Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática
Digital
- Autores:
-
Utrera-Mejía, Eva Ariana Cece
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2025
- Institución:
- Universidad de Santander
- Repositorio:
- Repositorio Universidad de Santander
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.udes.edu.co:001/12007
- Palabra clave:
- Trastornos de la conducta alimentaria
Tratamientos Farmacológicos
Psicoterapia
TCA
Eating disorders
Pharmacological treatments
Psychotherap
TCA
- Rights
- openAccess
- License
- http://purl.org/coar/access_right/c_abf2
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Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| dc.title.translated.none.fl_str_mv |
Applicability of Pharmacotherapy and Psychotherapy in Patients with Eating Disorders: A Systematic Review |
| title |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| spellingShingle |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática Trastornos de la conducta alimentaria Tratamientos Farmacológicos Psicoterapia TCA Eating disorders Pharmacological treatments Psychotherap TCA |
| title_short |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| title_full |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| title_fullStr |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| title_full_unstemmed |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| title_sort |
Aplicabilidad de la Farmacoterapia y la Psicoterapia en Pacientes con Trastornos de la Conducta Alimentaria: Revisión Sistemática |
| dc.creator.fl_str_mv |
Utrera-Mejía, Eva Ariana Cece |
| dc.contributor.advisor.none.fl_str_mv |
López-Rangel, Yaneth |
| dc.contributor.author.none.fl_str_mv |
Utrera-Mejía, Eva Ariana Cece |
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Nuván Hurtado, Irma Lizeth Varón-Vega, Anderson |
| dc.contributor.researchgroup.none.fl_str_mv |
Entropía |
| dc.subject.proposal.spa.fl_str_mv |
Trastornos de la conducta alimentaria Tratamientos Farmacológicos Psicoterapia TCA |
| topic |
Trastornos de la conducta alimentaria Tratamientos Farmacológicos Psicoterapia TCA Eating disorders Pharmacological treatments Psychotherap TCA |
| dc.subject.proposal.eng.fl_str_mv |
Eating disorders Pharmacological treatments Psychotherap TCA |
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Digital |
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2025 |
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2025-07-21T22:20:24Z |
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2025-07-21T22:20:24Z |
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2025-07-04 |
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Trabajo de grado - Pregrado |
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Universidad de Santander |
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T 21.25 U872a |
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Repositorio Universidad de Santander |
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Acosta-Gallego, A., Gamonales, osé M., Muñoz-Jiménez, J., Acosta Cañero, D., & Gámez-Calvo, L. (2022). Ejercicio físico y terapia nutricional en el tratamiento de los trastornos de la conducta alimentaria. Revisión Sistemática. Archivos Latinoamericanos de Nutrición, 72(1), 60–71. https://doi.org/10.37527/2022.72.1.007 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596 Arija Val, V., Santi Cano, M. J., Novalbos Ruiz, J. P., Canals, J., & Rodríguez Martín, A. (2022a). Characterization, epidemiology and trends of eating disorders. Nutrición Hospitalaria. https://doi.org/10.20960/nh.04173 Arija Val, V., Santi Cano, M. J., Novalbos Ruiz, J. P., Canals, J., & Rodríguez Martín, A. (2022b). Characterization, epidemiology and trends of eating disorders. Nutrición Hospitalaria. https://doi.org/10.20960/nh.04173 Barquero Morales, W. G. (2022). ANALISIS DE PRISMA COMO METODOLOGÍA PARA REVISIÓN SISTEMÁTICA: UNA APROXIMACIÓN GENERAL. Saúde Em Redes, 8(sup1), 339–360. https://doi.org/10.18310/2446-4813.2022v8nsup1p339-360 Berny Hernández, M. C., Rodríguez López, D., Cisneros Herrera, J., & Guzmán Díaz, G. (2020). Trastornos de la Conducta Alimentaria. Boletín Científico de La Escuela Superior Atotonilco de Tula, 7(14), 15–21. https://doi.org/10.29057/esat.v7i14.6036 Blanes, Á. (2022, May 4). Los Trastornos Alimentarios y las redes sociales. Https://Www.Clinicacta.Com/Trastornos-Alimentarios-y-Redes-Sociales/. Campos, C. S., Ferreira, G. F., Bastos, K. V., da Costa Carbogim, F., de Brito Poveda, V., de Araújo Püschel, V. A., & dos Santos, K. B. (2021). Immunosuppressive adherence after kidney transplantation in adult patients treated at an outpatient clinic: a better practice implementation project. JBI Evidence Implementation, 19(3), 306–314. https://doi.org/10.1097/XEB.0000000000000262 Cañón, M., & Buitrago-Gómez, Q. (2018). La pregunta de investigación en la práctica clínica: guía para formularla. Revista Colombiana de Psiquiatría, 47(3), 193–200. https://doi.org/10.1016/j.rcp.2016.06.004 Castaño, A. (2023). PROGRAMA PSICOEDUCATIVO GRUPAL PARA ADULTOS CON TRASTORNO DE LA CONDUCTA ALIMENTARIA. Universidad Autónoma de Madrid. Cerolini, S., D’Amico, M., Zagaria, A., Mocini, E., Monda, G., Donini, L. M., & Lombardo, C. (2024). A Brief Online Intervention Based on Dialectical Behavior Therapy for a Reduction in Binge-Eating Symptoms and Eating Pathology. Nutrients, 16(16), 2696. https://doi.org/10.3390/nu16162696 Chiu, H.-P., Huang, M.-W., Tsai, S.-Y., & Hsu, C.-Y. (2023). A retrospective study of pharmacological treatment in anorexia nervosa: 6-month and 12-month follow-up. BMC Psychiatry, 23(1), 126. https://doi.org/10.1186/s12888-023-04604-3 Congreso de Colombia. (2006). Ley 1090 de 2006. Congreso de Colombia. (2013). Ley 1616 de 2013: Vol. Diario No. 48.682. Constitución Política de Colombia. (1991). Constitución Política de Colombia: Vol. Art 49. de Jong, M., Spinhoven, P., Korrelboom, K., Deen, M., van der Meer, I., Danner, U. N., van der Schuur, S., Schoorl, M., & Hoek, H. W. (2020). Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial. International Journal of Eating Disorders, 53(5), 717–727. https://doi.org/10.1002/eat.23239 Delgado, M. (2020). Delgado_Piedra_Mara_del_Carmen_TFG_Psicologa. Universidad de Jaén. Escandón-Nagel, N., & Garrido-Rubilar, G. (2021). Trastorno por Atracón: una mirada integral a los factores psicosociales implicados en su desarrollo Binge Eating Disorder: a comprehensive look at the psychosocial factors involved in its development. Nutrición Clínica Y Dietética Hospitalaria. https://doi.org/10.12873/404escandon Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., O’Connor, M. E., & Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behaviour Research and Therapy, 70, 64–71. https://doi.org/10.1016/j.brat.2015.04.010 Fogelkvist, M., Gustafsson, S. A., Kjellin, L., & Parling, T. (2020). Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body Image, 32, 155–166. https://doi.org/10.1016/j.bodyim.2020.01.002 Fornaro, M., Mondin, A. M., Billeci, M., Fusco, A., De Prisco, M., Caiazza, C., Micanti, F., Calati, R., Carvalho, A. F., & de Bartolomeis, A. (2023). Psychopharmacology of eating disorders: Systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, 338, 526–545. https://doi.org/10.1016/j.jad.2023.06.068 Gaete, P., & López, C. (2020). Eating disorders in adolescents. A comprehensive approach. Revista Chilena de Pediatria, 91(5), 784–793. https://doi.org/10.32641/rchped.vi91i5.1534 Gempeler Rueda, J., & Rodríguez Guarín, M. (2022). Neurobiologia, temperamento y nuevos enfoques en el tratamiento de la Anorexia Nerviosa del adulto. Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders, 12(1), 88–104. https://doi.org/10.22201/fesi.20071523e.2022.1.727 Genis-Mendoza, A. D., Tovilla-Zarate, C. A., & Nicolini, H. (2013). Avances en genómica de los trastornos de la conducta alimentaria. Revista Colombiana de Psiquiatría, 42(4), 350–355. https://doi.org/10.1016/S0034-7450(13)70031-3 Glisenti, K., Strodl, E., King, R., & Greenberg, L. (2021). The feasibility of emotion-focused therapy for binge-eating disorder: a pilot randomised wait-list control trial. Journal of Eating Disorders, 9(1), 2. https://doi.org/10.1186/s40337-020-00358-5 Griffiths, K. R., Boulet, S., Barakat, S., Touyz, S., Hay, P., Maguire, S., & Kohn, M. R. (2024). Exploring bi-directional impacts of Lisdexamfetamine dimesylate on psychological comorbidities and quality of life in people with Binge Eating Disorder. Journal of Eating Disorders, 12(1), 80. https://doi.org/10.1186/s40337-024-01041-9 Grilo, C. M., Ivezaj, V., Yurkow, S., Tek, C., Wiedemann, A. A., & Gueorguieva, R. (2024). Lisdexamfetamine maintenance treatment for binge-eating disorder following successful treatments: randomized double-blind placebo-controlled trial. Psychological Medicine, 54(12), 3334–3344. https://doi.org/10.1017/S003329172400148X Grilo, C. M., Lydecker, J. A., Fineberg, S. K., Moreno, J. O., Ivezaj, V., & Gueorguieva, R. (2022). Naltrexone-Bupropion and Behavior Therapy, Alone and Combined, for Binge-Eating Disorder: Randomized Double-Blind Placebo-Controlled Trial. American Journal of Psychiatry, 179(12), 927–937. https://doi.org/10.1176/appi.ajp.20220267 Hamatani, S., Matsumoto, K., Ishibashi, T., Shibukawa, R., Honda, Y., Kosaka, H., Mizuno, Y., & Andersson, G. (2022). Development of a culturally adaptable internet-based cognitive behavioral therapy for Japanese women with bulimia nervosa. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.942936 Hamatani, S., Numata, N., Matsumoto, K., Sutoh, C., Ibuki, H., Oshiro, K., Tanaka, M., Setsu, R., Kawasaki, Y., Hirano, Y., & Shimizu, E. (2019). Internet-Based Cognitive Behavioral Therapy via Videoconference for Patients With Bulimia Nervosa and Binge-Eating Disorder: Pilot Prospective Single-Arm Feasibility Trial. JMIR Formative Research, 3(4), e15738. https://doi.org/10.2196/15738 Hay, P. (2020). Current approach to eating disorders: a clinical update. Internal Medicine Journal, 50(1), 24–29. https://doi.org/10.1111/imj.14691 Högdahl, L., Birgegård, A., Norring, C., de Man Lapidoth, J., Franko, M. A., & Björck, C. (2023). Internet-based cognitive behavioral therapy for bulimic eating disorders in a clinical setting: Results from a randomized trial with one-year follow-up. Internet Interventions, 31, 100598. https://doi.org/10.1016/j.invent.2022.100598 Huarancca, E. M., & Flores, G. (2024). Eficacia de la terapia de aceptación y compromiso en el tratamiento de los trastornos del comportamiento alimentario en mujeres: Una revisión narrativa. UNIVERSIDAD PERUANA UNIÓN. Hudson, J. I., McElroy, S. L., Ferreira-Cornwell, M. C., Radewonuk, J., & Gasior, M. (2017). Efficacy of Lisdexamfetamine in Adults With Moderate to Severe Binge-Eating Disorder. JAMA Psychiatry, 74(9), 903. https://doi.org/10.1001/jamapsychiatry.2017.1889 Johanna Briggs Institute. (2020). JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-20-01 Juarascio, A. S., Parker, M. N., Hunt, R., Murray, H. B., Presseller, E. K., & Manasse, S. M. (2021). Mindfulness and acceptance‐based behavioral treatment for bulimia‐spectrum disorders: A pilot feasibility randomized trial. International Journal of Eating Disorders, 54(7), 1270–1277. https://doi.org/10.1002/eat.23512 Kaczmarek-Fojtar, M., Musiał, P., & Szewczuk-Bogusławska, M. (2022). Short-term intensive group therapy in the clinical treatment of adolescents with the diagnosis of anorexia and bulimia nervosa at “Neuromed” Neuropsychiatry Centre in Wrocław. Psychiatria i Psychologia Kliniczna, 22(2), 107–116. https://doi.org/10.15557/PiPK.2022.0016 López-Gil, J. F., García-Hermoso, A., Smith, L., Firth, J., Trott, M., Mesas, A. E., Jiménez-López, E., Gutiérrez-Espinoza, H., Tárraga-López, P. J., & Victoria-Montesinos, D. (2023). Global Proportion of Disordered Eating in Children and Adolescents. JAMA Pediatrics, 177(4), 363. https://doi.org/10.1001/jamapediatrics.2022.5848 Loria-Kohen, V., Montiel Fernández, N., López-Plaza, B., & Aparicio, A. (2023). Anorexia nervosa, microbiota and brain. Nutrición Hospitalaria. https://doi.org/10.20960/nh.04955 Lozano-Muñoz, N., Borrallo-Riego, Á., & Guerra-Martín, M. D. (2024). Effectiveness of interventions to help mitigate the influence of social networks on anorexia and bulimia nervosa: a systematic review. Anales Del Sistema Sanitario de Navarra, 47(1). https://doi.org/10.23938/ASSN.1074 Margherita, G., Gargiulo, A., Gaudioso, R., & Esposito, G. (2022). Treating eating disorders in groups: A pilot study on the role of a structured intervention on perfectionism on group climate. Counselling and Psychotherapy Research, 22(2), 311–321. https://doi.org/10.1002/capr.12448 McElroy, S. L., Hudson, J. I., Mitchell, J. E., Wilfley, D., Ferreira-Cornwell, M. C., Gao, J., Wang, J., Whitaker, T., Jonas, J., & Gasior, M. (2015). Efficacy and Safety of Lisdexamfetamine for Treatment of Adults With Moderate to Severe Binge-Eating Disorder. JAMA Psychiatry, 72(3), 235. https://doi.org/10.1001/jamapsychiatry.2014.2162 Milos, G., Antel, J., Kaufmann, L.-K., Barth, N., Koller, A., Tan, S., Wiesing, U., Hinney, A., Libuda, L., Wabitsch, M., von Känel, R., & Hebebrand, J. (2020). Short-term metreleptin treatment of patients with anorexia nervosa: rapid on-set of beneficial cognitive, emotional, and behavioral effects. Translational Psychiatry, 10(1), 303. https://doi.org/10.1038/s41398-020-00977-1 National Institute of Mental Health. (2024). Trastornos de la alimentación: Lo que debe saber. Https://Www.Nimh.Nih.Gov/Health/Publications/Espanol/Los-Trastornos-de-La-Alimentacion?Utm_source. OMS. (2024, October 10). La salud mental de los adolescentes. Https://Www.Who.Int/Es/News-Room/Fact-Sheets/Detail/Adolescent-Mental-Health. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, n71. https://doi.org/10.1136/bmj.n71 Parling, T., Cernvall, M., Ramklint, M., Holmgren, S., & Ghaderi, A. (2016). A randomised trial of Acceptance and Commitment Therapy for Anorexia Nervosa after daycare treatment, including five-year follow-up. BMC Psychiatry, 16(1), 272. https://doi.org/10.1186/s12888-016-0975-6 Poo-Figueroa, A. M., Espinoza, S., Torres, N., & Vera, K. (2022). Representaciones de estándares de belleza en profesionales de la salud que atienden mujeres Chilenas Diagnosticadas con trastorno de la conducta alimentaria. Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders, 12(1), 25–38. https://doi.org/10.22201/fesi.20071523e.2022.1.728 Ragnhildstveit, A., Jackson, L. K., Cunningham, S., Good, L., Tanner, Q., Roughan, M., & Henrie-Barrus, P. (2021). Case Report: Unexpected Remission From Extreme and Enduring Bulimia Nervosa With Repeated Ketamine Assisted Psychotherapy. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.764112 Richards, J., Bang, N., Ratliff, E. L., Paszkowiak, M. A., Khorgami, Z., Khalsa, S. S., & Simmons, W. K. (2023). Successful treatment of binge eating disorder with the GLP-1 agonist semaglutide: A retrospective cohort study. Obesity Pillars, 7, 100080. https://doi.org/10.1016/j.obpill.2023.100080 Riesco, N., Agüera, Z., Granero, R., Jiménez-Murcia, S., Menchón, J. M., & Fernández-Aranda, F. (2018a). Other Specified Feeding or Eating Disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome. European Psychiatry, 54, 109–116. https://doi.org/10.1016/j.eurpsy.2018.08.001 Riesco, N., Agüera, Z., Granero, R., Jiménez-Murcia, S., Menchón, J. M., & Fernández-Aranda, F. (2018b). Other Specified Feeding or Eating Disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome. European Psychiatry, 54, 109–116. https://doi.org/10.1016/j.eurpsy.2018.08.001 Sakae, K., Suka, M., & Yanagisawa, H. (2020). Polaprezinc (Zinc–l-Carnosine Complex) as an Add-on Therapy for Binge Eating Disorder and Bulimia Nervosa, and the Possible Involvement of Zinc Deficiency in These Conditions. Journal of Clinical Psychopharmacology, 40(6), 599–606. https://doi.org/10.1097/JCP.0000000000001284 Schneider, E., Martin, E., Rotshtein, P., Qureshi, K. L., Chamberlain, S. R., Spetter, M. S., Dourish, C. T., & Higgs, S. (2022). The effects of lisdexamfetamine dimesylate on eating behaviour and homeostatic, reward and cognitive processes in women with binge-eating symptoms: an experimental medicine study. Translational Psychiatry, 12(1), 9. https://doi.org/10.1038/s41398-021-01770-4 Segreda, S., & Segura, C. (2020). Anorexia nerviosa en adolescentes y adultos. Revista Ciencia y Salud Integrando Conocimientos, 4(4). https://doi.org/10.34192/cienciaysalud.v4i4.199 Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates. Current Psychiatry Reports, 14(4), 406–414. https://doi.org/10.1007/s11920-012-0282-y Timek, A., Daniels-Brady, C., & Ferrando, S. (2024). Improvement in depressive symptoms in a patient with severe and enduring anorexia nervosa and comorbid major depressive disorder using psychotherapy-assisted IV ketamine : a case report. Journal of Eating Disorders, 12(1), 79. https://doi.org/10.1186/s40337-024-01039-3 Vrabel, K. R., Waller, G., Goss, K., Wampold, B., Kopland, M., & Hoffart, A. (2024). Cognitive behavioral therapy versus compassion focused therapy for adult patients with eating disorders with and without childhood trauma: A randomized controlled trial in an intensive treatment setting. Behaviour Research and Therapy, 174, 104480. https://doi.org/10.1016/j.brat.2024.104480 Willmott, E., Dickinson, R., Hall, C., Sadikovic, K., Wadhera, E., Micali, N., Trompeter, N., & Jewell, T. (2024). A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder ( <scp>ARFID</scp> ). International Journal of Eating Disorders, 57(1), 27–61. https://doi.org/10.1002/eat.24073 |
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López-Rangel, Yanethd9642e66-33f2-401e-b031-573e3dd2d6c8-1Utrera-Mejía, Eva Ariana Cece74513f53-d6a6-4287-898d-82f5ef415c7d-1Nuván Hurtado, Irma Lizeth66da4074-83f2-4d6f-9aed-d8d2e83c143f600Varón-Vega, Andersonbcfb3f87-9916-4905-aa6a-556cacc522ce-1Entropía2025-07-21T22:20:24Z2025-07-21T22:20:24Z2025-07-04DigitalEsta revisión sistemática tuvo como objetivo analizar los tratamientos psicoterapéuticos y farmacológicos más utilizados en pacientes con trastornos de la conducta alimentaria (TCA), según la evidencia científica publicada entre 2015 y 2025. Fue realizada bajo la metodología PRISMA, se consultaron tres bases de datos que dieron total de 38 estudios que fueron validados mediante el modelo del Joanna Briggs Institute (JBI). Los resultados mostraron una mayor representación de intervenciones psicoterapéuticas, siendo la CBT-E la más frecuente, el fármaco con mayor respaldo científico fue la lisdexanfetamina, especialmente en el trastorno por atracón. No se identificaron estudios en América Latina, lo cual evidencia la poca visibilidad de los TCA en Latino América. Se concluye que la psicoterapia sigue siendo la base del tratamiento, dejando claro que la farmacoterapia actúa como coadyuvante fundamental en la intervención de casos severos y comorbilidades.This systematic review aimed to analyze the most commonly used psychotherapeutic and pharmacological treatments in patients with eating disorders (EDs), based on scientific evidence published between 2015 and 2025. It was conducted using the PRISMA methodology, consulting three databases that yielded a total of 38 studies validated using the Joanna Briggs Institute (JBI) model. The results showed a greater representation of psychotherapeutic interventions, with CBT-E being the most common. The drug with the greatest scientific support was lisdexamfetamine, especially for binge eating disorder. No studies from Latin America were identified, highlighting the low visibility of EDs in Latin America. The conclusion is that psychotherapy remains the mainstay of treatment, making it clear that pharmacotherapy acts as a fundamental adjuvant in the treatment of severe cases and comorbidities.PregradoPsicólogoCuidado de la SaludIntroducción 19 Planteamiento del Problema 22 Justificación 26 Objetivos 28 Objetivo General 28 Objetivos Específicos 28 Grupos de Investigación/Líneas de Investigación 28 Marco Teórico 29 Marco Conceptual 32 Trastornos de la Conducta Alimentaria (TCA) 32 Anorexia Nerviosa 32 Bulimia Nerviosa 33 Trastorno por Atracón 33 Terapia Cognitivo-Conductual 34 Otras Terapias 34 Tratamientos Farmacológicos 35 Marco Legal 35 Constitución Política de Colombia (1991) 35 Artículo 49 35 Ley 1616 de 2013 36 Ley de Salud Mental 36 Ley 1090 de 2006 36 Código Deontológico del Psicólogo .......................................................................................................................................................................................... 36 Marco Metodológico ......................................................................................................................................................................................................... 37 Formulación de la Pregunta ................................................................................................................................................................................................................ 38 Criterios de Inclusión .......................................................................................................................................................................................... 38 Población Objetivo.................................................................................................................................................................................................................... 38 Tipo de Estudio .............................................................................................................................................................................................................................. 38 Límite Temporal ........................................................................................................................................................................................................................ 38 Criterios de Exclusión .................................................................................................................................................................................................................. 38 Intervenciones no Psicológicas o Farmacológicas ................................................................................................................................................ 38 Disponibilidad ....................................................................................................................................................................................................................... 39 Selección de Estudios ................................................................................................................................................................................................................ 40 Resultados ........................................................................................................................................................................................................................................... 46 Análisis de Resultados ................................................................................................................................................................................................................. 46 Diagrama de Flujo PRISMA .................................................................................................................................................................................................................. 46 Validación Metodológica de Estudios ...................................................................................................................................................................................... 67 Discusión............................................................................................................................................................................................................................................... 70 Limitaciones del Estudio................................................................................................................................................................................................................... 80 Conclusiones .................................................................................................................................................................................................................................. 81 Recomendaciones ............................................................................................................................................................................................................................... 85 Referencias Bibliográficas ............................................................................................................................................................................................................. 86 Apéndices .......................................................................................................................................................................................................................................... 96100 p.application/pdfapplication/mswordUniversidad de SantanderT 21.25 U872aRepositorio Universidad de Santanderhttps://repositorio.udes.edu.cohttps://repositorio.udes.edu.co/handle/001/12007spaUniversidad de SantanderCúcutaFacultad de Ciencias SocialesCúcuta, ColombiaPsicologíaAcosta-Gallego, A., Gamonales, osé M., Muñoz-Jiménez, J., Acosta Cañero, D., & Gámez-Calvo, L. (2022). Ejercicio físico y terapia nutricional en el tratamiento de los trastornos de la conducta alimentaria. Revisión Sistemática. Archivos Latinoamericanos de Nutrición, 72(1), 60–71. https://doi.org/10.37527/2022.72.1.007American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596Arija Val, V., Santi Cano, M. J., Novalbos Ruiz, J. P., Canals, J., & Rodríguez Martín, A. (2022a). Characterization, epidemiology and trends of eating disorders. Nutrición Hospitalaria. https://doi.org/10.20960/nh.04173Arija Val, V., Santi Cano, M. J., Novalbos Ruiz, J. P., Canals, J., & Rodríguez Martín, A. (2022b). Characterization, epidemiology and trends of eating disorders. Nutrición Hospitalaria. https://doi.org/10.20960/nh.04173Barquero Morales, W. G. (2022). ANALISIS DE PRISMA COMO METODOLOGÍA PARA REVISIÓN SISTEMÁTICA: UNA APROXIMACIÓN GENERAL. 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Exploring bi-directional impacts of Lisdexamfetamine dimesylate on psychological comorbidities and quality of life in people with Binge Eating Disorder. Journal of Eating Disorders, 12(1), 80. https://doi.org/10.1186/s40337-024-01041-9Grilo, C. M., Ivezaj, V., Yurkow, S., Tek, C., Wiedemann, A. A., & Gueorguieva, R. (2024). Lisdexamfetamine maintenance treatment for binge-eating disorder following successful treatments: randomized double-blind placebo-controlled trial. Psychological Medicine, 54(12), 3334–3344. https://doi.org/10.1017/S003329172400148XGrilo, C. M., Lydecker, J. A., Fineberg, S. K., Moreno, J. O., Ivezaj, V., & Gueorguieva, R. (2022). Naltrexone-Bupropion and Behavior Therapy, Alone and Combined, for Binge-Eating Disorder: Randomized Double-Blind Placebo-Controlled Trial. American Journal of Psychiatry, 179(12), 927–937. https://doi.org/10.1176/appi.ajp.20220267Hamatani, S., Matsumoto, K., Ishibashi, T., Shibukawa, R., Honda, Y., Kosaka, H., Mizuno, Y., & Andersson, G. 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Revista Ciencia y Salud Integrando Conocimientos, 4(4). https://doi.org/10.34192/cienciaysalud.v4i4.199Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates. Current Psychiatry Reports, 14(4), 406–414. https://doi.org/10.1007/s11920-012-0282-yTimek, A., Daniels-Brady, C., & Ferrando, S. (2024). Improvement in depressive symptoms in a patient with severe and enduring anorexia nervosa and comorbid major depressive disorder using psychotherapy-assisted IV ketamine : a case report. Journal of Eating Disorders, 12(1), 79. https://doi.org/10.1186/s40337-024-01039-3Vrabel, K. R., Waller, G., Goss, K., Wampold, B., Kopland, M., & Hoffart, A. (2024). Cognitive behavioral therapy versus compassion focused therapy for adult patients with eating disorders with and without childhood trauma: A randomized controlled trial in an intensive treatment setting. Behaviour Research and Therapy, 174, 104480. https://doi.org/10.1016/j.brat.2024.104480Willmott, E., Dickinson, R., Hall, C., Sadikovic, K., Wadhera, E., Micali, N., Trompeter, N., & Jewell, T. (2024). A scoping review of psychological interventions and outcomes for avoidant and restrictive food intake disorder ( <scp>ARFID</scp> ). International Journal of Eating Disorders, 57(1), 27–61. https://doi.org/10.1002/eat.24073Derechos Reservados - Universidad de Santander, 2025. 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GF1dG9yKSBwYXJhIGVqZXJjZXIgZXN0b3MgZGVyZWNob3Mgc29icmUgbGEgT2JyYSB0YWwgeSBjb21vIHNlIGluZGljYSBhIGNvbnRpbnVhY2nDs246PC9wPgogICAgPG9sIHR5cGU9ImEiPgogICAgICA8bGk+UmVwcm9kdWNpciBsYSBPYnJhLCBpbmNvcnBvcmFyIGxhIE9icmEgZW4gdW5hIG8gbcOhcyBPYnJhcyBDb2xlY3RpdmFzLCB5IHJlcHJvZHVjaXIgbGEgT2JyYSBpbmNvcnBvcmFkYSBlbiBsYXMgT2JyYXMgQ29sZWN0aXZhcy48L2xpPgogICAgICA8bGk+RGlzdHJpYnVpciBjb3BpYXMgbyBmb25vZ3JhbWFzIGRlIGxhcyBPYnJhcywgZXhoaWJpcmxhcyBww7pibGljYW1lbnRlLCBlamVjdXRhcmxhcyBww7pibGljYW1lbnRlIHkvbyBwb25lcmxhcyBhIGRpc3Bvc2ljacOzbiBww7pibGljYSwgaW5jbHV5w6luZG9sYXMgY29tbyBpbmNvcnBvcmFkYXMgZW4gT2JyYXMgQ29sZWN0aXZhcywgc2Vnw7puIGNvcnJlc3BvbmRhLjwvbGk+CiAgICAgIDxsaT5EaXN0cmlidWlyIGNvcGlhcyBkZSBsYXMgT2JyYXMgRGVyaXZhZGFzIHF1ZSBzZSBnZW5lcmVuLCBleGhpYmlybGFzIHDDumJsaWNhbWVudGUsIGVqZWN1dGFybGFzIHDDumJsaWNhbWVudGUgeS9vIHBvbmVybGFzIGEgZGlzcG9zaWNpw7NuIHDDumJsaWNhLjwvbGk+CiAgICA8L29sPgogICAgPHA+TG9zIGRlcmVjaG9zIG1lbmNpb25hZG9zIGFudGVyaW9ybWVudGUgcHVlZGVuIHNlciBlamVyY2lkb3MgZW4gdG9kb3MgbG9zIG1lZGlvcyB5IGZvcm1hdG9zLCBhY3R1YWxtZW50ZSBjb25vY2lkb3MgbyBxdWUgc2UgaW52ZW50ZW4gZW4gZWwgZnV0dXJvLiBMb3MgZGVyZWNob3MgYW50ZXMgbWVuY2lvbmFkb3MgaW5jbHV5ZW4gZWwgZGVyZWNobyBhIHJlYWxpemFyIGRpY2hhcyBtb2RpZmljYWNpb25lcyBlbiBsYSBtZWRpZGEgcXVlIHNlYW4gdMOpY25pY2FtZW50ZSBuZWNlc2FyaWFzIHBhcmEgZWplcmNlciBsb3MgZGVyZWNob3MgZW4gb3RybyBtZWRpbyBvIGZvcm1hdG9zLCBwZXJvIGRlIG90cmEgbWFuZXJhIHVzdGVkIG5vIGVzdMOhIGF1dG9yaXphZG8gcGFyYSByZWFsaXphciBvYnJhcyBkZXJpdmFkYXMuIFRvZG9zIGxvcyBkZXJlY2hvcyBubyBvdG9yZ2Fkb3MgZXhwcmVzYW1lbnRlIHBvciBlbCBMaWNlbmNpYW50ZSBxdWVkYW4gcG9yIGVzdGUgbWVkaW8gcmVzZXJ2YWRvcywgaW5jbHV5ZW5kbyBwZXJvIHNpbiBsaW1pdGFyc2UgYSBhcXVlbGxvcyBxdWUgc2UgbWVuY2lvbmFuIGVuIGxhcyBzZWNjaW9uZXMgNChkKSB5IDQoZSkuPC9wPgogIDwvbGk+CiAgPGJyLz4KICA8bGk+CiAgICBSZXN0cmljY2lvbmVzLgogICAgPHA+TGEgbGljZW5jaWEgb3RvcmdhZGEgZW4gbGEgYW50ZXJpb3IgU2VjY2nDs24gMyBlc3TDoSBleHByZXNhbWVudGUgc3VqZXRhIHkgbGltaXRhZGEgcG9yIGxhcyBzaWd1aWVudGVzIHJlc3RyaWNjaW9uZXM6PC9wPgogICAgPG9sIHR5cGU9ImEiPgogICAgICA8bGk+VXN0ZWQgcHVlZGUgZGlzdHJpYnVpciwgZXhoaWJpciBww7pibGljYW1lbnRlLCBlamVjdXRhciBww7pibGljYW1lbnRlLCBvIHBvbmVyIGEgZGlzcG9zaWNpw7NuIHDDumJsaWNhIGxhIE9icmEgc8OzbG8gYmFqbyBsYXMgY29uZGljaW9uZXMgZGUgZXN0YSBMaWNlbmNpYSwgeSBVc3RlZCBkZWJlIGluY2x1aXIgdW5hIGNvcGlhIGRlIGVzdGEgbGljZW5jaWEgbyBkZWwgSWRlbnRpZmljYWRvciBVbml2ZXJzYWwgZGUgUmVjdXJzb3MgZGUgbGEgbWlzbWEgY29uIGNhZGEgY29waWEgZGUgbGEgT2JyYSBxdWUgZGlzdHJpYnV5YSwgZXhoaWJhIHDDumJsaWNhbWVudGUsIGVqZWN1dGUgcMO6YmxpY2FtZW50ZSBvIHBvbmdhIGEgZGlzcG9zaWNpw7NuIHDDumJsaWNhLiBObyBlcyBwb3NpYmxlIG9mcmVjZXIgbyBpbXBvbmVyIG5pbmd1bmEgY29uZGljacOzbiBzb2JyZSBsYSBPYnJhIHF1ZSBhbHRlcmUgbyBsaW1pdGUgbGFzIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEgbyBlbCBlamVyY2ljaW8gZGUgbG9zIGRlcmVjaG9zIGRlIGxvcyBkZXN0aW5hdGFyaW9zIG90b3JnYWRvcyBlbiBlc3RlIGRvY3VtZW50by4gTm8gZXMgcG9zaWJsZSBzdWJsaWNlbmNpYXIgbGEgT2JyYS4gVXN0ZWQgZGViZSBtYW50ZW5lciBpbnRhY3RvcyB0b2RvcyBsb3MgYXZpc29zIHF1ZSBoYWdhbiByZWZlcmVuY2lhIGEgZXN0YSBMaWNlbmNpYSB5IGEgbGEgY2zDoXVzdWxhIGRlIGxpbWl0YWNpw7NuIGRlIGdhcmFudMOtYXMuIFVzdGVkIG5vIHB1ZWRlIGRpc3RyaWJ1aXIsIGV4aGliaXIgcMO6YmxpY2FtZW50ZSwgZWplY3V0YXIgcMO6YmxpY2FtZW50ZSwgbyBwb25lciBhIGRpc3Bvc2ljacOzbiBww7pibGljYSBsYSBPYnJhIGNvbiBhbGd1bmEgbWVkaWRhIHRlY25vbMOzZ2ljYSBxdWUgY29udHJvbGUgZWwgYWNjZXNvIG8gbGEgdXRpbGl6YWNpw7NuIGRlIGVsbGEgZGUgdW5hIGZvcm1hIHF1ZSBzZWEgaW5jb25zaXN0ZW50ZSBjb24gbGFzIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEuIExvIGFudGVyaW9yIHNlIGFwbGljYSBhIGxhIE9icmEgaW5jb3Jwb3JhZGEgYSB1bmEgT2JyYSBDb2xlY3RpdmEsIHBlcm8gZXN0byBubyBleGlnZSBxdWUgbGEgT2JyYSBDb2xlY3RpdmEgYXBhcnRlIGRlIGxhIG9icmEgbWlzbWEgcXVlZGUgc3VqZXRhIGEgbGFzIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEuIFNpIFVzdGVkIGNyZWEgdW5hIE9icmEgQ29sZWN0aXZhLCBwcmV2aW8gYXZpc28gZGUgY3VhbHF1aWVyIExpY2VuY2lhbnRlIGRlYmUsIGVuIGxhIG1lZGlkYSBkZSBsbyBwb3NpYmxlLCBlbGltaW5hciBkZSBsYSBPYnJhIENvbGVjdGl2YSBjdWFscXVpZXIgcmVmZXJlbmNpYSBhIGRpY2hvIExpY2VuY2lhbnRlIG8gYWwgQXV0b3IgT3JpZ2luYWwsIHNlZ8O6biBsbyBzb2xpY2l0YWRvIHBvciBlbCBMaWNlbmNpYW50ZSB5IGNvbmZvcm1lIGxvIGV4aWdlIGxhIGNsw6F1c3VsYSA0KGMpLjwvbGk+CiAgICAgIDxsaT5Vc3RlZCBubyBwdWVkZSBlamVyY2VyIG5pbmd1bm8gZGUgbG9zIGRlcmVjaG9zIHF1ZSBsZSBoYW4gc2lkbyBvdG9yZ2Fkb3MgZW4gbGEgU2VjY2nDs24gMyBwcmVjZWRlbnRlIGRlIG1vZG8gcXVlIGVzdMOpbiBwcmluY2lwYWxtZW50ZSBkZXN0aW5hZG9zIG8gZGlyZWN0YW1lbnRlIGRpcmlnaWRvcyBhIGNvbnNlZ3VpciB1biBwcm92ZWNobyBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYS4gRWwgaW50ZXJjYW1iaW8gZGUgbGEgT2JyYSBwb3Igb3RyYXMgb2JyYXMgcHJvdGVnaWRhcyBwb3IgZGVyZWNob3MgZGUgYXV0b3IsIHlhIHNlYSBhIHRyYXbDqXMgZGUgdW4gc2lzdGVtYSBwYXJhIGNvbXBhcnRpciBhcmNoaXZvcyBkaWdpdGFsZXMgKGRpZ2l0YWwgZmlsZS1zaGFyaW5nKSBvIGRlIGN1YWxxdWllciBvdHJhIG1hbmVyYSBubyBzZXLDoSBjb25zaWRlcmFkbyBjb21vIGVzdGFyIGRlc3RpbmFkbyBwcmluY2lwYWxtZW50ZSBvIGRpcmlnaWRvIGRpcmVjdGFtZW50ZSBhIGNvbnNlZ3VpciB1biBwcm92ZWNobyBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYSwgc2llbXByZSBxdWUgbm8gc2UgcmVhbGljZSB1biBwYWdvIG1lZGlhbnRlIHVuYSBjb21wZW5zYWNpw7NuIG1vbmV0YXJpYSBlbiByZWxhY2nDs24gY29uIGVsIGludGVyY2FtYmlvIGRlIG9icmFzIHByb3RlZ2lkYXMgcG9yIGVsIGRlcmVjaG8gZGUgYXV0b3IuPC9saT4KICAgICAgPGxpPlNpIHVzdGVkIGRpc3RyaWJ1eWUsIGV4aGliZSBww7pibGljYW1lbnRlLCBlamVjdXRhIHDDumJsaWNhbWVudGUgbyBlamVjdXRhIHDDumJsaWNhbWVudGUgZW4gZm9ybWEgZGlnaXRhbCBsYSBPYnJhIG8gY3VhbHF1aWVyIE9icmEgRGVyaXZhZGEgdSBPYnJhIENvbGVjdGl2YSwgVXN0ZWQgZGViZSBtYW50ZW5lciBpbnRhY3RhIHRvZGEgbGEgaW5mb3JtYWNpw7NuIGRlIGRlcmVjaG8gZGUgYXV0b3IgZGUgbGEgT2JyYSB5IHByb3BvcmNpb25hciwgZGUgZm9ybWEgcmF6b25hYmxlIHNlZ8O6biBlbCBtZWRpbyBvIG1hbmVyYSBxdWUgVXN0ZWQgZXN0w6kgdXRpbGl6YW5kbzogKGkpIGVsIG5vbWJyZSBkZWwgQXV0b3IgT3JpZ2luYWwgc2kgZXN0w6EgcHJvdmlzdG8gKG8gc2V1ZMOzbmltbywgc2kgZnVlcmUgYXBsaWNhYmxlKSwgeS9vIChpaSkgZWwgbm9tYnJlIGRlIGxhIHBhcnRlIG8gbGFzIHBhcnRlcyBxdWUgZWwgQXV0b3IgT3JpZ2luYWwgeS9vIGVsIExpY2VuY2lhbnRlIGh1YmllcmVuIGRlc2lnbmFkbyBwYXJhIGxhIGF0cmlidWNpw7NuICh2LmcuLCB1biBpbnN0aXR1dG8gcGF0cm9jaW5hZG9yLCBlZGl0b3JpYWwsIHB1YmxpY2FjacOzbikgZW4gbGEgaW5mb3JtYWNpw7NuIGRlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBkZWwgTGljZW5jaWFudGUsIHTDqXJtaW5vcyBkZSBzZXJ2aWNpb3MgbyBkZSBvdHJhcyBmb3JtYXMgcmF6b25hYmxlczsgZWwgdMOtdHVsbyBkZSBsYSBPYnJhIHNpIGVzdMOhIHByb3Zpc3RvOyBlbiBsYSBtZWRpZGEgZGUgbG8gcmF6b25hYmxlbWVudGUgZmFjdGlibGUgeSwgc2kgZXN0w6EgcHJvdmlzdG8sIGVsIElkZW50aWZpY2Fkb3IgVW5pZm9ybWUgZGUgUmVjdXJzb3MgKFVuaWZvcm0gUmVzb3VyY2UgSWRlbnRpZmllcikgcXVlIGVsIExpY2VuY2lhbnRlIGVzcGVjaWZpY2EgcGFyYSBzZXIgYXNvY2lhZG8gY29uIGxhIE9icmEsIHNhbHZvIHF1ZSB0YWwgVVJJIG5vIHNlIHJlZmllcmEgYSBsYSBub3RhIHNvYnJlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBvIGEgbGEgaW5mb3JtYWNpw7NuIHNvYnJlIGVsIGxpY2VuY2lhbWllbnRvIGRlIGxhIE9icmE7IHkgZW4gZWwgY2FzbyBkZSB1bmEgT2JyYSBEZXJpdmFkYSwgYXRyaWJ1aXIgZWwgY3LDqWRpdG8gaWRlbnRpZmljYW5kbyBlbCB1c28gZGUgbGEgT2JyYSBlbiBsYSBPYnJhIERlcml2YWRhICh2LmcuLCAiVHJhZHVjY2nDs24gRnJhbmNlc2EgZGUgbGEgT2JyYSBkZWwgQXV0b3IgT3JpZ2luYWwsIiBvICJHdWnDs24gQ2luZW1hdG9ncsOhZmljbyBiYXNhZG8gZW4gbGEgT2JyYSBvcmlnaW5hbCBkZWwgQXV0b3IgT3JpZ2luYWwiKS4gVGFsIGNyw6lkaXRvIHB1ZWRlIHNlciBpbXBsZW1lbnRhZG8gZGUgY3VhbHF1aWVyIGZvcm1hIHJhem9uYWJsZTsgZW4gZWwgY2Fzbywgc2luIGVtYmFyZ28sIGRlIE9icmFzIERlcml2YWRhcyB1IE9icmFzIENvbGVjdGl2YXMsIHRhbCBjcsOpZGl0byBhcGFyZWNlcsOhLCBjb21vIG3DrW5pbW8sIGRvbmRlIGFwYXJlY2UgZWwgY3LDqWRpdG8gZGUgY3VhbHF1aWVyIG90cm8gYXV0b3IgY29tcGFyYWJsZSB5IGRlIHVuYSBtYW5lcmEsIGFsIG1lbm9zLCB0YW4gZGVzdGFjYWRhIGNvbW8gZWwgY3LDqWRpdG8gZGUgb3RybyBhdXRvciBjb21wYXJhYmxlLjwvbGk+CiAgICAgIDxsaT4KICAgICAgICBQYXJhIGV2aXRhciB0b2RhIGNvbmZ1c2nDs24sIGVsIExpY2VuY2lhbnRlIGFjbGFyYSBxdWUsIGN1YW5kbyBsYSBvYnJhIGVzIHVuYSBjb21wb3NpY2nDs24gbXVzaWNhbDoKICAgICAgICA8b2wgdHlwZT0iaSI+CiAgICAgICAgICA8bGk+UmVnYWzDrWFzIHBvciBpbnRlcnByZXRhY2nDs24geSBlamVjdWNpw7NuIGJham8gbGljZW5jaWFzIGdlbmVyYWxlcy4gRWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSBhdXRvcml6YXIgbGEgZWplY3VjacOzbiBww7pibGljYSBvIGxhIGVqZWN1Y2nDs24gcMO6YmxpY2EgZGlnaXRhbCBkZSBsYSBvYnJhIHkgZGUgcmVjb2xlY3Rhciwgc2VhIGluZGl2aWR1YWxtZW50ZSBvIGEgdHJhdsOpcyBkZSB1bmEgc29jaWVkYWQgZGUgZ2VzdGnDs24gY29sZWN0aXZhIGRlIGRlcmVjaG9zIGRlIGF1dG9yIHkgZGVyZWNob3MgY29uZXhvcyAocG9yIGVqZW1wbG8sIFNBWUNPKSwgbGFzIHJlZ2Fsw61hcyBwb3IgbGEgZWplY3VjacOzbiBww7pibGljYSBvIHBvciBsYSBlamVjdWNpw7NuIHDDumJsaWNhIGRpZ2l0YWwgZGUgbGEgb2JyYSAocG9yIGVqZW1wbG8gV2ViY2FzdCkgbGljZW5jaWFkYSBiYWpvIGxpY2VuY2lhcyBnZW5lcmFsZXMsIHNpIGxhIGludGVycHJldGFjacOzbiBvIGVqZWN1Y2nDs24gZGUgbGEgb2JyYSBlc3TDoSBwcmltb3JkaWFsbWVudGUgb3JpZW50YWRhIHBvciBvIGRpcmlnaWRhIGEgbGEgb2J0ZW5jacOzbiBkZSB1bmEgdmVudGFqYSBjb21lcmNpYWwgbyB1bmEgY29tcGVuc2FjacOzbiBtb25ldGFyaWEgcHJpdmFkYS48L2xpPgogICAgICAgICAgPGxpPlJlZ2Fsw61hcyBwb3IgRm9ub2dyYW1hcy4gRWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSByZWNvbGVjdGFyLCBpbmRpdmlkdWFsbWVudGUgbyBhIHRyYXbDqXMgZGUgdW5hIHNvY2llZGFkIGRlIGdlc3Rpw7NuIGNvbGVjdGl2YSBkZSBkZXJlY2hvcyBkZSBhdXRvciB5IGRlcmVjaG9zIGNvbmV4b3MgKHBvciBlamVtcGxvLCBsb3MgY29uc2FncmFkb3MgcG9yIGxhIFNBWUNPKSwgdW5hIGFnZW5jaWEgZGUgZGVyZWNob3MgbXVzaWNhbGVzIG8gYWxnw7puIGFnZW50ZSBkZXNpZ25hZG8sIGxhcyByZWdhbMOtYXMgcG9yIGN1YWxxdWllciBmb25vZ3JhbWEgcXVlIFVzdGVkIGNyZWUgYSBwYXJ0aXIgZGUgbGEgb2JyYSAo4oCcdmVyc2nDs24gY292ZXLigJ0pIHkgZGlzdHJpYnV5YSwgZW4gbG9zIHTDqXJtaW5vcyBkZWwgcsOpZ2ltZW4gZGUgZGVyZWNob3MgZGUgYXV0b3IsIHNpIGxhIGNyZWFjacOzbiBvIGRpc3RyaWJ1Y2nDs24gZGUgZXNhIHZlcnNpw7NuIGNvdmVyIGVzdMOhIHByaW1vcmRpYWxtZW50ZSBkZXN0aW5hZGEgbyBkaXJpZ2lkYSBhIG9idGVuZXIgdW5hIHZlbnRhamEgY29tZXJjaWFsIG8gdW5hIGNvbXBlbnNhY2nDs24gbW9uZXRhcmlhIHByaXZhZGEuPC9saT4KICAgICAgICA8L29sPgogICAgICA8L2xpPgogICAgICA8bGk+R2VzdGnDs24gZGUgRGVyZWNob3MgZGUgQXV0b3Igc29icmUgSW50ZXJwcmV0YWNpb25lcyB5IEVqZWN1Y2lvbmVzIERpZ2l0YWxlcyAoV2ViQ2FzdGluZykuIFBhcmEgZXZpdGFyIHRvZGEgY29uZnVzacOzbiwgZWwgTGljZW5jaWFudGUgYWNsYXJhIHF1ZSwgY3VhbmRvIGxhIG9icmEgc2VhIHVuIGZvbm9ncmFtYSwgZWwgTGljZW5jaWFudGUgc2UgcmVzZXJ2YSBlbCBkZXJlY2hvIGV4Y2x1c2l2byBkZSBhdXRvcml6YXIgbGEgZWplY3VjacOzbiBww7pibGljYSBkaWdpdGFsIGRlIGxhIG9icmEgKHBvciBlamVtcGxvLCB3ZWJjYXN0KSB5IGRlIHJlY29sZWN0YXIsIGluZGl2aWR1YWxtZW50ZSBvIGEgdHJhdsOpcyBkZSB1bmEgc29jaWVkYWQgZGUgZ2VzdGnDs24gY29sZWN0aXZhIGRlIGRlcmVjaG9zIGRlIGF1dG9yIHkgZGVyZWNob3MgY29uZXhvcyAocG9yIGVqZW1wbG8sIEFDSU5QUk8pLCBsYXMgcmVnYWzDrWFzIHBvciBsYSBlamVjdWNpw7NuIHDDumJsaWNhIGRpZ2l0YWwgZGUgbGEgb2JyYSAocG9yIGVqZW1wbG8sIHdlYmNhc3QpLCBzdWpldGEgYSBsYXMgZGlzcG9zaWNpb25lcyBhcGxpY2FibGVzIGRlbCByw6lnaW1lbiBkZSBEZXJlY2hvIGRlIEF1dG9yLCBzaSBlc3RhIGVqZWN1Y2nDs24gcMO6YmxpY2EgZGlnaXRhbCBlc3TDoSBwcmltb3JkaWFsbWVudGUgZGlyaWdpZGEgYSBvYnRlbmVyIHVuYSB2ZW50YWphIGNvbWVyY2lhbCBvIHVuYSBjb21wZW5zYWNpw7NuIG1vbmV0YXJpYSBwcml2YWRhLjwvbGk+CiAgICA8L29sPgogIDwvbGk+CiAgPGJyLz4KICA8bGk+CiAgICBSZXByZXNlbnRhY2lvbmVzLCBHYXJhbnTDrWFzIHkgTGltaXRhY2lvbmVzIGRlIFJlc3BvbnNhYmlsaWRhZC4KICAgIDxwPkEgTUVOT1MgUVVFIExBUyBQQVJURVMgTE8gQUNPUkRBUkFOIERFIE9UUkEgRk9STUEgUE9SIEVTQ1JJVE8sIEVMIExJQ0VOQ0lBTlRFIE9GUkVDRSBMQSBPQlJBIChFTiBFTCBFU1RBRE8gRU4gRUwgUVVFIFNFIEVOQ1VFTlRSQSkg4oCcVEFMIENVQUzigJ0sIFNJTiBCUklOREFSIEdBUkFOVMONQVMgREUgQ0xBU0UgQUxHVU5BIFJFU1BFQ1RPIERFIExBIE9CUkEsIFlBIFNFQSBFWFBSRVNBLCBJTVBMw41DSVRBLCBMRUdBTCBPIENVQUxRVUlFUkEgT1RSQSwgSU5DTFVZRU5ETywgU0lOIExJTUlUQVJTRSBBIEVMTEFTLCBHQVJBTlTDjUFTIERFIFRJVFVMQVJJREFELCBDT01FUkNJQUJJTElEQUQsIEFEQVBUQUJJTElEQUQgTyBBREVDVUFDScOTTiBBIFBST1DDk1NJVE8gREVURVJNSU5BRE8sIEFVU0VOQ0lBIERFIElORlJBQ0NJw5NOLCBERSBBVVNFTkNJQSBERSBERUZFQ1RPUyBMQVRFTlRFUyBPIERFIE9UUk8gVElQTywgTyBMQSBQUkVTRU5DSUEgTyBBVVNFTkNJQSBERSBFUlJPUkVTLCBTRUFOIE8gTk8gREVTQ1VCUklCTEVTIChQVUVEQU4gTyBOTyBTRVIgRVNUT1MgREVTQ1VCSUVSVE9TKS4gQUxHVU5BUyBKVVJJU0RJQ0NJT05FUyBOTyBQRVJNSVRFTiBMQSBFWENMVVNJw5NOIERFIEdBUkFOVMONQVMgSU1QTMONQ0lUQVMsIEVOIENVWU8gQ0FTTyBFU1RBIEVYQ0xVU0nDk04gUFVFREUgTk8gQVBMSUNBUlNFIEEgVVNURUQuPC9wPgogIDwvbGk+CiAgPGJyLz4KICA8bGk+CiAgICBMaW1pdGFjacOzbiBkZSByZXNwb25zYWJpbGlkYWQuCiAgICA8cD5BIE1FTk9TIFFVRSBMTyBFWElKQSBFWFBSRVNBTUVOVEUgTEEgTEVZIEFQTElDQUJMRSwgRUwgTElDRU5DSUFOVEUgTk8gU0VSw4EgUkVTUE9OU0FCTEUgQU5URSBVU1RFRCBQT1IgREHDkU8gQUxHVU5PLCBTRUEgUE9SIFJFU1BPTlNBQklMSURBRCBFWFRSQUNPTlRSQUNUVUFMLCBQUkVDT05UUkFDVFVBTCBPIENPTlRSQUNUVUFMLCBPQkpFVElWQSBPIFNVQkpFVElWQSwgU0UgVFJBVEUgREUgREHDkU9TIE1PUkFMRVMgTyBQQVRSSU1PTklBTEVTLCBESVJFQ1RPUyBPIElORElSRUNUT1MsIFBSRVZJU1RPUyBPIElNUFJFVklTVE9TIFBST0RVQ0lET1MgUE9SIEVMIFVTTyBERSBFU1RBIExJQ0VOQ0lBIE8gREUgTEEgT0JSQSwgQVVOIENVQU5ETyBFTCBMSUNFTkNJQU5URSBIQVlBIFNJRE8gQURWRVJUSURPIERFIExBIFBPU0lCSUxJREFEIERFIERJQ0hPUyBEQcORT1MuIEFMR1VOQVMgTEVZRVMgTk8gUEVSTUlURU4gTEEgRVhDTFVTScOTTiBERSBDSUVSVEEgUkVTUE9OU0FCSUxJREFELCBFTiBDVVlPIENBU08gRVNUQSBFWENMVVNJw5NOIFBVRURFIE5PIEFQTElDQVJTRSBBIFVTVEVELjwvcD4KICA8L2xpPgogIDxici8+CiAgPGxpPgogICAgVMOpcm1pbm8uCiAgICA8b2wgdHlwZT0iYSI+CiAgICAgIDxsaT5Fc3RhIExpY2VuY2lhIHkgbG9zIGRlcmVjaG9zIG90b3JnYWRvcyBlbiB2aXJ0dWQgZGUgZWxsYSB0ZXJtaW5hcsOhbiBhdXRvbcOhdGljYW1lbnRlIHNpIFVzdGVkIGluZnJpbmdlIGFsZ3VuYSBjb25kaWNpw7NuIGVzdGFibGVjaWRhIGVuIGVsbGEuIFNpbiBlbWJhcmdvLCBsb3MgaW5kaXZpZHVvcyBvIGVudGlkYWRlcyBxdWUgaGFuIHJlY2liaWRvIE9icmFzIERlcml2YWRhcyBvIENvbGVjdGl2YXMgZGUgVXN0ZWQgZGUgY29uZm9ybWlkYWQgY29uIGVzdGEgTGljZW5jaWEsIG5vIHZlcsOhbiB0ZXJtaW5hZGFzIHN1cyBsaWNlbmNpYXMsIHNpZW1wcmUgcXVlIGVzdG9zIGluZGl2aWR1b3MgbyBlbnRpZGFkZXMgc2lnYW4gY3VtcGxpZW5kbyDDrW50ZWdyYW1lbnRlIGxhcyBjb25kaWNpb25lcyBkZSBlc3RhcyBsaWNlbmNpYXMuIExhcyBTZWNjaW9uZXMgMSwgMiwgNSwgNiwgNywgeSA4IHN1YnNpc3RpcsOhbiBhIGN1YWxxdWllciB0ZXJtaW5hY2nDs24gZGUgZXN0YSBMaWNlbmNpYS48L2xpPgogICAgICA8bGk+U3VqZXRhIGEgbGFzIGNvbmRpY2lvbmVzIHkgdMOpcm1pbm9zIGFudGVyaW9yZXMsIGxhIGxpY2VuY2lhIG90b3JnYWRhIGFxdcOtIGVzIHBlcnBldHVhIChkdXJhbnRlIGVsIHBlcsOtb2RvIGRlIHZpZ2VuY2lhIGRlIGxvcyBkZXJlY2hvcyBkZSBhdXRvciBkZSBsYSBvYnJhKS4gTm8gb2JzdGFudGUgbG8gYW50ZXJpb3IsIGVsIExpY2VuY2lhbnRlIHNlIHJlc2VydmEgZWwgZGVyZWNobyBhIHB1YmxpY2FyIHkvbyBlc3RyZW5hciBsYSBPYnJhIGJham8gY29uZGljaW9uZXMgZGUgbGljZW5jaWEgZGlmZXJlbnRlcyBvIGEgZGVqYXIgZGUgZGlzdHJpYnVpcmxhIGVuIGxvcyB0w6lybWlub3MgZGUgZXN0YSBMaWNlbmNpYSBlbiBjdWFscXVpZXIgbW9tZW50bzsgZW4gZWwgZW50ZW5kaWRvLCBzaW4gZW1iYXJnbywgcXVlIGVzYSBlbGVjY2nDs24gbm8gc2Vydmlyw6EgcGFyYSByZXZvY2FyIGVzdGEgbGljZW5jaWEgbyBxdWUgZGViYSBzZXIgb3RvcmdhZGEgLCBiYWpvIGxvcyB0w6lybWlub3MgZGUgZXN0YSBsaWNlbmNpYSksIHkgZXN0YSBsaWNlbmNpYSBjb250aW51YXLDoSBlbiBwbGVubyB2aWdvciB5IGVmZWN0byBhIG1lbm9zIHF1ZSBzZWEgdGVybWluYWRhIGNvbW8gc2UgZXhwcmVzYSBhdHLDoXMuIExhIExpY2VuY2lhIHJldm9jYWRhIGNvbnRpbnVhcsOhIHNpZW5kbyBwbGVuYW1lbnRlIHZpZ2VudGUgeSBlZmVjdGl2YSBzaSBubyBzZSBsZSBkYSB0w6lybWlubyBlbiBsYXMgY29uZGljaW9uZXMgaW5kaWNhZGFzIGFudGVyaW9ybWVudGUuPC9saT4KICAgIDwvb2w+CiAgPC9saT4KICA8YnIvPgogIDxsaT4KICAgIFZhcmlvcy4KICAgIDxvbCB0eXBlPSJhIj4KICAgICAgPGxpPkNhZGEgdmV6IHF1ZSBVc3RlZCBkaXN0cmlidXlhIG8gcG9uZ2EgYSBkaXNwb3NpY2nDs24gcMO6YmxpY2EgbGEgT2JyYSBvIHVuYSBPYnJhIENvbGVjdGl2YSwgZWwgTGljZW5jaWFudGUgb2ZyZWNlcsOhIGFsIGRlc3RpbmF0YXJpbyB1bmEgbGljZW5jaWEgZW4gbG9zIG1pc21vcyB0w6lybWlub3MgeSBjb25kaWNpb25lcyBxdWUgbGEgbGljZW5jaWEgb3RvcmdhZGEgYSBVc3RlZCBiYWpvIGVzdGEgTGljZW5jaWEuPC9saT4KICAgICAgPGxpPlNpIGFsZ3VuYSBkaXNwb3NpY2nDs24gZGUgZXN0YSBMaWNlbmNpYSByZXN1bHRhIGludmFsaWRhZGEgbyBubyBleGlnaWJsZSwgc2Vnw7puIGxhIGxlZ2lzbGFjacOzbiB2aWdlbnRlLCBlc3RvIG5vIGFmZWN0YXLDoSBuaSBsYSB2YWxpZGV6IG5pIGxhIGFwbGljYWJpbGlkYWQgZGVsIHJlc3RvIGRlIGNvbmRpY2lvbmVzIGRlIGVzdGEgTGljZW5jaWEgeSwgc2luIGFjY2nDs24gYWRpY2lvbmFsIHBvciBwYXJ0ZSBkZSBsb3Mgc3VqZXRvcyBkZSBlc3RlIGFjdWVyZG8sIGFxdcOpbGxhIHNlIGVudGVuZGVyw6EgcmVmb3JtYWRhIGxvIG3DrW5pbW8gbmVjZXNhcmlvIHBhcmEgaGFjZXIgcXVlIGRpY2hhIGRpc3Bvc2ljacOzbiBzZWEgdsOhbGlkYSB5IGV4aWdpYmxlLjwvbGk+CiAgICAgIDxsaT5OaW5nw7puIHTDqXJtaW5vIG8gZGlzcG9zaWNpw7NuIGRlIGVzdGEgTGljZW5jaWEgc2UgZXN0aW1hcsOhIHJlbnVuY2lhZGEgeSBuaW5ndW5hIHZpb2xhY2nDs24gZGUgZWxsYSBzZXLDoSBjb25zZW50aWRhIGEgbWVub3MgcXVlIGVzYSByZW51bmNpYSBvIGNvbnNlbnRpbWllbnRvIHNlYSBvdG9yZ2FkbyBwb3IgZXNjcml0byB5IGZpcm1hZG8gcG9yIGxhIHBhcnRlIHF1ZSByZW51bmNpZSBvIGNvbnNpZW50YS48L2xpPgogICAgICA8bGk+RXN0YSBMaWNlbmNpYSByZWZsZWphIGVsIGFjdWVyZG8gcGxlbm8gZW50cmUgbGFzIHBhcnRlcyByZXNwZWN0byBhIGxhIE9icmEgYXF1w60gbGljZW5jaWFkYS4gTm8gaGF5IGFycmVnbG9zLCBhY3VlcmRvcyBvIGRlY2xhcmFjaW9uZXMgcmVzcGVjdG8gYSBsYSBPYnJhIHF1ZSBubyBlc3TDqW4gZXNwZWNpZmljYWRvcyBlbiBlc3RlIGRvY3VtZW50by4gRWwgTGljZW5jaWFudGUgbm8gc2UgdmVyw6EgbGltaXRhZG8gcG9yIG5pbmd1bmEgZGlzcG9zaWNpw7NuIGFkaWNpb25hbCBxdWUgcHVlZGEgc3VyZ2lyIGVuIGFsZ3VuYSBjb211bmljYWNpw7NuIGVtYW5hZGEgZGUgVXN0ZWQuIEVzdGEgTGljZW5jaWEgbm8gcHVlZGUgc2VyIG1vZGlmaWNhZGEgc2luIGVsIGNvbnNlbnRpbWllbnRvIG11dHVvIHBvciBlc2NyaXRvIGRlbCBMaWNlbmNpYW50ZSB5IFVzdGVkLjwvbGk+CiAgICA8L29sPgogIDwvbGk+CiAgPGJyLz4KPC9vbD4K 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