A model of eating disorders

1
A model of eating disorders
Restriction of eating
Bulimia Bingeing Purging Maintain weight
Anorexia Continued restriction Reduced
anxiety Excessive weight loss
psychlotron.org.uk
Based on Barlow Durand (1995)
2
Treatments for EDs

• Behaviour therapy
• Cognitive behaviour therapy
• Weight restoration (anorexia only)

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3
BT with bulimia

• Attempts to directly manipulate behaviour e.g.
• Allowing bingeing preventing purging (Exposure
  with Response Prevention)
• Reinforcement of appropriate eating punishment
  of inappropriate etc.
• Prescribed alterations in eating patterns

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4
BT with bulimia

• Waist cord therapy patients given cord to tie
  around waist
• Assumed it might provide stimulus to stop
  bingeing.
• Made bingeing more likely (Boggs et al, 2006)
• ERT better than no treatment
• No advantage over other therapies (Carter et al,
  2002 Leitenberg et al, 1988)

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5
BT with bulimia

• Patients given eating programme to follow
  (Fairburn et al, 1985)
• Small, manageable meals
• 5-6 times a day
• No more than 3 hours between meals
• Improvement in about 40 of patients half these
  had relapsed after 4 months

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6
BT with anorexia

• Use of reinforcement/punishment to encourage
  appropriate eating
• Useful for facilitating weight gain
  (reinforceraccess to physical activity Blinder
  et al, 1970)
• Generally helpful in weight restoration (Bemis,
  1987)
• Target weight for release from hospital
  facilitates weight restoration (Barlow Durand,
  1995)

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7
BT with anorexia nervosa

• Can play a part in initial treatment of anorexia
• Not a cure and not sufficient to bring about long
  term change
• May raise ethical questions (patients rights
  consent to treatment see token economy)

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