Project Portugal 2030

Summary

Since BED integrated the DSM as a nosologic disorder (1994), mounting evidence shows that BEB is associated with elevated rates of psychiatric conditions, impaired social functioning, obesity, diabetes, and other metabolic disorders. Across epidemiologic, community, and clinical samples, individuals with BED have higher levels of medical comorbidities and psychological distress compared with those with obesity and without BED. In obesity treatment, weight and psychological outcomes for individuals with BED are poorer than for individuals with obesity alone(Giel et al. 2022). Unfortunately, given the frequent co-occurrence between BED and obesity and some shared behavioral features of overeating behaviors, the emerging treatment literature for BED has been biased by the obesity field(Boswell et al. 2021). Accordingly, despite the significant overlap between BED and obesity, effective treatment for both conditions requires a comprehensive understanding of BED. To pursue such knowledge, the complex systems involving physiologic and neural substrates for hunger and satiety, including both homeostatic/appetitive- and hedonic/reward- based processes, should be investigated interactively. This project will put the field forward by having a multidisciplinary team working together to allow for an in-depth investigation of different neurobiological and psychological processes of BED. In doing such, we will conceptualize these processes within the MGBA mechanisms to bring a comprehensive understating of BED. We envision to: Objective 1(O1) - Identify alterations in the MGBA specific to BED, independent of obesity. The pathways of the MGBA investigated will include alterations in the microbiota, endocrine hormones, neurofunction, and psychological/behavior related to eating regulation. Objective 2(O2) - Investigate the role of psychobiotics in BED. We aim to: i) revert microbiota dysbiosis specific to BED; and ii) investigate the role of psychobiotics in modulating MGBA activity in BED. Specifically, we will test if supplementation with psychobiotics and the corresponding changes in the gut microbiota have an impact on the endocrine hormones related, neurofunction, psychological/behavior to eating regulation, and ultimately, in BED condition. Finally, the insufficient training of healthcare professionals in obesity treatment not only poses a significant barrier to its effective management but also perpetuates the (internalized) bias that weight control relies solely on "willpower." Proper training, accessible treatment, and effective preventive strategies are still of utmost importance. Improving the understanding of weight (and eating) control biological mechanisms among healthcare professionals is the first step for the effective management of these disorders(Rubino et al. 2020). Hence, we will: Objective 3(O3) – develop an online platform (O3) to spread our work by disseminating evidence-based knowledge among clinicians and the community at large. By relying on the use of highly scalable digital platforms and our international team to provide long-distance knowledge and will the necessity of global dissemination of our output worldwide. With this platform we envision to promote de-stigmatization around these problem in clinical settings but also in community at large.