3"> </span>j<span class="blank _1"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>í<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>de<span class="blank _1"> </span>f<span class="blank _3"> </span>i<span class="blank _1"> </span>n<span class="blank _1"> </span>i<span class="blank _1"> </span>t<span class="blank _1"> </span>i<span class="blank _1"> </span>v<span class="blank _1"> </span>a<span class="blank _1"> </span>,<span class="blank _1"> </span> <span class="blank _12"> </span>a<span class="blank _1"> </span> <span class="blank _f"> </span>d<span class="blank _1"> </span>i<span class="blank _3"> </span>f<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span>c<span class="blank _1"> </span>i<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span>l<span class="blank _1"> </span> <span class="blank _f"> </span>e<span class="blank _3"> </span>n<span class="blank _1"> </span>f<span class="blank _1"> </span>o<span class="blank _1"> </span>q<span class="blank _1"> </span>u<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _32"> </span><span class="fs7 v5">64-66</span></div><div class="t m0 x3c h1c y1be ff1 fs7 fc0 sc0 ls0 ws11">36-47<span class="blank"> </span><span class="fs5 ws1 v2">387 pacientes) <span class="blank _1"> </span>es <span class="blank _1"> </span>de 60 <span class="blank _1"> </span>mg/día.<span class="blank _13"> </span> <span class="blank _2"></span>Algunos de <span class="blank _1"> </span>los <span class="blank _1"> </span>efectos </span></div><div class="t m0 x4 h8 y1bf ff1 fs5 fc0 sc0 ls0 ws1">psicoterapéutico <span class="blank _c"></span>cognitivo <span class="blank _0"></span>conductual.<span class="blank _21"> </span><span class="v13">secundarios <span class="blank _d"> </span>comunes <span class="blank _3"> </span>que <span class="blank _d"> </span>pueden <span class="blank _3"> </span>ocurrir <span class="blank _d"> </span>a <span class="blank _3"> </span>dosis <span class="blank _d"> </span>altas <span class="blank _3"> </span>de </span></div><div class="t m0 x8 h8 y1c0 ff1 fs5 fc0 sc0 ls0 ws1">ISRS <span class="blank _6"> </span>incluyen <span class="blank _7"> </span>insomnio, <span class="blank _7"> </span>náuseas, <span class="blank _6"> </span>astenia <span class="blank _7"> </span>y <span class="blank _7"> </span>los <span class="blank _6"> </span>efectos </div><div class="t m0 x4 h8 y1c1 ff1 fs5 fc0 sc0 ls0 ws1">Dado <span class="blank _3"> </span>que <span class="blank _3"> </span>los <span class="blank _3"> </span>pacientes <span class="blank _3"> </span>con AN <span class="blank _3"> </span>presentan <span class="blank _3"> </span>una <span class="blank _3"> </span>frecuencia <span class="blank _33"> </span><span class="fs7 ws12 v5">67<span class="ff5 ws1"> </span></span></div><div class="t m0 x8 h8 y1c2 ff1 fs5 fc0 sc0 ls0 ws1">secundarios <span class="blank _8"> </span>sexuales.<span class="blank _34"> </span>Sin <span class="blank _8"> </span>embrago, <span class="blank _8"> </span>se <span class="blank _8"> </span>han <span class="blank _8"> </span>realizado </div><div class="t m0 x4 h8 y1c3 ff1 fs5 fc0 sc0 ls0 ws1">comorbilidades <span class="blank _f"> </span>como <span class="blank _10"> </span>síntomas <span class="blank _f"> </span>obsesivo-compulsivos, <span class="blank _2b"> </span><span class="v14">estudios <span class="blank _14"> </span>sobre <span class="blank _b"> </span>la <span class="blank _14"> </span>combinación <span class="blank _14"> </span>de <span class="blank _b"> </span>la <span class="blank _14"> </span>psicoterapia <span class="blank _14"> </span>y <span class="blank _b"> </span>la </span></div><div class="t m0 x4 h8 y1c4 ff1 fs5 fc0 sc0 ls0 ws1">depresivos <span class="blank _1"> </span>y <span class="blank _3"> </span>de <span class="blank _3"> </span>ansiedad, <span class="blank _1"> </span>se <span class="blank _3"> </span>ha <span class="blank _3"> </span>explorado <span class="blank _1"> </span>el <span class="blank _3"> </span>papel <span class="blank _3"> </span>de <span class="blank _1"> </span>los <span class="blank _35"> </span><span class="fs7 v7">53</span></div><div class="t m0 x8 h8 y1c5 ff1 fs5 fc0 sc0 ls0 ws1">fluoxetina <span class="blank _a"> </span>para <span class="blank _6"> </span>el <span class="blank _a"> </span>tratamiento <span class="blank _6"> </span>de <span class="blank _a"> </span>pacientes <span class="blank _6"> </span>con <span class="blank _a"> </span>BN,<span class="blank _12"> </span> <span class="blank _a"> </span>la </div><div class="t m0 x4 h8 y1c6 ff1 fs5 fc0 sc0 ls0 ws1">antidepresivos, <span class="blank _6"> </span>especialmente, <span class="blank _6"> </span>los <span class="blank _6"> </span>inhibidores <span class="blank _6"> </span>selectivos <span class="blank _36"> </span><span class="fs7 ws13 v15">67-7<span class="blank"> </span>0</span></div><div class="t m0 x3d h1d y1c7 ff1 fs7 fc0 sc0 ls0 ws14">48-50<span class="blank"> </span><span class="fs5 ws1 v4">mayo<span class="blank _1"> </span>ría <span class="blank _12"> </span>de<span class="blank _1"> </span> <span class="blank _12"> </span>esto<span class="blank _1"> </span>s <span class="blank _12"> </span>cont<span class="blank _1"> </span>rola<span class="blank _1"> </span>do<span class="blank _1"> </span>s <span class="blank _12"> </span>con <span class="blank _12"> </span>pl<span class="blank _1"> </span>aceb<span class="blank _1"> </span>o.<span class="blank _26"> </span> <span class="blank _f"> </span>Lo<span class="blank _1"> </span>s </span></div><div class="t m0 x4 h8 y1c8 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _d"> </span>la <span class="blank _3"> </span>recaptación <span class="blank _d"> </span>de <span class="blank _d"> </span>serotonina <span class="blank _d"> </span>(ISRS).<span class="blank _2a"> </span> <span class="blank _d"> </span>Los <span class="blank _d"> </span>hallazgos <span class="blank _2b"> </span><span class="v6">resultados no <span class="blank _2"></span>son todos <span class="blank _2"></span>consistentes entre sí; <span class="blank _2"></span>en 2 <span class="blank _2"></span>estudios </span></div><div class="t m0 x4 h8 y1c9 ff1 fs5 fc0 sc0 ls0 ws1">sugieren <span class="blank _2"></span>que <span class="blank _2"></span>la <span class="blank _2"></span>actividad <span class="blank _2"></span>serotoninér<span class="blank _2"></span>gica <span class="blank _2"></span>es <span class="blank _2"></span>reducida, <span class="blank _2"></span>pues <span class="blank _2b"> </span><span class="v6">se <span class="blank _14"> </span>determinó <span class="blank _8"> </span>la <span class="blank _b"> </span>asociación <span class="blank _b"> </span>entre <span class="blank _8"> </span>la <span class="blank _b"> </span>terapia <span class="blank _b"> </span>cognitivo-</span></div><div class="t m0 x4 h8 y1ca ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _3"> </span>restricción <span class="blank _d"> </span>alimentaria <span class="blank _3"> </span>disminuye <span class="blank _d"> </span>la <span class="blank _3"> </span>disponibilidad <span class="blank _d"> </span>del <span class="blank _2b"> </span><span class="v6">conductual <span class="blank _d"> </span>y <span class="blank _a"> </span>la <span class="blank _d"> </span>medicación <span class="blank _a"> </span>como <span class="blank _d"> </span>tratamiento <span class="blank _a"> </span>adecuado, </span></div><div class="t m0 x4 h8 y1cb ff1 fs5 fc0 sc0 ls0 ws1">triptófano <span class="blank _a"> </span>(precursor <span class="blank _d"> </span>en <span class="blank _a"> </span>la <span class="blank _a"> </span>producción <span class="blank _a"> </span>de <span class="blank _d"> </span>serotonina) <span class="blank _a"> </span>en <span class="blank _2b"> </span><span class="v6">mientras <span class="blank _1"> </span>que <span class="blank _1"> </span>otros <span class="blank _3"> </span>dos <span class="blank _1"> </span>estudios <span class="blank _1"> </span>informaron <span class="blank _1"> </span>que <span class="blank _3"> </span>la <span class="blank _1"> </span>terapia </span></div><div class="t m0 x4 h8 y1cc ff1 fs5 fc0 sc0 ls0 ws1">pacientes <span class="blank _2"></span>con <span class="blank _0"></span>TCA<span class="blank _2"></span> <span class="blank _2"></span>tipo <span class="blank _c"></span>AN. Dado <span class="blank _0"></span>este déficit, <span class="blank _0"></span>los ISRS <span class="blank _2"></span>no <span class="blank _28"> </span><span class="v6">cognitivo-conductual, el asesoramiento <span class="blank _1"> </span>nutricional y otras </span></div><div class="t m0 x4 h8 y1cd ff1 fs5 fc0 sc0 ls0 ws1">serían <span class="blank _c"></span>eficaces <span class="blank _0"></span>para <span class="blank _c"></span>el <span class="blank _0"></span>manejo <span class="blank _c"></span>de <span class="blank _0"></span>los <span class="blank _c"></span>síntomas <span class="blank _c"></span>depresivos <span class="blank _0"></span>en </div><div class="t m0 x3e h1e y1ce ff5 fs7 fc0 sc0 ls0 ws1">51 <span class="blank _37"> </span> <span class="blank _38"> </span><span class="ff1 fs5 v3">intervenciones <span class="blank"> </span>psicoterapéuticas <span class="blank"> </span>mostraron <span class="blank _7"> </span>superioridad </span></div><div class="t m0 x4 h8 y1cf ff1 fs5 fc0 sc0 ls0 ws1">pacientes <span class="blank _d"> </span>con <span class="blank _3"> </span>AN.<span class="blank _39"> </span>Sin <span class="blank _d"> </span>embargo,<span class="blank _b"> </span>a <span class="blank _d"> </span>pesar <span class="blank _a"> </span>de <span class="blank _d"> </span>las <span class="blank _a"> </span>pruebas <span class="blank _2b"> </span><span class="v14">e<span class="blank _1"> </span>s<span class="blank _3"> </span>t<span class="blank _3"> </span>a<span class="blank _1"> </span>d<span class="blank _3"> </span>í<span class="blank _3"> </span>s<span class="blank _3"> </span>t<span class="blank _1"> </span>i<span class="blank _3"> </span>c<span class="blank _3"> </span>a<span class="blank _1"> </span>m<span class="blank _3"> </span>e<span class="blank _3"> </span>n<span class="blank _1"> </span>t<span class="blank _3"> </span>e<span class="blank _3"> </span> <span class="blank _12"> </span>s<span class="blank _1"> </span>i<span class="blank _3"> </span>g<span class="blank _3"> </span>n<span class="blank _1"> </span>i<span class="blank _3"> </span>f<span class="blank _3"> </span>i<span class="blank _1"> </span>c<span class="blank _3"> </span>a<span class="blank _3"> </span>t<span class="blank _3"> </span>i<span class="blank _1"> </span>v<span class="blank _3"> </span>a<span class="blank _3"> </span> <span class="blank _12"> </span>c<span class="blank _1"> </span>o<span class="blank _3"> </span>m<span class="blank _1"> </span>p<span class="blank _3"> </span>a<span class="blank _3"> </span>r<span class="blank _3"> </span>a<span class="blank _1"> </span>d<span class="blank _3"> </span>a<span class="blank _3"> </span> <span class="blank _12"> </span>c<span class="blank _1"> </span>o<span class="blank _3"> </span>n<span class="blank _1"> </span> <span class="blank _12"> </span>l<span class="blank _3"> </span>a<span class="blank _1"> </span> </span></div><div class="t m0 x4 h8 y1d0 ff1 fs5 fc0 sc0 ls0 ws1">biológicas de <span class="blank _1"> </span>la <span class="blank _1"> </span>disfunción <span class="blank _1"> </span>serotoninérgica en <span class="blank _1"> </span>la <span class="blank _1"> </span>etiología <span class="blank _3a"> </span><span class="fs7 v7">63, <span class="blank _2"></span>71</span></div><div class="t m0 x8 h8 y1d1 ff1 fs5 fc0 sc0 ls0 ws1">medicación <span class="blank _c"></span>aislada.</div><div class="t m0 x4 h8 y1d2 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _6"> </span>la <span class="blank _a"> </span>AN, <span class="blank _7"> </span>el <span class="blank _7"> </span>uso <span class="blank _7"> </span>terapéutico <span class="blank _7"> </span>de <span class="blank _7"> </span>los <span class="blank _7"> </span>ISRS <span class="blank _6"> </span>sigue <span class="blank _7"> </span>siendo </div><div class="t m0 x4 h8 y1d3 ff1 fs5 fc0 sc0 ls0 ws1">controvertido. <span class="blank _1"> </span>Se han <span class="blank _1"> </span>publicado <span class="blank _1"> </span>estudios <span class="blank _1"> </span>clínicos <span class="blank _1"> </span>sobre <span class="blank _1"> </span>el </div><div class="t m0 x3f h1f y1d4 ff1 fs7 fc0 sc0 ls0 ws1">52, <span class="blank _3"> </span>53<span class="blank _3b"> </span><span class="fs5 v2">Se debe in<span class="blank _2"></span>form<span class="blank _2"></span>ar y vigi<span class="blank _2"></span>lar la in<span class="blank _2"></span>cidenc<span class="blank _2"></span>ia de pe<span class="blank _2"></span>nsamien<span class="blank _2"></span>tos y </span></div><div class="t m0 x4 h8 y1d5 ff1 fs5 fc0 sc0 ls0 ws1">uso de fluoxetina,<span class="blank _28"> </span> en <span class="blank _1"> </span>los que se sugiere <span class="blank _1"> </span>el uso de ISRS <span class="blank _15"> </span><span class="v13">compor<span class="blank _2"></span>tamien<span class="blank _2"></span>tos suicidas en <span class="blank _1"> </span>pacien<span class="blank _2"></span>tes tratados con ISRS, </span></div><div class="t m0 x4 h8 y1d6 ff1 fs5 fc0 sc0 ls0 ws1">para <span class="blank _7"> </span>la <span class="blank _7"> </span>restauración <span class="blank _7"> </span>del <span class="blank _7"> </span>peso, <span class="blank _7"> </span>pero <span class="blank _7"> </span>aclarando <span class="blank _7"> </span>que <span class="blank _9"> </span>debe <span class="blank _2b"> </span><span class="v13">además <span class="blank"> </span>del <span class="blank"> </span>riesgo <span class="blank _14"> </span>aumentad<span class="blank _2"></span>o <span class="blank _14"> </span>de <span class="blank _14"> </span>convulsione<span class="blank _2"></span>s <span class="blank _14"> </span>en <span class="blank _14"> </span>esta </span></div><div class="t m0 x4 h8 y1d7 ff1 fs5 fc0 sc0 ls0 ws1">sumarse <span class="blank"> </span>a <span class="blank"> </span>una <span class="blank _14"> </span>psicoterapia <span class="blank _14"> </span>cognitivo <span class="blank"> </span>conductual <span class="blank _14"> </span>y <span class="blank _14"> </span>no <span class="blank _3c"> </span><span class="fs7 v7">72</span></div><div class="t m0 x8 h8 y1d8 ff1 fs5 fc0 sc0 ls0 ws1">poblac<span class="blank _2"></span>ión. <span class="blank _f"> </span> La F<span class="blank _2"></span>DA<span class="blank _0"></span> recomiend<span class="blank _2"></span>a hac<span class="blank _2"></span>er esta s<span class="blank _2"></span>alveda<span class="blank _2"></span>d en e<span class="blank _2"></span>l </div><div class="t m0 x4 h8 y1d9 ff1 fs5 fc0 sc0 ls0 ws1">pretender <span class="blank _d"> </span>un <span class="blank _3"> </span>control <span class="blank _d"> </span>aislado <span class="blank _d"> </span>de <span class="blank _d"> </span>forma <span class="blank _d"> </span>farmacológica. <span class="blank _3"> </span>Lo <span class="blank _2b"> </span><span class="v6">consentim<span class="blank _2"></span>iento <span class="blank _1"> </span>inform<span class="blank _2"></span>ado <span class="blank _1"> </span>de <span class="blank _3"> </span>los <span class="blank _1"> </span>paciente<span class="blank _2"></span>s <span class="blank _1"> </span>y <span class="blank _3"> </span>sus <span class="blank _1"> </span>familias.<span class="blank _2"></span> </span></div><div class="t m0 x4 h8 y1da ff1 fs5 fc0 sc0 ls0 ws1">indicado <span class="blank _1"> </span>es <span class="blank _3"> </span>iniciar <span class="blank _3"> </span>el <span class="blank _3"> </span>tratamiento <span class="blank _3"> </span>con <span class="blank _3"> </span>ISRS <span class="blank _1"> </span>después <span class="blank _3"> </span>de <span class="blank _3"> </span>la <span class="blank _2b"> </span><span class="v6">Se ha sug<span class="blank _2"></span>erido q<span class="blank _2"></span>ue lo<span class="blank _2"></span>s pacie<span class="blank _2"></span>ntes <span class="blank _2"></span>con bul<span class="blank _2"></span>imia <span class="blank _2"></span>pueden <span class="blank _2"></span>sufri<span class="blank _2"></span>r </span></div><div class="t m0 x4 h8 y1db ff1 fs5 fc0 sc0 ls0 ws1">mejora <span class="blank _a"> </span>nutricional <span class="blank _6"> </span>para <span class="blank _a"> </span>restablecer <span class="blank _6"> </span>la <span class="blank _a"> </span>disponibilidad <span class="blank _a"> </span>del </div><div class="t m0 xf h7 y84 ff3 fs4 fc0 sc0 ls0">134</div><div class="t m0 x10 he y85 ff3 fs8 fc2 sc0 ls0 ws1">V<span class="blank _2"></span>ol. 12 Número 3, Diciembre de 2009</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x29 y1dc w5 h20" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg7.png"><div class="t m0 x29 h8 y1dd ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _0"></span>un <span class="blank _0"></span>de<span class="blank _2"></span>fecto <span class="blank _c"></span>en <span class="blank _0"></span>la <span class="blank _0"></span>modulaci<span class="blank _2"></span>ón <span class="blank _0"></span>ser<span class="blank _2"></span>otonin<span class="blank _2"></span>ér<span class="blank _2"></span>gica <span class="blank _0"></span>que <span class="blank _c"></span>conduce <span class="blank _13"> </span>ha <span class="blank _f"> </span>sid<span class="blank _1"> </span>o <span class="blank _f"> </span>contro<span class="blank _1"> </span>vertid<span class="blank _1"> </span>o <span class="blank _f"> </span>recientem<span class="blank _1"> </span>ente. <span class="blank _f"> </span>En <span class="blank _f"> </span>un <span class="blank _f"> </span>est<span class="blank _1"> </span>udio </div><div class="t m0 x29 h8 y1de ff1 fs5 fc0 sc0 ls0 ws1">a <span class="blank _10"> </span>una <span class="blank _f"> </span>defici<span class="blank _2"></span>ente <span class="blank _10"> </span>modulaci<span class="blank _2"></span>ón <span class="blank _10"> </span>de <span class="blank _f"> </span>impulso<span class="blank _2"></span>s <span class="blank _10"> </span>y <span class="blank _f"> </span>estad<span class="blank _2"></span>os <span class="blank _4"> </span>aleato<span class="blank _1"> </span>rizado<span class="blank _1"> </span>, <span class="blank _2"></span>el <span class="blank _2"></span>cual buscaba la <span class="blank _2"></span>efectivid<span class="blank _1"> </span>ad <span class="blank _2"></span>en <span class="blank _2"></span>los distintos </div><div class="t m0 x29 h8 y1df ff1 fs5 fc0 sc0 ls0 ws1">afecti<span class="blank _2"></span>vos, <span class="blank _0"></span>y <span class="blank _0"></span>a <span class="blank _0"></span>la <span class="blank _2"></span>la<span class="blank _2"></span>bilida<span class="blank _2"></span>d <span class="blank _0"></span>de <span class="blank _0"></span>su <span class="blank _2"></span>est<span class="blank _2"></span>ado <span class="blank _0"></span>de <span class="blank _0"></span>ánimo, <span class="blank _0"></span>aument<span class="blank _2"></span>o <span class="blank _0"></span>en <span class="blank _4"> </span>tratam<span class="blank _1"> </span>ientos <span class="blank"> </span>en <span class="blank _7"> </span>pac<span class="blank _1"> </span>ientes <span class="blank"> </span>con <span class="blank _6"> </span>AN, <span class="blank _9"> </span>expone <span class="blank"> </span>que <span class="blank _7"> </span>no <span class="blank"> </span>hay </div><div class="t m0 x29 h8 y1e0 ff1 fs5 fc0 sc0 ls0 ws1">su <span class="blank _0"></span>disforia <span class="blank _0"></span>con <span class="blank _0"></span>tendenci<span class="blank _2"></span>a <span class="blank _0"></span>a <span class="blank _2"></span>ser <span class="blank _0"></span>excesiv<span class="blank _2"></span>o <span class="blank _0"></span>cuando <span class="blank _0"></span>se <span class="blank _2"></span>som<span class="blank _2"></span>ete <span class="blank _0"></span>el <span class="blank _4"> </span>ven<span class="blank _1"> </span>tajas <span class="blank _0"></span>en <span class="blank _0"></span>el <span class="blank _c"></span>tra<span class="blank _1"> </span>tamien<span class="blank _1"> </span>to <span class="blank _0"></span>de <span class="blank _c"></span>pac<span class="blank _1"> </span>ientes <span class="blank _0"></span>hospit<span class="blank _1"> </span>alizad<span class="blank _1"> </span>os <span class="blank _0"></span>sobre </div><div class="t m0 x40 hb y1e1 ff1 fs7 fc0 sc0 ls0 ws1">73-76 <span class="blank _3d"> </span>81</div><div class="t m0 x29 h8 y1e2 ff1 fs5 fc0 sc0 ls0 ws1">cuerpo a <span class="blank _3"> </span>un <span class="blank _3"> </span>agotam<span class="blank _2"></span>iento de <span class="blank _3"> </span>triptófa<span class="blank _2"></span>no.<span class="blank _2b"> </span>No <span class="blank _1"> </span>hay <span class="blank _3"> </span>ensay<span class="blank _2"></span>os <span class="blank _4"> </span>el <span class="blank _3"> </span>tratam<span class="blank _1"> </span>iento <span class="blank _3"> </span>de <span class="blank _3"> </span>pacien<span class="blank _1"> </span>tes <span class="blank _3"> </span>ambula<span class="blank _1"> </span>torios<span class="blank _1"> </span>.<span class="blank _12"> </span>La <span class="blank _1"> </span>adm<span class="blank _1"> </span>isión <span class="blank _3"> </span>al </div><div class="t m0 x29 h8 y1e3 ff1 fs5 fc0 sc0 ls0 ws1">contro<span class="blank _2"></span>lados <span class="blank _7"> </span>de <span class="blank _9"> </span>la <span class="blank _7"> </span>eficacia <span class="blank _7"> </span>de <span class="blank"> </span>la<span class="blank _2"></span>s <span class="blank _7"> </span>benzodiace<span class="blank _2"></span>pinas <span class="blank _7"> </span>en <span class="blank"> </span>el <span class="blank _13"> </span>hospit<span class="blank _1"> </span>al es <span class="blank _1"> </span>una <span class="blank _1"> </span>dec<span class="blank _1"> </span>isión <span class="blank _1"> </span>clínic<span class="blank _1"> </span>a so<span class="blank _1"> </span>bre <span class="blank _1"> </span>la bas<span class="blank _1"> </span>e de <span class="blank _1"> </span>múltip<span class="blank _1"> </span>les </div><div class="t m0 x29 h8 y1e4 ff1 fs5 fc0 sc0 ls0 ws1">tratam<span class="blank _2"></span>iento <span class="blank _0"></span>de la <span class="blank _2"></span>BN, <span class="blank _0"></span>pues <span class="blank _2"></span>el <span class="blank _2"></span>uso <span class="blank _2"></span>de <span class="blank _0"></span>estos <span class="blank _2"></span>medica<span class="blank _2"></span>mentos <span class="blank _0"></span>es <span class="blank _4"> </span>fac<span class="blank _1"> </span>tores que <span class="blank _0"></span>deb<span class="blank _1"> </span>en <span class="blank _2"></span>inclui<span class="blank _1"> </span>r <span class="blank _2"></span>siempre el <span class="blank _0"></span>pac<span class="blank _1"> </span>iente <span class="blank _2"></span>y <span class="blank _2"></span>su <span class="blank _2"></span>familia, </div><div class="t m0 x29 h8 y1e5 ff1 fs5 fc0 sc0 ls0 ws1">limita<span class="blank _2"></span>do de<span class="blank _2"></span>bido a <span class="blank _2"></span>la re<span class="blank _2"></span>lación <span class="blank _2"></span>entre <span class="blank _2"></span>BN y <span class="blank _2"></span>trast<span class="blank _2"></span>orno de <span class="blank _2"></span>abuso <span class="blank _13"> </span>in<span class="blank _1"> </span>c<span class="blank _1"> </span>lu<span class="blank _1"> </span>so<span class="blank _1"> </span> <span class="blank _f"> </span>c<span class="blank _1"> </span>ua<span class="blank _1"> </span>n<span class="blank _1"> </span>do<span class="blank _1"> </span> <span class="blank _f"> </span>e<span class="blank _1"> </span>s <span class="blank _12"> </span>in<span class="blank _1"> </span>v<span class="blank _1"> </span>ol<span class="blank _1"> </span>un<span class="blank _1"> </span>ta<span class="blank _1"> </span>ri<span class="blank _1"> </span>a<span class="blank _1"> </span>. <span class="blank _12"> </span>Lo<span class="blank _1"> </span>s <span class="blank _12"> </span>cr<span class="blank _1"> </span>it<span class="blank _1"> </span>er<span class="blank _1"> </span>i<span class="blank _1"> </span>os <span class="blank _12"> </span>p<span class="blank _1"> </span>ar<span class="blank _1"> </span>a </div><div class="t m0 x3e hb y1e6 ff1 fs7 fc0 sc0 ls0 ws1">77, <span class="blank _0"></span>78<span class="blank _3e"> </span><span class="fs5 v9">consid<span class="blank _1"> </span>erar <span class="blank _6"> </span>el <span class="blank _a"> </span>ing<span class="blank _1"> </span>reso <span class="blank _6"> </span>al <span class="blank _a"> </span>hos<span class="blank _1"> </span>pital <span class="blank _6"> </span>se <span class="blank _6"> </span>resume<span class="blank _1"> </span>n <span class="blank _a"> </span>en <span class="blank _6"> </span>la <span class="blank _6"> </span>tabla </span></div><div class="t m0 x29 h8 y1e7 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _c"></span>sustancia<span class="blank _2"></span>s.</div><div class="t m0 x41 hb y1e8 ff1 fs7 fc0 sc0 ls0">81</div><div class="t m0 x9 h8 y1e9 ff1 fs5 fc0 sc0 ls0 ws15">tres.</div><div class="t m0 x9 h8 y1ea ff6 fs5 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>ratamiento <span class="blank _14"> </span>hospital <span class="blank _14"> </span>día<span class="ff1">. <span class="blank _b"> </span>El <span class="blank _b"> </span>programa <span class="blank"> </span>de <span class="blank _b"> </span>hospital <span class="blank _14"> </span>día </span></div><div class="t m0 x29 ha y1eb ff5 fs6 fc0 sc0 ls0 ws16">Psicoterapia<span class="blank"> </span><span class="ff1 fs5 ws1 v6">propone, <span class="blank _d"> </span>dentro <span class="blank _d"> </span>de <span class="blank _d"> </span>su <span class="blank _d"> </span>tratamiento, <span class="blank _3"> </span>que <span class="blank _d"> </span>el <span class="blank _a"> </span>paciente <span class="blank _3"> </span>pueda </span></div><div class="t m0 x9 h8 y1ec ff1 fs5 fc0 sc0 ls0 ws1">aprender <span class="blank _a"> </span>y <span class="blank _a"> </span>aplicar <span class="blank _d"> </span>las <span class="blank _a"> </span>enseñanzas <span class="blank _a"> </span>instauradas <span class="blank _a"> </span>en <span class="blank _a"> </span>torno <span class="blank _a"> </span>a </div><div class="t m0 x29 h8 y1ed ff1 fs5 fc0 sc0 ls0 ws1">A<span class="blank _0"></span> <span class="blank _14"> </span>pesar <span class="blank _14"> </span>de <span class="blank _14"> </span>la <span class="blank _14"> </span>alta <span class="blank _14"> </span>prevalencia <span class="blank _14"> </span>de <span class="blank _14"> </span>los <span class="blank _14"> </span>trastornos <span class="blank _14"> </span>de <span class="blank _14"> </span>la <span class="blank _4"> </span><span class="v14">situaciones <span class="blank _1"> </span>de <span class="blank _1"> </span>la <span class="blank _1"> </span>vida <span class="blank _1"> </span>cotidiana. <span class="blank _2"></span>Además de <span class="blank _1"> </span>los <span class="blank _1"> </span>beneficios </span></div><div class="t m0 x29 h8 y1ee ff1 fs5 fc0 sc0 ls0 ws1">conducta <span class="blank _2"></span>alimentaria, <span class="blank _0"></span>la <span class="blank _2"></span>literatura <span class="blank _0"></span>basada <span class="blank _2"></span>en <span class="blank _2"></span>la <span class="blank _0"></span>evidencia <span class="blank _2"></span>se <span class="blank _4"> </span><span class="v14">financieros, <span class="blank _25"> </span>este <span class="blank _10"> </span>tratamiento <span class="blank _10"> </span>posee <span class="blank _10"> </span>ventajas <span class="blank _10"> </span>sobre <span class="blank _10"> </span>la </span></div><div class="t m0 x29 h8 y1ef ff1 fs5 fc0 sc0 ls0 ws1">ve limitada y los resultados contradictorios de los estudios <span class="blank _26"> </span><span class="v14">atención <span class="blank _12"> </span>hospitalaria <span class="blank _12"> </span>como <span class="blank _12"> </span>permitir <span class="blank _f"> </span>a <span class="blank _12"> </span>los <span class="blank _12"> </span>pacientes </span></div><div class="t m0 x29 h8 y1f0 ff1 fs5 fc0 sc0 ls0 ws1">sobre <span class="blank _1"> </span>eficacia <span class="blank _3"> </span>psicofarmacológica <span class="blank _3"> </span>versus <span class="blank _3"> </span>psicoterapéutica <span class="blank _4"> </span><span class="v14">mantener <span class="blank _3"> </span>contacto <span class="blank _d"> </span>con <span class="blank _d"> </span>su <span class="blank _3"> </span>familia, <span class="blank _d"> </span>escuela, <span class="blank _3"> </span>compañeros <span class="blank _d"> </span>y </span></div><div class="t m0 x29 h8 y1f1 ff1 fs5 fc0 sc0 ls0 ws1">no arrojan resultados claros <span class="blank _1"> </span>sobre la superioridad de <span class="blank _1"> </span>una u <span class="blank _4"> </span><span class="v14">amigos. <span class="blank _0"></span>No <span class="blank _0"></span>obstante<span class="blank _2"></span>, <span class="blank _0"></span>solo <span class="blank _0"></span>se <span class="blank _0"></span>ha <span class="blank _0"></span>encontra<span class="blank _2"></span>do <span class="blank _0"></span>un <span class="blank _0"></span>estudio <span class="blank _c"></span>sobre </span></div><div class="t m0 x29 h8 y1f2 ff1 fs5 fc0 sc0 ls0 ws1">otra. <span class="blank _c"></span>Sin <span class="blank _0"></span>embargo, <span class="blank _c"></span>la <span class="blank _0"></span>psicoterapia, <span class="blank _c"></span>caracterizada <span class="blank _0"></span>por <span class="blank _c"></span>generar <span class="blank _3f"> </span><span class="fs7 vc">82</span></div><div class="t m0 x9 h8 y1f3 ff1 fs5 fc0 sc0 ls0 ws1">este <span class="blank _0"></span>tratamiento <span class="blank _c"></span>que <span class="blank _0"></span>toma <span class="blank _0"></span>tres <span class="blank _0"></span>instituciones,<span class="blank _f"> </span> <span class="blank _0"></span>en <span class="blank _0"></span>los <span class="blank _0"></span>Estados </div><div class="t m0 x29 h8 y1f4 ff1 fs5 fc0 sc0 ls0 ws1">hábitos <span class="blank _6"> </span>nutricionales <span class="blank _7"> </span>y <span class="blank _7"> </span>comportamentales <span class="blank _7"> </span>saludables, <span class="blank _7"> </span>se <span class="blank _4"> </span><span class="v16">Unidos, <span class="blank"> </span>en <span class="blank _14"> </span>Canadá <span class="blank _14"> </span>y <span class="blank _14"> </span>en <span class="blank"> </span>Alem<span class="blank _2"></span>ania <span class="blank"> </span>(una <span class="blank"> </span>en <span class="blank _b"> </span>cada <span class="blank"> </span>país, </span></div><div class="t m0 x29 h8 y1f5 ff1 fs5 fc0 sc0 ls0 ws1">considera <span class="blank _a"> </span>un <span class="blank _6"> </span>tratamiento <span class="blank _a"> </span>prometedor <span class="blank _6"> </span>(al <span class="blank _a"> </span>menos <span class="blank _6"> </span>para <span class="blank _a"> </span>los </div><div class="t m0 x42 h21 y1f6 ff1 fs7 fc0 sc0 ls0 ws1">79, <span class="blank"> </span>80<span class="blank _40"> </span><span class="fs5 v3">respectivame<span class="blank _2"></span>nte). <span class="blank _3"> </span>Los <span class="blank _d"> </span>resultados <span class="blank _d"> </span>en <span class="blank _3"> </span>estos <span class="blank _d"> </span>lugares <span class="blank _3"> </span>indican </span></div><div class="t m0 x29 h8 y1f7 ff1 fs5 fc0 sc0 ls0 ws1">pacientes <span class="blank _3"> </span>menos <span class="blank _d"> </span>graves).<span class="blank _2b"> </span><span class="ff5 lsa"> </span>A<span class="blank _2"></span> <span class="blank _3"> </span>continuación <span class="blank _d"> </span>se <span class="blank _3"> </span>presentan <span class="blank _4"> </span><span class="v14">que <span class="blank _d"> </span>el <span class="blank _d"> </span>programa <span class="blank _3"> </span>hospital <span class="blank _d"> </span>día <span class="blank _d"> </span>proporcionó <span class="blank _3"> </span>un <span class="blank _d"> </span>aumento <span class="blank _d"> </span>de </span></div><div class="t m0 x29 h8 y1f8 ff1 fs5 fc0 sc0 ls0 ws1">las <span class="blank _c"></span>diferentes <span class="blank _0"></span>psicoterapias <span class="blank _c"></span>descritas <span class="blank _0"></span>en <span class="blank _c"></span>la <span class="blank _c"></span>literatura.<span class="blank _41"> </span><span class="v14">peso <span class="blank _0"></span>significativ<span class="blank _2"></span>o <span class="blank _0"></span>y <span class="blank _0"></span>una <span class="blank _2"></span>mejo<span class="blank _2"></span>ra <span class="blank _0"></span>en <span class="blank _0"></span>la <span class="blank _0"></span>psicopatología <span class="blank _0"></span>general </span></div><div class="t m0 x9 h8 y1f9 ff1 fs5 fc0 sc0 ls0 ws1">y espe<span class="blank _2"></span>cífica <span class="blank _2"></span>en <span class="blank _2"></span>paciente<span class="blank _2"></span>s <span class="blank _2"></span>con <span class="blank _0"></span>AN <span class="blank _2"></span>al <span class="blank _2"></span>instaurar <span class="blank _2"></span>talleres <span class="blank _0"></span>en los </div><div class="t m0 x9 h8 y1fa ff1 fs5 fc0 sc0 ls0 ws1">que <span class="blank _2"></span>se <span class="blank _2"></span>instruye <span class="blank _0"></span>acerca <span class="blank _2"></span>del <span class="blank _2"></span>régimen <span class="blank _0"></span>nutricional, <span class="blank _0"></span>se refuerza<span class="blank _2"></span>n </div><div class="t m0 x29 h8 y1fb ff5 fs5 fc0 sc0 ls0 ws1">Anorexia <span class="blank"> </span>nerviosa.<span class="ff1"> <span class="blank"> </span>Existen <span class="blank"> </span>varias <span class="blank _14"> </span>alternativas <span class="blank _14"> </span>en <span class="blank _14"> </span>este </span></div><div class="t m0 x9 h8 y1fc ff1 fs5 fc0 sc0 ls0 ws1">positivament<span class="blank _2"></span>e <span class="blank _a"> </span>conductas <span class="blank _a"> </span>autoprotectoras <span class="blank _a"> </span>del <span class="blank _a"> </span>cuerpo <span class="blank _a"> </span>y <span class="blank _6"> </span>se </div><div class="t m0 x29 h8 y1fd ff1 fs5 fc0 sc0 ls0 ws1">aspecto. </div><div class="t m0 x9 h8 y1fe ff1 fs5 fc0 sc0 ls0 ws1">educa <span class="blank _d"> </span>al <span class="blank _a"> </span>paciente <span class="blank _a"> </span>en <span class="blank _d"> </span>autoreconocimiento <span class="blank _d"> </span>corporal, <span class="blank _a"> </span>de <span class="blank _d"> </span>tal </div><div class="t m0 x9 h8 y1ff ff1 fs5 fc0 sc0 ls0 ws1">forma <span class="blank _2"></span>que <span class="blank _2"></span>este <span class="blank _2"></span>pueda <span class="blank _2"></span>mejorar <span class="blank _0"></span>su autoesti<span class="blank _2"></span>ma y <span class="blank _2"></span>reco<span class="blank _2"></span>nocer <span class="blank _2"></span>su </div><div class="t m0 x29 h8 y200 ff6 fs5 fc0 sc0 ls0 ws1">Pacien<span class="blank _1"> </span>tes <span class="blank _14"> </span>hos<span class="blank _1"> </span>pitali<span class="blank _1"> </span>zados<span class="blank _1"> </span>.<span class="ff5 lsb"> </span><span class="ff1">Especi<span class="blank _1"> </span>alment<span class="blank _1"> </span>e <span class="blank"> </span>en <span class="blank _b"> </span>Europa<span class="blank _1"> </span>, <span class="blank"> </span>el </span></div><div class="t m0 x9 h8 y201 ff1 fs5 fc0 sc0 ls0 ws1">cuerpo <span class="blank _0"></span>como <span class="blank _2"></span>único <span class="blank _0"></span>y <span class="blank _2"></span>propio <span class="blank _0"></span>(alejándolo <span class="blank _0"></span>de <span class="blank _2"></span>figuras <span class="blank _0"></span>externas </div><div class="t m0 x29 h8 y202 ff1 fs5 fc0 sc0 ls0 ws1">tratam<span class="blank _1"> </span>iento <span class="blank _7"> </span>de <span class="blank _6"> </span>pac<span class="blank _1"> </span>ientes <span class="blank _7"> </span>hos<span class="blank _1"> </span>pitali<span class="blank _1"> </span>zados <span class="blank _7"> </span>se <span class="blank _7"> </span>consid<span class="blank _1"> </span>era <span class="blank _7"> </span>de </div><div class="t m0 x9 h8 y203 ff1 fs5 fc0 sc0 ls0 ws1">que <span class="blank _0"></span>desee <span class="blank _c"></span>copiar). <span class="blank _0"></span>En <span class="blank _c"></span>la <span class="blank _0"></span>tabla <span class="blank _0"></span>4 <span class="blank _c"></span>se <span class="blank _0"></span>enuncian <span class="blank _0"></span>los <span class="blank _c"></span>criterios <span class="blank _0"></span>para </div><div class="t m0 x29 h8 y204 ff1 fs5 fc0 sc0 ls0 ws1">elecci<span class="blank _1"> </span>ón <span class="blank"> </span>para <span class="blank"> </span>pacientes <span class="blank"> </span>jóv<span class="blank _1"> </span>enes <span class="blank"> </span>con <span class="blank _7"> </span>AN <span class="blank"> </span>quienes <span class="blank"> </span>están </div><div class="t m0 x18 hb y205 ff1 fs7 fc0 sc0 ls0">83</div><div class="t m0 x9 h8 y206 ff1 fs5 fc0 sc0 ls0 ws1">tratamiento <span class="blank _e"></span>en <span class="blank _0"></span>modalida<span class="blank _2"></span>d <span class="blank _c"></span>hospital <span class="blank _c"></span>día.<span class="blank _12"> </span> </div><div class="t m0 x29 h8 y207 ff1 fs5 fc0 sc0 ls0 ws1">gravem<span class="blank _1"> </span>ente desnut<span class="blank _1"> </span>ridos,. Sin emb<span class="blank _1"> </span>argo, este punto de vista </div><div class="t m0 x29 h4 ydc ff2 fs2 fc0 sc0 ls0 ws1"> <span class="blank _c"></span>T<span class="blank _2"></span>abla <span class="blank _c"></span>3. <span class="blank _c"></span><span class="ff3">Criterios <span class="blank _0"></span>para <span class="blank _c"></span>ingreso <span class="blank _0"></span>hospitalario <span class="blank _c"></span>en <span class="blank _0"></span>adolescentes <span class="blank _c"></span>con <span class="blank _c"></span>anorexia <span class="blank _0"></span>nerviosa.</span></div><div class="t m0 x29 h4 y208 ff2 fs2 fc0 sc0 ls0 ws1"> <span class="blank _c"></span>T<span class="blank _2"></span>abla <span class="blank _c"></span>4.<span class="ff3"> <span class="blank _c"></span>Criterios <span class="blank _0"></span>para <span class="blank _c"></span>tratamiento <span class="blank _0"></span>en <span class="blank _c"></span>modalidad <span class="blank _0"></span>hospital <span class="blank _c"></span>día.</span></div><div class="t m0 x28 h22 y209 ff8 fsc fc0 sc0 ls0 ws1">BMI menor del percentil tres </div><div class="t m0 x28 h22 y20a ff8 fsc fc0 sc0 ls0 ws1">Rápida pérdida de peso, bajo aporte calórico </div><div class="t m0 x28 h22 y20b ff8 fsc fc0 sc0 ls0 ws1">Rehúsa a beber </div><div class="t m0 x43 h7 yd9 ff3 fs4 fc0 sc0 ls0">135</div><div class="t m0 x0 h6 yda ff3 fs3 fc2 sc0 ls0 ws1">T<span class="blank _2"></span>rastornos de la conducta alimentaria en niños y adolescentes</div><div class="t m1 x44 h23 y20c ff8 fsd fc0 sc0 ls0 ws1"> </div><div class="t m1 x45 h23 y20d ff8 fsd fc0 sc0 ls0 ws1">El paciente no consigue la normalización alimentaria adecuada manteniéndose fuera de </div><div class="t m1 x45 h23 y20e ff8 fsd fc0 sc0 ls0 ws1">control la frecuencia de vómitos, atracones o conductas restrictivas</div><div class="t m1 x45 h23 y20f ff8 fsd fc0 sc0 ls0 ws1">Falta de apoyo familiar<span class="blank _34"> </span>adecuado para establecer las pautas del tratamiento ambulatorio</div><div class="t m1 x45 h23 y210 ff8 fsd fc0 sc0 ls0 ws1">Falta el apoyo familiar adecuado para establecer la pautas del tratamiento ambulatorio</div><div class="t m1 x45 h23 y211 ff8 fsd fc0 sc0 ls0 ws1">La enfermedad interfiere con las tareas cotidianas del paciente (estudios, trabajo, etc)</div><div class="t m0 x2b h24 y212 ff8 fs5 fc0 sc0 ls0">é</div><div class="t m0 x46 h24 y213 ff8 fs5 fc0 sc0 ls0">í</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x4 y214 w6 h25" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg8.png"><div class="t m0 x47 h8 y215 ff6 fs5 fc0 sc0 ls0 ws1">Enfoque <span class="blank _a"> </span>multimodal.<span class="ff5 lsc"> </span><span class="ff1">Aunque <span class="blank _6"> </span>aún <span class="blank _a"> </span>no <span class="blank _6"> </span>se <span class="blank _6"> </span>ha <span class="blank _a"> </span>evaluado <span class="blank _6"> </span>en </span></div><div class="t m0 x47 h8 y216 ff1 fs5 fc0 sc0 ls0 ws1">ensayos <span class="blank _2"></span>controlados, <span class="blank _2"></span>hay <span class="blank _0"></span>cierta evidencia <span class="blank _0"></span>clínica <span class="blank _2"></span>de <span class="blank _2"></span>que <span class="blank _2"></span>un </div><div class="t m0 x47 h8 y217 ff1 fs5 fc0 sc0 ls0 ws1">p<span class="blank _3"> </span>r<span class="blank _1"> </span>o<span class="blank _3"> </span>g<span class="blank _3"> </span>r<span class="blank _3"> </span>a<span class="blank _3"> </span>m<span class="blank _3"> </span>a<span class="blank _3"> </span> <span class="blank _12"> </span>d<span class="blank _1"> </span>e<span class="blank _3"> </span> <span class="blank _12"> </span>t<span class="blank _3"> </span>r<span class="blank _1"> </span>a<span class="blank _3"> </span>t<span class="blank _3"> </span>a<span class="blank _3"> </span>m<span class="blank _3"> </span>i<span class="blank _3"> </span>e<span class="blank _3"> </span>n<span class="blank _3"> </span>t<span class="blank _3"> </span>o<span class="blank _1"> </span> <span class="blank _12"> </span>m<span class="blank _3"> </span>u<span class="blank _3"> </span>l<span class="blank _3"> </span>t<span class="blank _3"> </span>i<span class="blank _1"> </span>d<span class="blank _3"> </span>i<span class="blank _3"> </span>s<span class="blank _3"> </span>c<span class="blank _3"> </span>i<span class="blank _3"> </span>p<span class="blank _3"> </span>l<span class="blank _3"> </span>i<span class="blank _1"> </span>n<span class="blank _3"> </span>a<span class="blank _3"> </span>r<span class="blank _3"> </span> <span class="blank _12"> </span>e<span class="blank _3"> </span>n<span class="blank _3"> </span> <span class="blank _f"> </span>l<span class="blank _3"> </span>a<span class="blank _3"> </span> </div><div class="t m0 x47 h8 y218 ff1 fs5 fc0 sc0 ls0 ws1">hospitalización <span class="blank _14"> </span>del <span class="blank _b"> </span>paciente <span class="blank _b"> </span>es <span class="blank _b"> </span>un <span class="blank _b"> </span>método <span class="blank _b"> </span>eficaz <span class="blank _b"> </span>para </div><div class="t m0 x47 h8 y219 ff1 fs5 fc0 sc0 ls0 ws1">restablecer <span class="blank _b"> </span>un <span class="blank _b"> </span>peso <span class="blank _b"> </span>corporal <span class="blank _b"> </span>saludable <span class="blank _b"> </span>y <span class="blank _b"> </span>lograr <span class="blank _8"> </span>mejor </div><div class="t m0 x47 h8 y21a ff1 fs5 fc0 sc0 ls0 ws1">funcionamiento <span class="blank _7"> </span>psicológico <span class="blank"> </span>y <span class="blank _7"> </span>adecuado <span class="blank"> </span>funcionamiento </div><div class="t m0 x47 h8 y21b ff1 fs5 fc0 sc0 ls0 ws1">social. <span class="blank _6"> </span>Los <span class="blank _6"> </span>componentes <span class="blank _6"> </span>principales <span class="blank _6"> </span>de <span class="blank _6"> </span>este <span class="blank _6"> </span>tratamiento </div><div class="t m0 x48 hb y21c ff1 fs7 fc0 sc0 ls0">81</div><div class="t m0 x47 h8 y21d ff1 fs5 fc0 sc0 ls0 ws1">multimodal <span class="blank _c"></span>se <span class="blank _0"></span>exponen <span class="blank _c"></span>en <span class="blank _0"></span>la <span class="blank _c"></span>tabla <span class="blank _c"></span>5.</div><div class="t m0 x47 h8 y21e ff6 fs5 fc0 sc0 ls0 ws1">Psicoterapia <span class="blank"> </span>individual.<span class="ff5 lsd"> </span><span class="ff1">Prácticamente <span class="blank"> </span>no <span class="blank"> </span>hay <span class="blank"> </span>estudios </span></div><div class="t m0 x47 h8 y21f ff1 fs5 fc0 sc0 ls0 ws1">cont<span class="blank _1"> </span>rola<span class="blank _1"> </span>dos <span class="blank _12"> </span>so<span class="blank _1"> </span>bre <span class="blank _12"> </span>la <span class="blank _12"> </span>efec<span class="blank _1"> </span>tivi<span class="blank _1"> </span>dad <span class="blank _12"> </span>de<span class="blank _1"> </span> <span class="blank _12"> </span>la <span class="blank _12"> </span>psic<span class="blank _1"> </span>oter<span class="blank _1"> </span>apia<span class="blank _1"> </span> </div><div class="t m0 x47 h8 y220 ff1 fs5 fc0 sc0 ls0 ws1">individual <span class="blank _7"> </span>en <span class="blank"> </span>los <span class="blank _7"> </span>adolescentes. <span class="blank _7"> </span>De <span class="blank"> </span>cualquier <span class="blank _7"> </span>modo, <span class="blank"> </span>los </div><div class="t m0 x47 h8 y221 ff1 fs5 fc0 sc0 ls0 ws1">posibles <span class="blank _2"></span>planteamientos <span class="blank _2"></span>terapéuticos <span class="blank _0"></span>en este <span class="blank _0"></span>grupo de <span class="blank _2"></span>edad </div><div class="t m0 x47 h8 y222 ff1 fs5 fc0 sc0 ls0 ws1">comprenden <span class="blank"> </span>terapia <span class="blank _14"> </span>conductual <span class="blank _14"> </span>(TC), <span class="blank _14"> </span>terapia <span class="blank _14"> </span>cognitivo </div><div class="t m0 x47 h8 y223 ff1 fs5 fc0 sc0 ls0 ws1">analítica <span class="blank _18"> </span>(TCA), <span class="blank _1a"> </span>terapia <span class="blank _18"> </span>cognitiva <span class="blank _1a"> </span>de <span class="blank _18"> </span>comportamiento </div><div class="t m0 x49 hb y224 ff1 fs7 fc0 sc0 ls0 ws1">84 </div><div class="t m0 x47 h8 y225 ff1 fs5 fc0 sc0 ls0 ws1">(TCdC) <span class="blank _0"></span>y <span class="blank _2"></span>psicoterapia <span class="blank _0"></span>interpersonal <span class="blank _2"></span>(PIP).<span class="blank _42"> </span>V<span class="blank _c"></span>arios <span class="blank _2"></span>de <span class="blank _0"></span>estos </div><div class="t m0 x47 h8 y226 ff1 fs5 fc0 sc0 ls0 ws1">estudios <span class="blank _3"> </span>se <span class="blank _3"> </span>centraron <span class="blank _d"> </span>en <span class="blank _3"> </span>la <span class="blank _1"> </span>TCdC, <span class="blank _d"> </span>que <span class="blank _3"> </span>ha <span class="blank _3"> </span>demostrado <span class="blank _3"> </span>ser </div><div class="t m0 x47 h8 y227 ff1 fs5 fc0 sc0 ls0 ws1">eficaz <span class="blank _b"> </span>en <span class="blank _8"> </span>el <span class="blank _8"> </span>tratamiento <span class="blank _b"> </span>de <span class="blank _8"> </span>la <span class="blank _8"> </span>BN <span class="blank _8"> </span>(una <span class="blank _b"> </span>revisión <span class="blank _8"> </span>más </div><div class="t m0 x47 h8 y228 ff1 fs5 fc0 sc0 ls0 ws1">profunda <span class="blank _7"> </span>de <span class="blank _7"> </span>esta <span class="blank _7"> </span>modalidad <span class="blank _7"> </span>de <span class="blank _7"> </span>tratamiento <span class="blank _7"> </span>se <span class="blank _7"> </span>da <span class="blank _7"> </span>en <span class="blank _7"> </span>el </div><div class="t m0 x47 h8 y229 ff1 fs5 fc0 sc0 ls0 ws1">estudio <span class="blank _2"></span>de <span class="blank _2"></span>Schmidt <span class="blank _2"></span>et <span class="blank _2"></span>al) <span class="blank _0"></span>a diferencia <span class="blank _2"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>AN, <span class="blank _2"></span>en <span class="blank _2"></span>la <span class="blank _2"></span>que <span class="blank _2"></span>la </div><div class="t m0 x47 h8 y22a ff1 fs5 fc0 sc0 ls0 ws1">TCdC <span class="blank _6"> </span>no <span class="blank _6"> </span>tiene <span class="blank _6"> </span>ninguna <span class="blank _6"> </span>ventaja <span class="blank _a"> </span>frente <span class="blank _6"> </span>a <span class="blank _6"> </span>otras <span class="blank _6"> </span>clases <span class="blank _6"> </span>de </div><div class="t m0 x47 h8 y22b ff1 fs5 fc0 sc0 ls0 ws1">tratamiento. <span class="blank _14"> </span>En <span class="blank _b"> </span>esta <span class="blank _14"> </span>modalidad <span class="blank _b"> </span>terapéutica <span class="blank _b"> </span>se <span class="blank _14"> </span>enseñan <span class="blank _4"> </span><span class="ff6 va">Psicoterapia <span class="blank _0"></span>grupal.<span class="ff5"> <span class="blank _2"></span><span class="ff1">Esta <span class="blank _0"></span>terapia <span class="blank _0"></span>permite <span class="blank _0"></span>que <span class="blank _2"></span>se <span class="blank _0"></span>compartan </span></span></span></div><div class="t m0 x47 h8 y22c ff1 fs5 fc0 sc0 ls0 ws1">algunas <span class="blank _a"> </span>estrategias <span class="blank _d"> </span>y <span class="blank _a"> </span>habilidades <span class="blank _a"> </span>de <span class="blank _a"> </span>afrontamiento <span class="blank _a"> </span>útiles <span class="blank _13"> </span><span class="va">pensamientos, <span class="blank _d"> </span>sentimientos <span class="blank _d"> </span>y <span class="blank _3"> </span>temores <span class="blank _d"> </span>con <span class="blank _d"> </span>otras <span class="blank _3"> </span>personas </span></div><div class="t m0 x4a hb y22d ff1 fs7 fc0 sc0 ls0 ws1"> <span class="blank _2"></span>83<span class="blank _43"> </span><span class="fs5 vb">que <span class="blank _8"> </span>entiendan <span class="blank _18"> </span>esta <span class="blank _18"> </span>experiencia. <span class="blank _18"> </span>Es <span class="blank _8"> </span>conducida <span class="blank _18"> </span>por <span class="blank _18"> </span>un </span></div><div class="t m0 x47 h8 y22e ff1 fs5 fc0 sc0 ls0 ws1">para <span class="blank _c"></span>los <span class="blank _0"></span>pacientes, <span class="blank _c"></span>las <span class="blank _0"></span>cuales <span class="blank _c"></span>se <span class="blank _c"></span>encuentran <span class="blank _0"></span>en <span class="blank _c"></span>la <span class="blank _0"></span>tabla <span class="blank _c"></span>6.</div><div class="t m0 x4b h8 y22f ff1 fs5 fc0 sc0 ls0 ws1">t<span class="blank _1"> </span>e<span class="blank _3"> </span>r<span class="blank _1"> </span>a<span class="blank _3"> </span>p<span class="blank _1"> </span>e<span class="blank _3"> </span>u<span class="blank _1"> </span>t<span class="blank _3"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>p<span class="blank _3"> </span>r<span class="blank _1"> </span>o<span class="blank _3"> </span>f<span class="blank _1"> </span>e<span class="blank _3"> </span>s<span class="blank _1"> </span>i<span class="blank _3"> </span>o<span class="blank _1"> </span>n<span class="blank _3"> </span>a<span class="blank _1"> </span>l<span class="blank _3"> </span> <span class="blank _12"> </span>q<span class="blank _1"> </span>u<span class="blank _3"> </span>e<span class="blank _1"> </span> <span class="blank _12"> </span>a<span class="blank _1"> </span>y<span class="blank _3"> </span>u<span class="blank _1"> </span>d<span class="blank _3"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>a<span class="blank _3"> </span> <span class="blank _f"> </span>c<span class="blank _3"> </span>o<span class="blank _1"> </span>n<span class="blank _3"> </span>s<span class="blank _1"> </span>e<span class="blank _3"> </span>r<span class="blank _1"> </span>v<span class="blank _3"> </span>a<span class="blank _3"> </span>r<span class="blank _1"> </span> <span class="blank _12"> </span>l<span class="blank _1"> </span>a<span class="blank _3"> </span> </div><div class="t m0 x4b h8 y230 ff1 fs5 fc0 sc0 ls0 ws1">concentración del <span class="blank _2"></span>grupo <span class="blank _2"></span>y en <span class="blank _2"></span>ella, los <span class="blank _2"></span>participantes <span class="blank _2"></span>pueden </div><div class="t m0 x4b h8 y231 ff1 fs5 fc0 sc0 ls0 ws1">hablar <span class="blank _d"> </span>de <span class="blank _d"> </span>la <span class="blank _a"> </span>alimentación <span class="blank _d"> </span>y <span class="blank _d"> </span>de <span class="blank _d"> </span>las <span class="blank _d"> </span>maneras <span class="blank _a"> </span>de <span class="blank _d"> </span>cambiarla </div><div class="t m0 x4b h8 y232 ff1 fs5 fc0 sc0 ls0 ws1">tanto <span class="blank _c"></span>como <span class="blank _0"></span>de <span class="blank _c"></span>los <span class="blank _0"></span>conflictos <span class="blank _c"></span>subyacentes. </div><div class="t m0 x4b h8 y233 ff1 fs5 fc0 sc0 ls0 ws1">Los <span class="blank _f"> </span>miembros <span class="blank _f"> </span>del <span class="blank _f"> </span>grupo <span class="blank _f"> </span>pueden <span class="blank _f"> </span>ayudar <span class="blank _12"> </span>ofreciendo </div><div class="t m0 x4b h8 y234 ff1 fs5 fc0 sc0 ls0 ws1">mutuamente <span class="blank _0"></span>estímulo, <span class="blank _c"></span>apoyo <span class="blank _0"></span>y <span class="blank _c"></span>empatía, <span class="blank _0"></span>lo <span class="blank _0"></span>cual <span class="blank _c"></span>enriquece <span class="blank _0"></span>el </div><div class="t m0 x4b h8 y235 ff1 fs5 fc0 sc0 ls0 ws1">experimentada <span class="blank _d"> </span>por <span class="blank _3"> </span>estas <span class="blank _d"> </span>personas\u201d. <span class="blank _d"> </span>Muchos <span class="blank _3"> </span>estudios <span class="blank _d"> </span>han </div><div class="t m0 x4b h8 y236 ff1 fs5 fc0 sc0 ls0 ws1">demostrado <span class="blank _0"></span>la <span class="blank _2"></span>asociación <span class="blank _0"></span>entre <span class="blank _0"></span>la <span class="blank _2"></span>patología <span class="blank _0"></span>alimentaria <span class="blank _0"></span>con </div><div class="t m0 x4c hb y237 ff1 fs7 fc0 sc0 ls0">87</div><div class="t m0 x4b h8 y238 ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _c"></span>imagen <span class="blank _0"></span>corporal <span class="blank _c"></span>perturbada<span class="blank _12"> </span>. </div><div class="t m0 x4b h8 y239 ff1 fs5 fc0 sc0 ls0 ws1">Más <span class="blank _2"></span>allá <span class="blank _0"></span>de <span class="blank _2"></span>eso, <span class="blank _2"></span>una <span class="blank _0"></span>imagen corporal <span class="blank _0"></span>negativa <span class="blank _2"></span>parece <span class="blank _2"></span>jugar </div><div class="t m0 x4b h8 y23a ff1 fs5 fc0 sc0 ls0 ws1">un <span class="blank _2"></span>papel <span class="blank _2"></span>importante <span class="blank _2"></span>en el <span class="blank _0"></span>desarrollo y <span class="blank _2"></span>mantenimiento <span class="blank _2"></span>de <span class="blank _2"></span>la </div><div class="t m0 x4b h8 y23b ff1 fs5 fc0 sc0 ls0 ws1">AN. <span class="blank _a"> </span>Aunque <span class="blank _6"> </span>se <span class="blank _7"> </span>han <span class="blank _6"> </span>desarrollado <span class="blank _7"> </span>programas <span class="blank _7"> </span>específicos </div><div class="t m0 x4b h8 y23c ff1 fs5 fc0 sc0 ls0 ws1">enfocados <span class="blank _1a"> </span>a <span class="blank _1a"> </span>la <span class="blank _25"> </span>imagen <span class="blank _1a"> </span>corporal, <span class="blank _25"> </span>hay <span class="blank _1a"> </span>pocos <span class="blank _25"> </span>estudios </div><div class="t m0 x4b h8 y23d ff1 fs5 fc0 sc0 ls0 ws1">controlados <span class="blank _1"> </span>aleatorizados <span class="blank _3"> </span>para <span class="blank _1"> </span>adolescentes <span class="blank _3"> </span>y <span class="blank _1"> </span>adultos <span class="blank _3"> </span>con </div><div class="t m0 x4b h8 y23e ff1 fs5 fc0 sc0 ls0 ws1">trastornos <span class="blank _f"> </span>en <span class="blank _f"> </span>la <span class="blank _12"> </span>alimentación. <span class="blank _f"> </span>La <span class="blank _f"> </span>terapia <span class="blank _f"> </span>cognitivo-</div><div class="t m0 x4b h8 y23f ff1 fs5 fc0 sc0 ls0 ws1">conductual <span class="blank _8"> </span>de <span class="blank _18"> </span>la <span class="blank _18"> </span>imagen <span class="blank _8"> </span>corporal <span class="blank _18"> </span>incluye: <span class="blank _8"> </span>terapia <span class="blank _18"> </span>de </div><div class="t m0 x4b h8 y240 ff1 fs5 fc0 sc0 ls0 ws1">exposición corporal a través <span class="blank _1"> </span>de desensibilización (\u201chágalo </div><div class="t m0 x4b h8 y241 ff1 fs5 fc0 sc0 ls0 ws1">usted <span class="blank _0"></span>mismo\u201d), <span class="blank _0"></span>ejercicios <span class="blank _0"></span>y <span class="blank _0"></span>exposición <span class="blank _0"></span>al <span class="blank _0"></span>espejo <span class="blank _0"></span>por <span class="blank _0"></span>tiempo </div><div class="t m0 x4b h8 y242 ff1 fs5 fc0 sc0 ls0 ws1">prolongado. <span class="blank _c"></span>Además, <span class="blank _0"></span>las <span class="blank _2"></span>técnicas <span class="blank _0"></span>cognitivas <span class="blank _0"></span>que <span class="blank _2"></span>se <span class="blank _0"></span>utilizan </div><div class="t m0 x4b h8 y243 ff1 fs5 fc0 sc0 ls0 ws1">para <span class="blank _12"> </span>identificar <span class="blank _12"> </span>y <span class="blank _12"> </span>modificar <span class="blank _12"> </span>pensamientos <span class="blank _12"> </span>negativos </div><div class="t m0 x4b h8 y244 ff1 fs5 fc0 sc0 ls0 ws1">relacionados <span class="blank _18"> </span>con <span class="blank _18"> </span>el <span class="blank _18"> </span>cuerpo. <span class="blank _18"> </span>En <span class="blank _18"> </span>general, <span class="blank _18"> </span>perder <span class="blank _18"> </span>peso, </div><div class="t m0 x4b h8 y245 ff1 fs5 fc0 sc0 ls0 ws1">independientemente <span class="blank _2"></span>del <span class="blank _0"></span>TCA<span class="blank _0"></span> del <span class="blank _0"></span>que <span class="blank _2"></span>se <span class="blank _2"></span>trate, <span class="blank _0"></span>se traduce <span class="blank _0"></span>en </div><div class="t m0 x4b h8 y246 ff1 fs5 fc0 sc0 ls0 ws1">un<span class="blank _1"> </span>a <span class="blank _12"> </span>est<span class="blank _1"> </span>ra<span class="blank _1"> </span>te<span class="blank _1"> </span>gia<span class="blank _1"> </span> <span class="blank _12"> </span>de <span class="blank _12"> </span>co<span class="blank _1"> </span>nt<span class="blank _1"> </span>rol<span class="blank _1"> </span> <span class="blank _12"> </span>por<span class="blank _1"> </span> <span class="blank _12"> </span>la <span class="blank _12"> </span>cu<span class="blank _1"> </span>al<span class="blank _1"> </span> <span class="blank _f"> </span>s<span class="blank _1"> </span>e <span class="blank _12"> </span>pr<span class="blank _1"> </span>od<span class="blank _1"> </span>uce<span class="blank _1"> </span> </div><div class="t m0 x4b h8 y247 ff1 fs5 fc0 sc0 ls0 ws1">reforzamiento <span class="blank _2"></span>positivo <span class="blank _2"></span>para <span class="blank _2"></span>la persona <span class="blank _0"></span>de alguna <span class="blank _2"></span>o <span class="blank _2"></span>algunas </div><div class="t m0 x4d hb y248 ff1 fs7 fc0 sc0 ls0">88</div><div class="t m0 x4b h8 y249 ff1 fs5 fc0 sc0 ls0 ws1">de <span class="blank _c"></span>las <span class="blank _0"></span>maneras <span class="blank _c"></span>como <span class="blank _0"></span>muestra <span class="blank _c"></span>la <span class="blank _c"></span>tabla <span class="blank _0"></span>7.</div><div class="t m0 x35 hb y24a ff1 fs7 fc0 sc0 ls0">85</div><div class="t m0 x47 h8 y24b ff6 fs5 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>erapia <span class="blank _0"></span>de imagen <span class="blank _2"></span>corporal.<span class="ff5"> <span class="blank _0"></span><span class="ff1">Bruch<span class="blank _12"> </span> es <span class="blank _0"></span>acreditado como <span class="blank _0"></span>la </span></span></div><div class="t m0 x47 h8 y24c ff1 fs5 fc0 sc0 ls0 ws1">primera <span class="blank _b"> </span>persona <span class="blank _14"> </span>en <span class="blank _b"> </span>definir <span class="blank _b"> </span>que <span class="blank _b"> </span>los <span class="blank _b"> </span>pacientes <span class="blank _b"> </span>con <span class="blank"> </span>AN </div><div class="t m0 x47 h8 y24d ff1 fs5 fc0 sc0 ls0 ws1">generan <span class="blank _b"> </span>una <span class="blank _8"> </span>distorsión <span class="blank _8"> </span>perceptiva <span class="blank _8"> </span>y <span class="blank _b"> </span>conceptual <span class="blank _8"> </span>de <span class="blank _8"> </span>su </div><div class="t m0 x4e hb y24e ff1 fs7 fc0 sc0 ls0 ws1">86 </div><div class="t m0 x47 h8 y24f ff1 fs5 fc0 sc0 ls0 ws1">imagen <span class="blank _2"></span>corporal. <span class="blank _2"></span>En <span class="blank _0"></span>el DSM-IV<span class="blank _e"></span>,<span class="blank _44"> </span>se <span class="blank _2"></span>define <span class="blank _2"></span>la <span class="blank _0"></span>distorsión de </div><div class="t m0 x47 h8 y250 ff1 fs5 fc0 sc0 ls0 ws1">la <span class="blank _12"> </span>imag<span class="blank _1"> </span>en <span class="blank _12"> </span>corpor<span class="blank _1"> </span>al <span class="blank _12"> </span>como<span class="blank _1"> </span> <span class="blank _f"> </span>\u201cu<span class="blank _1"> </span>na <span class="blank _12"> </span>pert<span class="blank _1"> </span>urba<span class="blank _1"> </span>ción <span class="blank _12"> </span>en <span class="blank _12"> </span>la<span class="blank _1"> </span> </div><div class="t m0 x47 h8 y251 ff1 fs5 fc0 sc0 ls0 ws1">percepción <span class="blank _a"> </span>de <span class="blank _a"> </span>la <span class="blank _a"> </span>imagen <span class="blank _a"> </span>corporal <span class="blank _6"> </span>o <span class="blank _a"> </span>la <span class="blank _a"> </span>figura, <span class="blank _a"> </span>la <span class="blank _a"> </span>cual <span class="blank _a"> </span>es </div><div class="t m0 x16 h7 y84 ff3 fs4 fc0 sc0 ls0">136</div><div class="t m0 x47 h4 y252 ff2 fs2 fc0 sc0 ls0 ws1"> <span class="blank _c"></span>T<span class="blank _2"></span>abla <span class="blank _c"></span>5.<span class="ff3"> <span class="blank _c"></span>Enfoque <span class="blank _0"></span>de <span class="blank _c"></span>tratamiento <span class="blank _0"></span>multimodal</span></div><div class="t m0 x4f h4 y253 ff2 fs2 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>abla <span class="blank _0"></span>6.<span class="ff3"> <span class="blank _e"></span>Adquisición <span class="blank _c"></span>de <span class="blank _c"></span>estrategias <span class="blank _0"></span>y <span class="blank _c"></span>habilidades <span class="blank _0"></span>de <span class="blank _c"></span>afrontamiento</span></div><div class="t m0 x50 h26 y254 ff8 fse fc0 sc0 ls0 ws1">2. <span class="blank _2"></span>Asesoramiento nutricional para restablecer un comportamiento de alimentación saludable</div><div class="t m0 x50 h26 y255 ff8 fse fc0 sc0 ls0 ws1">4. T<span class="blank _c"></span>erapia grupal</div><div class="t m0 x50 h27 y256 ff8 fsf fc0 sc0 ls0 ws1">Para <span class="blank _d"> </span>modificar los rituales y obsesiones respecto a la comida. Ejemplo: ritual anoréxico (hacer múltiples pequeños </div><div class="t m0 x50 h27 y257 ff8 fsf fc0 sc0 ls0 ws1">trozos con los alimentos, <span class="blank _14"> </span>extenderlos en el plato, jugar con ellos, etc.)</div><div class="t m0 x50 h27 y258 ff8 fsf fc0 sc0 ls0 ws1">Para <span class="blank _d"> </span>recuperar las relaciones sociales.<span class="blank _d"> </span> En estos pacientes<span class="blank"> </span>, <span class="blank"> </span>las relaciones sociales se han alterado notablemente.</div><div class="t m0 x50 h27 y259 ff8 fsf fc0 sc0 ls0 ws1">El aislamiento social es muy frecuente: los amigos han desaparecido.</div><div class="t m0 x50 h27 y25a ff8 fsf fc0 sc0 ls0 ws1">Enseñarles a <span class="blank _6"> </span>afrontar<span class="blank _8"> </span>los problemas cotidianos<span class="blank"> </span>. Hay que evitar que la comida se convierta en el \u201crefugio\u201d de la </div><div class="t m0 x50 h27 y25b ff8 fsf fc0 sc0 ls0 ws1">frustración que le ocasiona la incapacidad para afrontarlos. Hay que demostrar al paciente que los problemas se </div><div class="t m0 x50 h27 y25c ff8 fsf fc0 sc0 ls0 ws1">pueden resolver sin necesidad de adoptar actitudes que amenacen su salud.</div><div class="t m0 x50 h27 y25d ff8 fsf fc0 sc0 ls0 ws1">Mejorar el nivel de <span class="blank"> </span>expresión de los sentimientos <span class="blank _14"> </span>y comunicación con el entorno familiar. </div><div class="t m0 x50 h27 y25e ff8 fsf fc0 sc0 ls0 ws1">Entrenamiento en técnicas de habilidades sociales y de a<span class="blank _1"> </span>utoestima <span class="blank _a"> </span>que posibilitará la recuperación de estos pacientes.</div><div class="t m0 x10 he y85 ff3 fs8 fc2 sc0 ls0 ws1">V<span class="blank _2"></span>ol. 12 Número 3, Diciembre de 2009</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf9" class="pf w0 h0" data-page-no="9"><div class="pc pc9 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1b y25f w7 h28" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bg9.png"><div class="t m0 x0 h8 y260 ff1 fs5 fc0 sc0 ls0 ws1">proceso <span class="blank _2"></span>de <span class="blank _0"></span>recuperación. <span class="blank _2"></span>En <span class="blank _0"></span>la <span class="blank _2"></span>terapia <span class="blank _2"></span>grupal <span class="blank _0"></span>se <span class="blank _2"></span>consideran <span class="blank _4"> </span>no <span class="blank _18"> </span>reconocen <span class="blank _8"> </span>cómo <span class="blank _18"> </span>los <span class="blank _18"> </span>padres <span class="blank _18"> </span>desempeñan <span class="blank _18"> </span>un <span class="blank _8"> </span>papel </div><div class="t m0 x0 h8 y261 ff1 fs5 fc0 sc0 ls0 ws1">los <span class="blank _c"></span>siguientes <span class="blank _0"></span>objetivos:<span class="blank _45"> </span>importante <span class="blank _0"></span>en <span class="blank _c"></span>la <span class="blank _0"></span>enfermedad <span class="blank _0"></span>de <span class="blank _c"></span>sus <span class="blank _0"></span>hijos <span class="blank _0"></span>y<span class="blank _0"></span>, <span class="blank _c"></span>de <span class="blank _0"></span>hecho, <span class="blank _0"></span>uno <span class="blank _0"></span>de </div><div class="t m0 x12 h8 y262 ff1 fs5 fc0 sc0 ls0 ws1">los <span class="blank _2"></span>primeros <span class="blank _2"></span>debates <span class="blank _2"></span>de <span class="blank _2"></span>la <span class="blank _2"></span>literatura <span class="blank _2"></span>fue <span class="blank _2"></span>si <span class="blank _2"></span>era posible <span class="blank _0"></span>tratar </div><div class="t m0 x12 h8 y263 ff1 fs5 fc0 sc0 ls0 ws1">al <span class="blank _d"> </span>paciente <span class="blank _d"> </span>sin <span class="blank _a"> </span>aislarlo <span class="blank _d"> </span>de <span class="blank _d"> </span>su <span class="blank _a"> </span>familia. <span class="blank _d"> </span>Durante <span class="blank _d"> </span>la <span class="blank _d"> </span>primera </div><div class="t m0 x0 h8 y264 ff1 fs5 fc0 sc0 ls0 ws1">1. <span class="blank _c"></span>Relatar <span class="blank _0"></span>los <span class="blank _c"></span>hábitos <span class="blank _0"></span>alimentarios <span class="blank _c"></span>anómalos <span class="blank _c"></span>propios.</div><div class="t m0 x12 h8 y265 ff1 fs5 fc0 sc0 ls0 ws1">mitad del siglo <span class="blank _2"></span>XX, la familia <span class="blank _2"></span>seguía siendo <span class="blank _2"></span>vista como un </div><div class="t m0 x0 h8 y266 ff1 fs5 fc0 sc0 ls0 ws1">2. <span class="blank _a"> </span>Relatar <span class="blank _a"> </span>los <span class="blank _a"> </span>conflictos <span class="blank _a"> </span>de <span class="blank _a"> </span>cada <span class="blank _a"> </span>uno <span class="blank _6"> </span>frente <span class="blank _a"> </span>a <span class="blank _a"> </span>la <span class="blank _a"> </span>imagen </div><div class="t m0 x51 hb y267 ff1 fs7 fc0 sc0 ls0 ws1">79, 92</div><div class="t m0 x0 h29 y268 ff1 fs5 fc0 sc0 ls0 ws17">corporal.<span class="blank"> </span><span class="ws1 v0">obstáculo <span class="blank _0"></span>para <span class="blank _0"></span>el <span class="blank _0"></span>tratamiento,<span class="blank _26"> </span> <span class="blank _0"></span>lo <span class="blank _0"></span>cual <span class="blank _0"></span>llevó <span class="blank _0"></span>a <span class="blank _2"></span>la <span class="blank _0"></span>exclusión </span></div><div class="t m0 x52 hb y269 ff1 fs7 fc0 sc0 ls0">80</div><div class="t m0 x0 h8 y26a ff1 fs5 fc0 sc0 ls0 ws1">3. <span class="blank _3"> </span>Comprender <span class="blank _3"> </span>e <span class="blank _3"> </span>interiorizar <span class="blank _3"> </span>la <span class="blank _d"> </span>relación <span class="blank _1"> </span>entre <span class="blank _d"> </span>autoestima, <span class="blank _13"> </span><span class="va">familiar <span class="blank _0"></span>en <span class="blank _0"></span>la <span class="blank _0"></span>terapéutica.<span class="blank _12"> </span> <span class="blank _0"></span>No <span class="blank _0"></span>obstante, <span class="blank _0"></span>hasta <span class="blank _0"></span>1960, <span class="blank _0"></span>autores </span></div><div class="t m0 x53 hb y26b ff1 fs7 fc0 sc0 ls0 ws1">93, 94 <span class="blank _46"> </span>95, 96</div><div class="t m0 x0 h8 y26c ff1 fs5 fc0 sc0 ls0 ws1">interés desproporcionado <span class="blank _2"></span>por <span class="blank _2"></span>el control, <span class="blank _2"></span>imagen corporal <span class="blank _2"></span>y <span class="blank _13"> </span><span class="v1">como <span class="blank _2"></span>Brush, <span class="blank _2"></span>Palazzoli<span class="blank _2b"> </span>y<span class="blank _0"></span>, <span class="blank _2"></span>en <span class="blank _0"></span>particular, <span class="blank _0"></span>Minuchin<span class="blank _26"> </span> <span class="blank _2"></span>dan </span></div><div class="t m0 x0 h8 y26d ff1 fs5 fc0 sc0 ls0 ws1">hábitos <span class="blank _c"></span>alimenticios.<span class="blank _47"> </span><span class="v1">un <span class="blank _1"> </span>giro <span class="blank _3"> </span>al <span class="blank _3"> </span>pensamiento <span class="blank _3"> </span>sobre <span class="blank _1"> </span>el <span class="blank _3"> </span>papel <span class="blank _3"> </span>de <span class="blank _1"> </span>la <span class="blank _3"> </span>familia <span class="blank _3"> </span>en <span class="blank _3"> </span>los </span></div><div class="t m0 x0 h8 y26e ff1 fs5 fc0 sc0 ls0 ws1">4. <span class="blank _1"> </span> <span class="blank _0"></span>Reconocer <span class="blank _2"></span>los <span class="blank _0"></span>complejos <span class="blank _0"></span>afectivos <span class="blank _0"></span>ligados <span class="blank _2"></span>a <span class="blank _0"></span>la <span class="blank _0"></span>conducta <span class="blank _4"> </span><span class="v1">trastornos <span class="blank _6"> </span>de <span class="blank _6"> </span>la <span class="blank _6"> </span>alimentación, <span class="blank _6"> </span>postulando <span class="blank _6"> </span>que <span class="blank _6"> </span>la <span class="blank _6"> </span>familia </span></div><div class="t m0 x0 h8 y26f ff1 fs5 fc0 sc0 ls0 ws18">anormal.<span class="blank"> </span><span class="ws1 v1">posee <span class="blank _1"> </span>mecanismos <span class="blank _3"> </span>específicos <span class="blank _3"> </span>que <span class="blank _3"> </span>sustentan <span class="blank _1"> </span>el <span class="blank _3"> </span>desarrollo </span></div><div class="t m0 x0 h8 y270 ff1 fs5 fc0 sc0 ls0 ws1">5. <span class="blank _d"> </span>Educar <span class="blank _a"> </span>en <span class="blank _a"> </span>conceptos <span class="blank _d"> </span>básicos <span class="blank _a"> </span>sobre <span class="blank _d"> </span>nutrición, <span class="blank _a"> </span>metabo-<span class="blank _5"> </span><span class="v1">de <span class="blank _3"> </span>la AN. <span class="blank _3"> </span>Desde <span class="blank _3"> </span>los <span class="blank _3"> </span>primeros <span class="blank _3"> </span>trabajos <span class="blank _1"> </span>de <span class="blank _3"> </span>Minuchin <span class="blank _3"> </span>y <span class="blank _3"> </span>sus </span></div><div class="t m0 x0 h8 y271 ff1 fs5 fc0 sc0 ls0 ws1">lismo <span class="blank _c"></span>y <span class="blank _0"></span>ejercicio.<span class="blank _48"> </span><span class="v1">colegas, <span class="blank _2"></span>algunos <span class="blank _0"></span>de <span class="blank _2"></span>los <span class="blank _2"></span>otros <span class="blank _0"></span>pioneros cifran <span class="blank _0"></span>el <span class="blank _2"></span>campo <span class="blank _2"></span>de <span class="blank _0"></span>la </span></div><div class="t m0 x54 hb y272 ff1 fs7 fc0 sc0 ls0 ws1">97<span class="blank _49"> </span>98 </div><div class="t m0 x0 h8 y273 ff1 fs5 fc0 sc0 ls0 ws1">6. <span class="blank _1"> </span> <span class="blank _2"></span>Reconocer <span class="blank _0"></span>aquellos <span class="blank _0"></span>factores <span class="blank _2"></span>que <span class="blank _0"></span>provocan <span class="blank _0"></span>una <span class="blank _2"></span>conducta <span class="blank _13"> </span><span class="v2">terapia <span class="blank _1a"> </span>familiar<span class="blank _2"></span>, <span class="blank _18"> </span>como <span class="blank _1a"> </span>Palazzoli,<span class="blank _12"> </span> <span class="blank _18"> </span>Stierlin, <span class="blank _18"> </span>W<span class="blank _0"></span>eber,<span class="blank _4a"> </span>y </span></div><div class="t m0 x55 hb y274 ff1 fs7 fc0 sc0 ls0">99</div><div class="t m0 x0 h8 y275 ff1 fs5 fc0 sc0 ls0 ws1">alimentaria <span class="blank _c"></span>anormal. <span class="blank _4b"> </span><span class="v3">Blanco.<span class="blank _f"> </span> <span class="blank _1"> </span>La <span class="blank _1"> </span>terapia <span class="blank _1"> </span>familiar <span class="blank _1"> </span>se <span class="blank _1"> </span>ha <span class="blank _1"> </span>ido <span class="blank _1"> </span>consolidando <span class="blank _1"> </span>como </span></div><div class="t m0 x0 h8 y276 ff1 fs5 fc0 sc0 ls0 ws1">7. <span class="blank _3"> </span>Identificar <span class="blank _d"> </span>las <span class="blank _3"> </span>dificultades <span class="blank _3"> </span>interpersonales <span class="blank _d"> </span>relacionadas <span class="blank _4"> </span><span class="v3">un <span class="blank _6"> </span>importante <span class="blank _6"> </span>método <span class="blank _a"> </span>de <span class="blank _6"> </span>tratamiento <span class="blank _6"> </span>para <span class="blank _6"> </span>adolescentes, </span></div><div class="t m0 x0 h8 y277 ff1 fs5 fc0 sc0 ls0 ws1">con <span class="blank _c"></span>el <span class="blank _0"></span>trastorno <span class="blank _c"></span>alimentario. <span class="blank _4c"> </span><span class="v3">apoyado <span class="blank _1a"> </span>por <span class="blank _1a"> </span>una <span class="blank _1a"> </span>creciente <span class="blank _1a"> </span>evidencia <span class="blank _1a"> </span>empírica <span class="blank _1a"> </span>de <span class="blank _1a"> </span>su </span></div><div class="t m0 x12 h8 y278 ff1 fs5 fc0 sc0 ls0 ws1">eficacia. <span class="blank _c"></span>Aunque <span class="blank _2"></span>el <span class="blank _0"></span>papel <span class="blank _2"></span>del <span class="blank _0"></span>medio <span class="blank _2"></span>ambiente <span class="blank _0"></span>familiar <span class="blank _2"></span>en <span class="blank _0"></span>la </div><div class="t m0 x0 h8 y279 ff6 fs5 fc0 sc0 ls0 ws1">Intervenciones basadas <span class="blank _1"> </span>en <span class="blank _1"> </span>la familia.<span class="ff5 lse"> </span><span class="ff1">Las <span class="blank _1"> </span>opiniones <span class="blank _1"> </span>sobre <span class="blank _4"> </span><span class="v17">etiología <span class="blank _3"> </span>de <span class="blank _d"> </span>los <span class="blank _3"> </span>trastornos <span class="blank _3"> </span>de <span class="blank _d"> </span>la <span class="blank _3"> </span>alimentación <span class="blank _3"> </span>no <span class="blank _d"> </span>es <span class="blank _3"> </span>claro, </span></span></div><div class="t m0 x4b hb y27a ff1 fs7 fc0 sc0 ls0">89</div><div class="t m0 x0 h8 y27b ff1 fs5 fc0 sc0 ls0 ws1">el rol <span class="blank _1"> </span>de <span class="blank _1"> </span>los padres <span class="blank _1"> </span>en la AN han variado <span class="blank _1"> </span>desde <span class="blank _1"> </span>Lasegue,<span class="blank _f"> </span> <span class="blank _26"> </span><span class="v18">hay menos <span class="blank _1"> </span>dudas de <span class="blank _1"> </span>que la <span class="blank _1"> </span>presencia de <span class="blank _1"> </span>un <span class="blank _1"> </span>trastorno de <span class="blank _1"> </span>la </span></div><div class="t m0 x0 h8 y27c ff1 fs5 fc0 sc0 ls0 ws1">neutral <span class="blank _0"></span>(la <span class="blank _0"></span>inclusión <span class="blank _0"></span>de <span class="blank _0"></span>este <span class="blank _0"></span>término <span class="blank _0"></span>no <span class="blank _0"></span>es <span class="blank _0"></span>clara) <span class="blank _0"></span>teniendo <span class="blank _0"></span>en <span class="blank _4"> </span><span class="v18">alimentación <span class="blank _1"> </span>tiene <span class="blank _3"> </span>un <span class="blank _1"> </span>impacto <span class="blank _3"> </span>importante <span class="blank _1"> </span>en <span class="blank _3"> </span>la <span class="blank _1"> </span>vida <span class="blank _3"> </span>de <span class="blank _1"> </span>la </span></div><div class="t m0 x56 hb y27d ff1 fs7 fc0 sc0 ls0 ws19">90<span class="blank"> </span><span class="v18">100</span></div><div class="t m0 x0 h8 y27e ff1 fs5 fc0 sc0 ls0 ws1">cuenta las <span class="blank _2"></span>preocupaciones de <span class="blank _2"></span>los familiares, <span class="blank _2"></span>a Gull,<span class="blank _f"> </span> quien <span class="blank _13"> </span><span class="v18">familia<span class="blank _4d"> </span>. En <span class="blank _1"> </span>consecuencia, las rutinas <span class="blank _1"> </span>diarias familiares <span class="blank _1"> </span>y </span></div><div class="t m0 x0 h8 y27f ff1 fs5 fc0 sc0 ls0 ws1">tiene <span class="blank _0"></span>en <span class="blank _2"></span>cuenta <span class="blank _0"></span>los <span class="blank _2"></span>padres <span class="blank _0"></span>como <span class="blank _0"></span>''el <span class="blank _2"></span>peor <span class="blank _0"></span>de <span class="blank _2"></span>los <span class="blank _0"></span>asistentes <span class="blank _0"></span>en <span class="blank _4"> </span><span class="v18">las <span class="blank"> </span>conductas <span class="blank _7"> </span>de <span class="blank _7"> </span>resolución <span class="blank"> </span>de <span class="blank _7"> </span>problemas <span class="blank _7"> </span>comienzan <span class="blank"> </span>a </span></div><div class="t m0 x2b hb y280 ff1 fs7 fc0 sc0 ls0">91</div><div class="t m0 x0 h8 y281 ff1 fs5 fc0 sc0 ls0 ws1">general'', <span class="blank _a"> </span>y <span class="blank _a"> </span>Charcot,<span class="blank _12"> </span> <span class="blank _a"> </span>que <span class="blank _6"> </span>pensaba <span class="blank _a"> </span>que <span class="blank _a"> </span>su <span class="blank _6"> </span>influencia <span class="blank _a"> </span>era <span class="blank _4"> </span><span class="v19">afectarlo <span class="blank _d"> </span>todo. <span class="blank _a"> </span>En <span class="blank _d"> </span>la <span class="blank _d"> </span>tabla <span class="blank _d"> </span>8 <span class="blank _d"> </span>se <span class="blank _a"> </span>exponen <span class="blank _d"> </span>los <span class="blank _d"> </span>objetivos <span class="blank _d"> </span>de </span></div><div class="t m0 x1a hb y282 ff1 fs7 fc0 sc0 ls0">83</div><div class="t m0 x0 h8 y283 ff1 fs5 fc0 sc0 ls0 ws1">\u201cparticularmente <span class="blank _0"></span>perniciosa\u201d. <span class="blank _2"></span>Estas <span class="blank _0"></span>primeras <span class="blank _2"></span>descripciones <span class="blank _4"> </span><span class="v18">estas <span class="blank _c"></span>intervenciones <span class="blank _0"></span>basadas <span class="blank _c"></span>en <span class="blank _0"></span>la <span class="blank _c"></span>familia.<span class="blank _12"> </span> </span></div><div class="t m0 x29 h4 y284 ff2 fs2 fc0 sc0 ls0 ws1"> <span class="blank _c"></span>T<span class="blank _2"></span>abla <span class="blank _c"></span>7.<span class="ff3"> <span class="blank _c"></span>Reforzamientos <span class="blank _0"></span>positivo <span class="blank _c"></span>y <span class="blank _0"></span>negativo.</span></div><div class="t m0 x29 h4 y285 ff2 fs2 fc0 sc0 ls0 ws1"> <span class="blank _c"></span>T<span class="blank _2"></span>abla <span class="blank _c"></span>8.<span class="ff3"> <span class="blank _c"></span>Objetivos <span class="blank _0"></span>de <span class="blank _c"></span>las <span class="blank _0"></span>intervenciones <span class="blank _c"></span>basadas <span class="blank _0"></span>en <span class="blank _c"></span>la <span class="blank _c"></span>familia<span class="ff2">.</span></span></div><div class="t m0 x57 h2a y286 ff7 fs10 fc0 sc0 ls0 ws1">Reforzamiento negativo</div><div class="t m0 x58 h2b y287 ff8 fs10 fc0 sc0 ls0 ws1">Se aísla para evitar las críticas que hacen los demás de </div><div class="t m0 x58 h2b y288 ff8 fs10 fc0 sc0 ls0 ws1">su aspecto físico, su conducta desadaptativa, o su </div><div class="t m0 x58 h2b y289 ff8 fs10 fc0 sc0 ls0">enfermedad.</div><div class="t m0 x58 h2b y28a ff8 fs10 fc0 sc0 ls0 ws1">Disminuye la probabilidad de sentir malestar al no </div><div class="t m0 x58 h2b y28b ff8 fs10 fc0 sc0 ls0 ws1">comer o evitar las situaciones en las que, generalmente,</div><div class="t m0 x58 h2b y28c ff8 fs10 fc0 sc0 ls0 ws1">la interacción supone alimentarse.</div><div class="t m0 x58 h2b y28d ff8 fs10 fc0 sc0 ls0 ws1">La evidencia de la disminución ponderal</div><div class="t m0 x58 h2b y28e ff8 fs10 fc0 sc0 ls0 ws1">aminora <span class="blank _a"> </span>su ansiedad <span class="blank _d"> </span>ante la idea de que está con </div><div class="t m0 x58 h2b y28f ff8 fs10 fc0 sc0 ls0">sobrepeso.</div><div class="t m0 x59 h23 y290 ff9 fsd fc0 sc0 ls0 ws1">\uf0b7 <span class="blank _0"></span><span class="ff8">Abordar <span class="blank _0"></span>los <span class="blank _0"></span>aspectos <span class="blank _c"></span>diagnósticos <span class="blank _0"></span>de <span class="blank _0"></span>la <span class="blank _0"></span>enfermedad, <span class="blank _0"></span>sus </span></div><div class="t m0 x5a h23 y291 ff8 fsd fc0 sc0 ls0 ws1">causas, así como las posibles complicaciones, su curso </div><div class="t m0 x5a h23 y292 ff8 fsd fc0 sc0 ls0 ws1">evolutivo <span class="blank _0"></span>y <span class="blank _c"></span>las <span class="blank _0"></span>posibilidades <span class="blank _0"></span>de <span class="blank _c"></span>curación <span class="blank _0"></span>definitiva.</div><div class="t m0 x59 h23 y293 ff9 fsd fc0 sc0 ls0 ws1">\uf0b7 <span class="blank _d"> </span><span class="ff8">Proporcionar <span class="blank _a"> </span>pautas <span class="blank _a"> </span>encaminadas <span class="blank _a"> </span>a <span class="blank _d"> </span>la <span class="blank _a"> </span>adquisición <span class="blank _a"> </span>de </span></div><div class="t m0 x5a h23 y294 ff8 fsd fc0 sc0 ls0 ws1">hábitos <span class="blank _0"></span>saludables.</div><div class="t m0 x5b h23 y290 ff9 fsd fc0 sc0 ls0 ws1">\uf0b7 <span class="blank _c"></span><span class="ff8">Calmar <span class="blank _0"></span>la <span class="blank _0"></span>ansiedad <span class="blank _0"></span>de <span class="blank _c"></span>los <span class="blank _0"></span>padres.</span></div><div class="t m0 x5b h23 y295 ff9 fsd fc0 sc0 ls0 ws1">\uf0b7 <span class="blank _c"></span><span class="ff8">Depurar <span class="blank _0"></span>los <span class="blank _0"></span>sentimientos <span class="blank _0"></span>de <span class="blank _c"></span>culpa<span class="ff9">.</span></span></div><div class="t m0 x36 h7 yd9 ff3 fs4 fc0 sc0 ls0">137</div><div class="t m0 x0 h6 yda ff3 fs3 fc2 sc0 ls0 ws1">T<span class="blank _2"></span>rastornos de la conducta alimentaria en niños y adolescentes</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pfa" class="pf w0 h0" data-page-no="a"><div class="pc pca w0 h0"><img fetchpriority="low" loading="lazy" class="bi x4 y1dc w5 h2c" alt="" src="https://files.passeidireto.com/12cfe341-b235-4d56-8f0a-c1a774aafe2e/bga.png"><div class="t m0 x2b hb y296 ff1 fs7 fc0 sc0 ls0 ws1">100 <span class="blank _4e"> </span><span class="fs5 v9">meses. <span class="blank _0"></span>La <span class="blank _0"></span>terapia <span class="blank _0"></span>de <span class="blank _0"></span>Fairburn <span class="blank _0"></span>se <span class="blank _0"></span>divide <span class="blank _0"></span>en <span class="blank _0"></span>tres <span class="blank _0"></span>etapas, <span class="blank _0"></span>cuyas </span></div><div class="t m0 x4 h8 y297 ff5 fs5 fc0 sc0 ls0 ws1">Bulim<span class="blank _2"></span>ia <span class="blank _0"></span>nerviosa<span class="blank _2"></span><span class="ff1 wsc">.<span class="ff5 ws1"> <span class="blank _0"></span><span class="ff1">Bolton,<span class="blank _4f"> </span>en <span class="blank _0"></span>una <span class="blank _0"></span>reflexió<span class="blank _2"></span>n <span class="blank _0"></span>sobre <span class="blank _0"></span>la <span class="blank _0"></span>teoría </span></span></span></div><div class="t m0 x5c hb y298 ff1 fs7 fc0 sc0 ls0">108</div><div class="t m0 x4 h8 y299 ff1 fs5 fc0 sc0 ls0 ws1">y <span class="blank _2"></span>el <span class="blank _2"></span>de<span class="blank _2"></span>sarroll<span class="blank _2"></span>o <span class="blank _2"></span>de <span class="blank _0"></span>la te<span class="blank _2"></span>rapia <span class="blank _0"></span>cognitivo <span class="blank _0"></span>conductu<span class="blank _2"></span>al <span class="blank _2"></span>para <span class="blank _0"></span>niños <span class="blank _4"> </span>pautas <span class="blank _c"></span>básicas <span class="blank _0"></span>resumimos <span class="blank _c"></span>seguidamente.</div><div class="t m0 x4 h8 y29a ff1 fs5 fc0 sc0 ls0 ws1">y <span class="blank"> </span>adolescen<span class="blank _2"></span>tes, <span class="blank"> </span>sugiere <span class="blank"> </span>que <span class="blank"> </span>una <span class="blank"> </span>forma <span class="blank"> </span>de <span class="blank"> </span>expresar <span class="blank"> </span>las <span class="blank _13"> </span><span class="ff5 wsc v14">Pica</span><span class="v14">. <span class="blank _7"> </span>No <span class="blank _6"> </span>hay <span class="blank _7"> </span>un <span class="blank _6"> </span>tratamiento <span class="blank _7"> </span>definitivo <span class="blank _6"> </span>para <span class="blank _7"> </span>la <span class="blank _7"> </span>pica. <span class="blank _6"> </span>El </span></div><div class="t m0 x4 h8 y29b ff1 fs5 fc0 sc0 ls0 ws1">princi<span class="blank _2"></span>pales <span class="blank"> </span>hipótesis <span class="blank"> </span>de <span class="blank _b"> </span>trabajo <span class="blank _14"> </span>de <span class="blank _b"> </span>la <span class="blank _b"> </span>terapia <span class="blank"> </span>cognitiva <span class="blank _13"> </span><span class="v14">primer <span class="blank _0"></span>paso <span class="blank _c"></span>es <span class="blank _0"></span>determinar <span class="blank _0"></span>su <span class="blank _c"></span>causa; <span class="blank _0"></span>entre <span class="blank _c"></span>éstas <span class="blank _0"></span>encontramos </span></div><div class="t m0 x4 h8 y29c ff1 fs5 fc0 sc0 ls0 ws1">conduc<span class="blank _2"></span>tual <span class="blank _c"></span>(TCC) <span class="blank _c"></span>es <span class="blank _c"></span>la <span class="blank _0"></span>valo<span class="blank _2"></span>ración <span class="blank _e"></span>o <span class="blank _0"></span>el <span class="blank _c"></span>sentido <span class="blank _c"></span>asignad<span class="blank _2"></span>o <span class="blank _c"></span>a <span class="blank _0"></span>los <span class="blank _13"> </span><span class="v14">abandono <span class="blank _0"></span>y <span class="blank _0"></span>maltrato, <span class="blank _c"></span>y <span class="blank _0"></span>corregir <span class="blank _c"></span>esas <span class="blank _0"></span>circunstancias. <span class="blank _c"></span>Se <span class="blank _0"></span>debe </span></div><div class="t m0 x4 h8 y29d ff1 fs5 fc0 sc0 ls0 ws1">estím<span class="blank _2"></span>ulos, <span class="blank _d"> </span>o <span class="blank _d"> </span>la <span class="blank _a"> </span>form<span class="blank _2"></span>a <span class="blank _d"> </span>en <span class="blank _a"> </span>que <span class="blank _d"> </span>están <span class="blank _d"> </span>repr<span class="blank _2"></span>esent<span class="blank _2"></span>ados, <span class="blank _d"> </span>ya <span class="blank _d"> </span>que <span class="blank _4"> </span><span class="v14">eliminar <span class="blank _b"> </span>el <span class="blank _b"> </span>contacto <span class="blank _b"> </span>con <span class="blank _14"> </span>sustancias <span class="blank _b"> </span>tóxicas, <span class="blank _b"> </span>como <span class="blank _b"> </span>por </span></div><div class="t m0 x4 h8 y29e ff1 fs5 fc0 sc0 ls0 ws1">éstas <span class="blank _1a"> </span>son <span class="blank _25"> </span>críticas <span class="blank _1a"> </span>en <span class="blank _10"> </span>la <span class="blank _25"> </span>regula<span class="blank _2"></span>ción <span class="blank _1a"> </span>del <span class="blank _25"> </span>afecto <span class="blank _25"> </span>y <span class="blank _25"> </span>del <span class="blank _4"> </span><span class="v14">ejemplo el <span class="blank _2"></span>plomo. <span class="blank _2"></span>Se <span class="blank _2"></span>centra <span class="blank _2"></span>básicamente <span class="blank _2"></span>en la <span class="blank _0"></span>educación y </span></div><div class="t m0 x4 h8 y29f ff1 fs5 fc0 sc0 ls0 ws1">compor<span class="blank _2"></span>tamien<span class="blank _2"></span>to. <span class="blank"> </span>De <span class="blank"> </span>esto <span class="blank _14"> </span>se <span class="blank _14"> </span>desprende <span class="blank"> </span>que <span class="blank"> </span>para <span class="blank"> </span>poder <span class="blank _13"> </span><span class="v14">modificación <span class="blank _3"> </span>de <span class="blank _3"> </span>la <span class="blank _1"> </span>conducta. <span class="blank _3"> </span>Se <span class="blank _3"> </span>hace <span class="blank _1"> </span>énfasis <span class="blank _3"> </span>en <span class="blank _3"> </span>enfoques </span></div><div class="t m0 x4 h8 y2a0 ff1 fs5 fc0 sc0 ls0 ws1">utiliz<span class="blank _2"></span>ar <span class="blank _0"></span>TCC, <span class="blank _0"></span>lo<span class="blank _2"></span>s <span class="blank _0"></span>jóvenes <span class="blank _0"></span>tienen <span class="blank _0"></span>que <span class="blank _0"></span>ser <span class="blank _0"></span>capa<span class="blank _2"></span>ces <span class="blank _0"></span>de <span class="blank _0"></span>constru<span class="blank _2"></span>ir </div><div class="t m0 x5d h2d y2a1 ff1 fs7 fc0 sc0 ls0 ws1">101 <span class="blank _50"> </span><span class="fs5 v17">psicosociales, <span class="blank _a"> </span>ambientales, <span class="blank _6"> </span>de <span class="blank _6"> </span>conducta <span class="blank _a"> </span>y <span class="blank _6"> </span>asesoramiento </span></div><div class="t m0 x4 h8 y2a2 ff1 fs5 fc0 sc0 ls0 ws1">sus <span class="blank _0"></span>propias <span class="blank _0"></span>teoría<span class="blank _2"></span>s <span class="blank _0"></span>y <span class="blank _2"></span>refl<span class="blank _2"></span>exiona<span class="blank _2"></span>r <span class="blank _0"></span>sobre <span class="blank _0"></span>su <span class="blank _2"></span>pensa<span class="blank _2"></span>mien<span class="blank _2"></span>to.<span class="blank _4f"> </span>Un <span class="blank _4"> </span><span class="v13">familiar<span class="blank _0"></span>. <span class="blank _0"></span>Un <span class="blank _0"></span>aspecto <span class="blank _2"></span>importante <span class="blank _c"></span>es <span class="blank _2"></span>eliminar <span class="blank _0"></span>cualquier <span class="blank _0"></span>factor </span></div><div class="t m0 x4 h8 y2a3 ff1 fs5 fc0 sc0 ls0 ws1">conse<span class="blank _2"></span>nso <span class="blank _0"></span>de <span class="blank _c"></span>expertos <span class="blank _c"></span>sugiere <span class="blank _c"></span>que <span class="blank _0"></span>lo<span class="blank _2"></span>s <span class="blank _0"></span>adol<span class="blank _2"></span>escente<span class="blank _2"></span>s <span class="blank _0"></span>se <span class="blank _c"></span>pueden </div><div class="t m0 x20 h2e y2a4 ff1 fs7 fc0 sc0 ls0 ws1">102 <span class="blank _45"> </span><span class="fs5 v18">de <span class="blank _18"> </span>estrés <span class="blank _8"> </span>en <span class="blank _8"> </span>el <span class="blank _8"> </span>ambiente <span class="blank _18"> </span>del <span class="blank _8"> </span>niño. <span class="blank _8"> </span>Entre <span class="blank _8"> </span>las <span class="blank _18"> </span>terapias </span></div><div class="t m0 x4 h8 y2a5 ff1 fs5 fc0 sc0 ls0 ws1">benefi<span class="blank _2"></span>ciar de la <span class="blank _2"></span>TCC,<span class="blank _51"> </span>ya que est<span class="blank _2"></span>os son transf<span class="blank _2"></span>orma<span class="blank _2"></span>dores y <span class="blank _13"> </span><span class="v12">conductistas, <span class="blank _2"></span>la <span class="blank _2"></span>más <span class="blank _0"></span>eficaz es <span class="blank _0"></span>la <span class="blank _2"></span>terapia <span class="blank _2"></span>de <span class="blank _0"></span>aversión <span class="blank _2"></span>suave <span class="blank _2"></span>o </span></div><div class="t m0 x4 h8 y2a6 ff1 fs5 fc0 sc0 ls0 ws1">están <span class="blank _12"> </span>en <span class="blank _12"> </span>continua <span class="blank _12"> </span>observació<span class="blank _1"> </span>n <span class="blank _12"> </span>de <span class="blank _12"> </span>sus <span class="blank _12"> </span>experiencias, </div><div class="t m0 x5e h2f y2a7 ff1 fs7 fc0 sc0 ls0 ws1a">103<span class="blank"> </span><span class="fs5 ws1 v19">de <span class="blank _a"> </span>reforzamiento <span class="blank _d"> </span>negativo. <span class="blank _a"> </span>Igualmente <span class="blank _a"> </span>se <span class="blank _d"> </span>ha <span class="blank _a"> </span>utilizado <span class="blank _a"> </span>el </span></div><div class="t m0 x4 h8 y2a8 ff1 fs5 fc0 sc0 ls0 ws1">almace<span class="blank _2"></span>nándol<span class="blank _2"></span>as <span class="blank _c"></span>en <span class="blank _0"></span>su <span class="blank _c"></span>memori<span class="blank _2"></span>a <span class="blank _c"></span>para <span class="blank _c"></span>reflexiona<span class="blank _2"></span>r<span class="blank _0"></span>.<span class="blank _52"> </span><span class="v10">reforzamiento <span class="blank _3"> </span>positivo, <span class="blank _3"> </span>la <span class="blank _d"> </span>conformación <span class="blank _3"> </span>de <span class="blank _3"> </span>conducta <span class="blank _3"> </span>y <span class="blank _3"> </span>el </span></div><div class="t m0 x8 h8 y2a9 ff1 fs5 fc0 sc0 ls0 ws1">tratamiento <span class="blank _12"> </span>supercorre<span class="blank _1"> </span>ctor<span class="blank _2"></span>. <span class="blank _f"> </span>Otra <span class="blank _12"> </span>forma <span class="blank _12"> </span>de <span class="blank _12"> </span>conseguir </div><div class="t m0 x4 h8 y2aa ff1 fs5 fc0 sc0 ls0 ws1">La adolescencia <span class="blank _1"> </span>es una época <span class="blank _1"> </span>de creciente <span class="blank _1"> </span>autonomía y <span class="blank _1"> </span>de <span class="blank _4"> </span><span class="v1a">resultados <span class="blank"> </span>favorables <span class="blank"> </span>es <span class="blank"> </span>conseguir <span class="blank _14"> </span>una <span class="blank"> </span>mayor <span class="blank _14"> </span>atención </span></div><div class="t m0 x4 h8 y2ab ff1 fs5 fc0 sc0 ls0 ws1">conflicto <span class="blank _2"></span>con <span class="blank _2"></span>la <span class="blank _2"></span>familia <span class="blank _2"></span>con <span class="blank _2"></span>una <span class="blank _2"></span>disminución <span class="blank _2"></span>de <span class="blank _2"></span>la <span class="blank _2"></span>cercanía <span class="blank _4"> </span><span class="v1a">hacia <span class="blank _18"> </span>el <span class="blank _18"> </span>niño <span class="blank _18"> </span>de <span class="blank _18"> </span>los <span class="blank _18"> </span>padres, <span class="blank _18"> </span>estimulación <span class="blank _18"> </span>y <span class="blank _18"> </span>atención </span></div><div class="t m0 x4 h8 y2ac ff1 fs5 fc0 sc0 ls0 ws1">y <span class="blank _3"> </span>tiempo <span class="blank _1"> </span>de <span class="blank _3"> </span>pasar <span class="blank _3"> </span>en <span class="blank _3"> </span>familia <span class="blank _3"> </span>y <span class="blank _3"> </span>un <span class="blank _3"> </span>acercamiento <span class="blank _3"> </span>a <span class="blank _3"> </span>la <span class="blank _1"> </span>edad <span class="blank _26"> </span><span class="v1a">emocional. <span class="blank"> </span>T<span class="blank _0"></span>ambién <span class="blank"> </span>se <span class="blank"> </span>debe <span class="blank"> </span>corregir <span class="blank"> </span>la <span class="blank _14"> </span>deficiencia <span class="blank"> </span>de </span></div><div class="t m0 x4 h8 y2ad ff1 fs5 fc0 sc0 ls0 ws1">adulta. <span class="blank _1"> </span>Sin <span class="blank _1"> </span>embargo, en <span class="blank _1"> </span>la <span class="blank _1"> </span>práctica <span class="blank _1"> </span>y <span class="blank _1"> </span>emocionalmente, <span class="blank _1"> </span>los <span class="blank _26"> </span><span class="v1a">hierro <span class="blank _1"> </span>o <span class="blank _3"> </span>zinc, <span class="blank _3"> </span>lo <span class="blank _1"> </span>que <span class="blank _3"> </span>consigue <span class="blank _3"> </span>eliminar <span class="blank _3"> </span>la <span class="blank _1"> </span>pica <span class="blank _3"> </span>en <span class="blank _3"> </span>algunos </span></div><div class="t m0 x4 h8 y2ae ff1 fs5 fc0 sc0 ls0 ws1">adolescentes <span class="blank"> </span>siguen <span class="blank _b"> </span>dependiendo <span class="blank _14"> </span>y <span class="blank _b"> </span>necesitando <span class="blank"> </span>de <span class="blank _b"> </span>sus <span class="blank _4"> </span><span class="v1a">pacientes.</span></div><div class="t m0 x5f hb y2af ff1 fs7 fc0 sc0 ls0 ws1">104 </div><div class="t m0 x4 h8 y2b0 ff1 fs5 fc0 sc0 ls0 ws1">padres.<span class="blank _51"> </span>La evidencia <span class="blank _0"></span>de cómo <span class="blank _2"></span>los <span class="blank _2"></span>padres <span class="blank _2"></span>deben participar </div><div class="t m0 x4 h8 y2b1 ff1 fs5 fc0 sc0 ls0 ws1">en el plano psicológ<span class="blank _2"></span>ico del tratamiento <span class="blank _2"></span>de los adolescentes <span class="blank _13"> </span><span class="ff5 v3">Rumiación. <span class="blank _6"> </span></span><span class="v3">Se <span class="blank _6"> </span>realiza <span class="blank _6"> </span>mediante <span class="blank _6"> </span>una <span class="blank _6"> </span>combinación <span class="blank _6"> </span>entre </span></div><div class="t m0 x4 h8 y2b2 ff1 fs5 fc0 sc0 ls0 ws1">es <span class="blank _2"></span>mezclada, <span class="blank _2"></span>y <span class="blank _2"></span>depende <span class="blank _2"></span>de <span class="blank _2"></span>múltiples <span class="blank _2"></span>factores, <span class="blank _2"></span>entre <span class="blank _2"></span>ellos <span class="blank _2"></span>la <span class="blank _4"> </span><span class="v3">educación <span class="blank _a"> </span>y <span class="blank _a"> </span>modelos <span class="blank _a"> </span>conductistas. <span class="blank _a"> </span>Se <span class="blank _a"> </span>evalúa <span class="blank _d"> </span>la <span class="blank _a"> </span>relación </span></div><div class="t m0 x4 h8 y2b3 ff1 fs5 fc0 sc0 ls0 ws1">naturaleza del <span class="blank _2"></span>adolescente, las <span class="blank _2"></span>dificultades <span class="blank _2"></span>, el <span class="blank _2"></span>estilo de <span class="blank _2"></span>los <span class="blank _13"> </span><span class="v3">entre <span class="blank _d"> </span>madre <span class="blank _d"> </span>e <span class="blank _d"> </span>hijo, <span class="blank _d"> </span>para <span class="blank _d"> </span>corregir <span class="blank _3"> </span>posibles <span class="blank _d"> </span>deficiencias <span class="blank _d"> </span>de </span></div><div class="t m0 x4 h8 y2b4 ff1 fs5 fc0 sc0 ls0 ws1">padres <span class="blank _6"> </span>, <span class="blank _7"> </span>sus <span class="blank _6"> </span>propias <span class="blank _7"> </span>dificultades, <span class="blank _6"> </span>y <span class="blank _7"> </span>la <span class="blank _6"> </span>disponibilidad <span class="blank _7"> </span>de <span class="blank _4"> </span><span class="v3">vínculo <span class="blank _6"> </span>emocional <span class="blank _a"> </span>que <span class="blank _6"> </span>lleven <span class="blank _6"> </span>al <span class="blank _a"> </span>trastorno. <span class="blank _6"> </span>En <span class="blank _6"> </span>cuanto <span class="blank _a"> </span>al </span></div><div class="t m0 x29 hb y2b5 ff1 fs7 fc0 sc0 ls0 ws1">105, <span class="blank _2"></span>106 </div><div class="t m0 x4 h8 y2b6 ff1 fs5 fc0 sc0 ls0 ws1">ellos.<span class="blank _53"> </span>En <span class="blank _0"></span>la <span class="blank _c"></span>TCC <span class="blank _0"></span>se <span class="blank _c"></span>asume <span class="blank _0"></span>que <span class="blank _0"></span>el <span class="blank _c"></span>paciente <span class="blank _0"></span>está <span class="blank _0"></span>motivado <span class="blank _13"> </span><span class="v17">modelo <span class="blank _3"> </span>conductista, <span class="blank _d"> </span>se <span class="blank _3"> </span>puede <span class="blank _3"> </span>verter <span class="blank _3"> </span>zumo <span class="blank _3"> </span>de <span class="blank _3"> </span>limón <span class="blank _d"> </span>en <span class="blank _1"> </span>la </span></div><div class="t m0 x4 h8 y2b7 ff1 fs5 fc0 sc0 ls0 ws1">por deseos de cambiar<span class="blank _2"></span>. Sin embar<span class="blank _2"></span>go, la motivación para el <span class="blank _4"> </span><span class="v17">boca <span class="blank _0"></span>del <span class="blank _0"></span>paciente <span class="blank _c"></span>cada <span class="blank _0"></span>vez <span class="blank _0"></span>que <span class="blank _c"></span>rumia, <span class="blank _0"></span>lo <span class="blank _0"></span>que <span class="blank _0"></span>consigue <span class="blank _c"></span>evitar </span></div><div class="t m0 x4 h8 y2b8 ff1 fs5 fc0 sc0 ls0 ws1">tratamiento <span class="blank _0"></span>de <span class="blank _0"></span>muchos <span class="blank _0"></span>adolescentes <span class="blank _2"></span>es <span class="blank _0"></span>baja, <span class="blank _0"></span>ya <span class="blank _0"></span>que <span class="blank _0"></span>estiman <span class="blank _4"> </span><span class="v17">la <span class="blank _2"></span>rumiación <span class="blank _2"></span>rápidamente. <span class="blank _0"></span>En un <span class="blank _0"></span>lapso de <span class="blank _0"></span>3 <span class="blank _2"></span>a <span class="blank _2"></span>5 <span class="blank _2"></span>días <span class="blank _0"></span>y en <span class="blank _0"></span>un </span></div><div class="t m0 x4 h8 y2b9 ff1 fs5 fc0 sc0 ls0 ws1">como <span class="blank _14"> </span>logros <span class="blank _b"> </span>las <span class="blank _b"> </span>consecuencias <span class="blank _b"> </span>de <span class="blank _b"> </span>la <span class="blank _14"> </span>enfermedad <span class="blank _b"> </span>(por <span class="blank _4"> </span><span class="v17">seguimiento <span class="blank _0"></span>de <span class="blank _0"></span>9 <span class="blank _c"></span>a <span class="blank _0"></span>12 <span class="blank _c"></span>meses, <span class="blank _0"></span>no <span class="blank _0"></span>muestra <span class="blank _c"></span>recidivas, <span class="blank _0"></span>mientras </span></div><div class="t m0 x4 h8 y2ba ff1 fs5 fc0 sc0 ls0 ws1">ejemplo, <span class="blank _2"></span>la <span class="blank _0"></span>pérdida <span class="blank _2"></span>de <span class="blank _0"></span>peso) <span class="blank _2"></span>y <span class="blank _2"></span>ven <span class="blank _0"></span>en <span class="blank _2"></span>ellas <span class="blank _2"></span>la <span class="blank _0"></span>posibilidad <span class="blank _2"></span>de <span class="blank _13"> </span><span class="v17">que <span class="blank _0"></span>mejora <span class="blank _0"></span>el <span class="blank _c"></span>peso <span class="blank _0"></span>del <span class="blank _c"></span>niño <span class="blank _0"></span>y <span class="blank _0"></span>su <span class="blank _c"></span>respuesta <span class="blank _0"></span>social. <span class="blank _c"></span>Otra <span class="blank _0"></span>forma </span></div><div class="t m0 x5e hb y2bb ff1 fs7 fc0 sc0 ls0">107</div><div class="t m0 x4 h8 y2bc ff1 fs5 fc0 sc0 ls0 ws1">aumento <span class="blank _c"></span>de <span class="blank _0"></span>la <span class="blank _c"></span>aprobación <span class="blank _0"></span>por <span class="blank _c"></span>parte <span class="blank _c"></span>de <span class="blank _0"></span>sus <span class="blank _c"></span>pares.<span class="blank _52"> </span><span class="v18">de <span class="blank _6"> </span>disminuir <span class="blank _6"> </span>la <span class="blank _7"> </span>rumiación <span class="blank _6"> </span>es <span class="blank _7"> </span>retirar <span class="blank _6"> </span>la <span class="blank _7"> </span>atención <span class="blank _7"> </span>al <span class="blank _6"> </span>niño </span></div><div class="t m0 x8 h8 y2bd ff1 fs5 fc0 sc0 ls0 ws1">cuando <span class="blank _c"></span>lo <span class="blank _0"></span>hace.</div><div class="t m0 x4 h8 y2be ff1 fs5 fc0 sc0 ls0 ws1">E<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>te<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>p<span class="blank _1"> </span>i<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _12"> </span>c<span class="blank _1"> </span>o<span class="blank _1"> </span>g<span class="blank _1"> </span>n<span class="blank _1"> </span>i<span class="blank _1"> </span>t<span class="blank _1"> </span>i<span class="blank _1"> </span>v<span class="blank _1"> </span>o<span class="blank _1"> </span>-<span class="blank _1"> </span>c<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span>d<span class="blank _1"> </span>u<span class="blank _1"> </span>c<span class="blank _1"> </span>t<span class="blank _1"> </span>u<span class="blank _1"> </span>a<span class="blank _1"> </span>l<span class="blank _1"> </span> <span class="blank _12"> </span>s<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _12"> </span>c<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span>s<span class="blank _1"> </span>i<span class="blank _1"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _f"> </span>e<span class="blank _1"> </span>l<span class="blank _3"> </span> </div><div class="t m0 x4 h30 y2bf ff1 fs5 fc0 sc0 ls0 ws1">tratamiento <span class="blank _b"> </span>de <span class="blank _8"> </span>elección <span class="blank _8"> </span>para <span class="blank _8"> </span>la <span class="blank _8"> </span>BN. <span class="blank _b"> </span>Fue <span class="blank _8"> </span>descrita <span class="blank _8"> </span>por <span class="blank _4"> </span><span class="v0">T<span class="blank _0"></span>ambién <span class="blank _a"> </span>se <span class="blank _a"> </span>incluye <span class="blank _a"> </span>en <span class="blank _d"> </span>el <span class="blank _a"> </span>tratamiento <span class="blank _a"> </span>mejorar <span class="blank _d"> </span>el <span class="blank _a"> </span>entorno </span></div><div class="t m0 x4 h31 y2c0 ff1 fs5 fc0 sc0 ls0 ws1">Fairburn <span class="blank _1"> </span>a <span class="blank _3"> </span>principios <span class="blank _3"> </span>de <span class="blank _1"> </span>los <span class="blank _3"> </span>años <span class="blank _3"> </span>80 <span class="blank _1"> </span>y<span class="blank _0"></span>, <span class="blank _3"> </span>desde <span class="blank _3"> </span>entonces, <span class="blank _1"> </span>se <span class="blank _26"> </span><span class="v0">psicosocial <span class="blank _2"></span>del <span class="blank _2"></span>niño, <span class="blank _2"></span>dar <span class="blank _2"></span>más <span class="blank _2"></span>atención <span class="blank _2"></span>tierna <span class="blank _0"></span>y cariñosa <span class="blank _2"></span>por </span></div><div class="t m0 x4 h30 y2c1 ff1 fs5 fc0 sc0 ls0 ws1">han <span class="blank _f"> </span>publicado <span class="blank _12"> </span>diferentes <span class="blank _12"> </span>adaptaciones <span class="blank _f"> </span>como <span class="blank _12"> </span>la <span class="blank _f"> </span>que <span class="blank _4"> </span><span class="v0">la <span class="blank _12"> </span>madre <span class="blank _f"> </span>o <span class="blank _f"> </span>cuidadora <span class="blank _f"> </span>y <span class="blank _f"> </span>brindar <span class="blank _12"> </span>psicoterapia <span class="blank _f"> </span>a <span class="blank _f"> </span>los </span></div><div class="t m0 x4 h30 y2c2 ff1 fs5 fc0 sc0 ls0 ws1">describimos <span class="blank _7"> </span>a <span class="blank _7"> </span>continuación. <span class="blank _7"> </span>En <span class="blank _7"> </span>su <span class="blank _7"> </span>forma <span class="blank _7"> </span>más <span class="blank _7"> </span>usual, <span class="blank _7"> </span>el <span class="blank _4"> </span><span class="v0">progenitores. <span class="blank _1"> </span>Antes, <span class="blank _d"> </span>se <span class="blank _d"> </span>debe <span class="blank _d"> </span>corregir <span class="blank _3"> </span>cualquier <span class="blank _d"> </span>condición </span></div><div class="t m0 x60 hb y2c3 ff1 fs7 fc0 sc0 ls0">109</div><div class="t m0 x4 h8 y2c4 ff1 fs5 fc0 sc0 ls0 ws1">tratamiento se <span class="blank _1"> </span>hace <span class="blank _1"> </span>individualmente y <span class="blank _1"> </span>dura alrededor <span class="blank _1"> </span>de <span class="blank _1"> </span>5 <span class="blank _4"> </span><span class="va">médica <span class="blank _c"></span>que <span class="blank _0"></span>lleve <span class="blank _c"></span>a <span class="blank _0"></span>la <span class="blank _c"></span>rumiación, <span class="blank _c"></span>como <span class="blank _0"></span>la <span class="blank _c"></span>hernia <span class="blank _0"></span>hiatal.</span></div><div class="t m0 x61 h7 yd9 ff3 fs4 fc0 sc0 ls0">138</div><div class="t m0 x4 h4 y2c5 ff2 fs2 fc0 sc0 ls0 ws1"> <span class="blank _c"></span>T<span class="blank _2"></span>abla <span class="blank _c"></span>9.<span class="ff3"> <span class="blank _c"></span>T<span class="blank _c"></span>erapia <span class="blank _0"></span>cognitivo-conductual <span class="blank _c"></span>de <span class="blank _0"></span>Fairburn</span></div><div class="t m0 x50 h32 y2c6 ff8 fs11 fc0 sc0 ls0 ws1">Primera </div><div class="t m0 xe h33 y2c7 ff8 fsa fc0 sc0 ls0 ws1"> </div><div class="t m0 x62 h34 y2c8 ff8 fs12 fc0 sc0 ls0 ws1b">A)<span class="blank"> </span><span class="fs11 ws1">Explicar al paciente el modelo cognitivo de la B N</span></div><div class="t m0 x62 h34 y2c9 ff8 fs12 fc0 sc0 ls0 ws1b">B)<span class="blank"> </span><span class="fs11 ws1">Monitorizar la alimentación <span class="blank _14"> </span>mediante un registro diario.</span></div><div class="t m0 x62 h34 y2ca ff8 fs12 fc0 sc0 ls0 ws1c">C)<span class="blank"> </span><span class="fs11 ws1">Pesarse semanalmente</span></div><div class="t m0 x62 h34 y2cb ff8 fs12 fc0 sc0 ls0 ws1c">D)<span class="blank"> </span><span class="fs11 ws1">Proporcionar información.</span></div><div class="t m0 x62 h34 y2cc ff8 fs12 fc0 sc0 ls0 ws1b">E)<span class="blank"> </span><span class="fs11 ws1">Prescribir un patrón de alimentación regular<span class="blank _2"></span>.</span></div><div class="t m0 x62 h34 y2cd ff8 fs12 fc0 sc0 ls0 ws1d">F)<span class="blank"> </span><span class="fs11 ws1">Dar c<span class="blank _1"> </span>onsejos sobre laxantes y <span class="blank _14"> </span>diuréticos.</span></div><div class="t m0 x62 h34 y2ce ff8 fs12 fc0 sc0 ls0 ws1e">G)<span class="blank"> </span><span class="fs11 ws1">Presentar a<span class="blank _a"> </span>lternativas al atracón y al vómito.</span></div><div class="t m0 x62 h34 y2cf ff8 fs12 fc0 sc0 ls0 ws1c">H)<span class="blank"> </span><span class="fs11 ws1">Entrevistar a algún amigo o familiar<span class="blank _2"></span>.</span></div><div class="t m0 x50 h32 y2d0 ff8 fs11 fc0 sc0 ls0 ws1">T<span class="blank _0"></span>ercera <span class="blank _4a"> </span>Consta de 3 entrevistas<span class="blank"> </span>:<span class="blank _f"> </span>una cada 15 días. Su objetivo es asegurar que el progreso se mantenga después de la terapia. </div><div class="t m2 x62 h35 y2d1 ffa fsd fc0 sc0 ls0 ws1">Dura 8 semanas, con una entrevista semanal. Los objetivos que se pretenden son</div><div class="t m0 x10 he y85 ff3 fs8 fc2 sc0 ls0 ws1">V<span class="blank _2"></span>ol. 12 Número 3, Diciembre de 2009</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
Compartir