Help seeking and satisfaction with care in 641 women with eating disorders; I. Patterns of utilization, attributed change, and perceived efficacy of treatment

Article Abstract:

Help-seeking behavior, the types of treatments sought and the experiences of patients with eating disorders were evaluated among 641 women who answered an eating problem questionnaire in a national magazine (Glamour). The questionnaire was designed to elicit information about experiences with many types of treatments and to facilitate diagnosis according to criteria set by the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised. Respondents were divided into three diagnostic groups, namely those with anorexia nervosa with bulimic features (59 respondents), bulimia nervosa (367 respondents), or subdiagnostic eating disorder (206 respondents). Significantly more anorectics (92 percent) sought professional treatment than bulimic (71.1 percent) or subdiagnostic respondents (60.6 percent). About 53 percent of all respondents had been in individual psychotherapy, but almost 90 percent of the anorectics reported experience with individual psychotherapy. Other treatments sought by respondents included behavior modification (28 percent), group therapy (24.6 percent), psychotropic medication (12.2 percent) and nutritional counseling (18.6 percent). In general, respondents did not feel that they were helped very much by any of the available treatments. The anorexia nervosa group described themselves as either ''unchanged'' or ''somewhat worse'' in relation to attending Overeater's Anonymous or other self-help groups. Health professionals considered to be experts in eating disorders were rated as being only slightly more helpful than nonexpert therapists. Over the 20-month follow-up period of the study, reported symptom improvements were very slight, with no differences between those who sought treatment and those who did not. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys

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An integrated psychotherapy for eating-disorder patients

Article Abstract:

Anorexia and bulimia nervosa are complex eating disorders which require treatments that integrate biological, psychological, and social factors. The integration of brief dynamic therapy and cognitive behavioral techniques for the treatment of anorexia and bulimia is proposed. Cognitive-behavioral techniques involve control of behavior to modify eating and/or eliminating patterns by stressing the destructive and illogical nature of the patient's rationalizations. Brief dynamic therapy emphasizes challenging the psychological defenses of the patient by forcing her or him to confront the dynamics that arise in the relationship with the therapist and others. The necessity of focusing on getting rid of the immediate, life-threatening symptoms while at the same time continuing to probe psychodynamic issues is discussed and a case study is presented.

Evaluation, Cognitive therapy, Brief psychotherapy

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Exposure plus prevention of bingeing vs. exposure plus prevention of vomiting in bulimia nervosa: a crossover study

Article Abstract:

Two different treatments for bulimia, an eating disorder in which the patient alternately gorges and purges food, were compared. The first treatment exposed patients to the sight, smell and taste of food and then prevented them from bingeing. The second treatment exposed patients to a situation that tempted them to purge by vomiting, but prevented them from doing so. Many patients dropped out of the study, but both treatments worked reasonably well and were about equally effective at reducing bulimia between treatment sessions. However, the binge treatment took less time and led to greater reductions in the urge to binge, anxiety and the liking of food. These facts support the use of such treatments.

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