[Interactional treatment of eating behavior disorders]

The Eating Disorders Center (EDC), is a clinical-research project of the Mental Research Institute (MRI) centered in the study and treatment of Anorexia Nervosa (Self Starvation), Bulimia (binge-eating and purging) and weight/diet obsessions/compulsions. This paper presents: a) A brief description of the Center, both in its research and clinical aspects. The clinical program is centered in the application of the MRI's brief interactional approach to the treatment of eating disorders. The research project is being developed. b) A definition of terms, taken from the Statistical Manual of Mental Disorders (DSM III) and how these eating disorders have shown an increase in recent years. c) A brief discussion of theories of etiology and maintenance in the field of eating disorders. This point includes the perspective on eating disorders of several theoretical models, and how we believe that it is the societal model the one that can account for the recent increase of eating disorders.

The syndrome of bulimia. Review and synthesis

This comprehensive review of the syndrome of bulimia outlines treatment modalities including response prevention, cognitive behavioral and group interventions, and antidepressant pharmacotherapy. The authors propose an etiologic model that synthesizes available data indicating that young women who are at risk for developing bulimia appear to have a biologic vulnerability to affective instability, have family environments that are conflicted and disorganized, and a variety of personality traits that result in low self-esteem and self-regulatory difficulties.

The function of self-help groups in recovery from anorexia nervosa and bulimia

This article describes the role of the self-help group in helping patients to recover from eating disorders. The author outlines benefits, potential problems, and a sample format for an eating disorders self-help group meeting. A list of self-help organizations is provided.

Bulimia: the emergence of a syndrome

The literature on bulimia, which has regarded it as a psychiatric entity or as a form of disordered eating, suggests that this behaviour is now widespread among the obese, among those with anorexia nervosa and those of normal weight. While physiological, psychological and sociocultural explanations and forms of treatment have been proposed, a holistic perspective on the context in which it occurs can distinguish bulimia nervosa and bulimarexia from 'simple' bulimia.

The role of social work in a model self-help organization

This article identifies current DSM-III criteria for anorexia nervosa and bulimia, discusses characteristics of the disorders, and reviews current interventions. The self-help practiced by a particular group is examined within the context of relevant literature on self-help, and the role of the social worker in conjunction with this model is considered. The author explores the future of self-help in relation to social work.

The interruption of bulimic behaviors. A review of three treatment programs

This article reviews three programs for treating bulimic behaviors. Although the structures of these programs differ considerably, all are geared to an outpatient approach and stress patient education, behavioral self-monitoring, and healthy eating behaviors. The programs described demonstrate a heavy reliance on behavioral treatments including cognitive restructuring, emphasis on individual patient responsibility for progress in treatment, and an expectation for success by supportive therapists and by patients.

An inpatient model for the treatment of eating disorders

The inpatient aspect of a comprehensive treatment program is detailed, including the daily hospital routine and description of professional staff personnel. The author provides an overview of the educational materials available to patients and their families to promote increased awareness of all facets of eating disorders. Categories of treatment for the care of anorectics and bulimics are detailed, and the importance of support systems in the form of self-help groups for patients and their families is stressed throughout.

Anorexia nervosa and bulimia

Anorexia nervosa may occur in one of 200 white adolescent girls, and bulimia appears to be much more common, particularly in older adolescents and young women. These disorders are distinctly uncommon in the male population. Current opinion supports a psychological basis for these disorders, although there are some findings that suggest a primary hypothalamic defect. Early warning signs of anorexia nervosa include an arrest in weight gain during puberty, increasing social isolation, hyperathleticism, and increasing concern over academic performance. Bulimia may exist concomitantly with anorexia nervosa or as an entirely separate disorder characterized by a recurrent binge-purge cycle. The signs and symptoms of these eating disorders are mainly those associated with weight loss, dehydration, and electrolyte imbalance. Because of the complex psychological issues involved, an experienced psychotherapist should be involved while the primary care clinician provides anticipatory and supportive medical care.

Group therapy for bulimic adults

Eating disorders are increasingly coming to the attention of mental health practitioners, and effective treatment approaches are a matter of growing concern. This paper describes the structure, process, and outcome of a group therapy project involving eight bulimic women.

Bulimia and alcoholism: two sides of the same coin?

There has been an epidemic rise recently in the number of women evidencing bulimia, an addictive cycle of binge eating and purging of food. A significant number of bulimics are reported to abuse alcohol and drugs as well. There is a need to account for the serious problem of symptom substitution in substance abusing populations. Substance abuse is considered within the framework of ego growth, with a particular focus on developmental deficits and compensatory actions. Alcohol, food, and drugs all serve as attempts to minimize the impact of ego deficits. In this regard, the function the substance serves is more crucial than the specific substance abused. A treatment model for bulimia is outlined which addresses both the addiction at hand and the underlying developmental deficits.

Cognitive behaviour therapy for anorexia nervosa: some preliminary findings

Five patients with anorexia nervosa were treated using a cognitive behavioural approach which was an adaptation of an established treatment for the related eating disorder, bulimia nervosa. The results were mixed. For patients with episodes of bulimia the outcome was sufficiently promising to merit more systematic research.