Psychotherapy
Eating disorders are nearly always treated with some form of psychotherapy. Depending on the problem, different psychological approaches may work better than others.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) works on the principle that a pattern of false thinking and belief about one's body can be recognized objectively and altered, thereby changing the response and eliminating the unhealthy reaction to food. One approach for bulimia is the following:
- Over a period of 4 - 6 months the patient builds up to eating 3 meals a day, including foods that the patient has previously avoided.
- During this period, the patient monitors and records the daily dietary intake along with any habitual unhealthy reactions and negative thoughts toward eating while they are occurring.
- The patient also records any relapses (binges or purging). Such lapses are reported objectively and without self-criticism and judgment.
- The patient discusses the responses with a cognitive therapist at regular sessions. Eventually the patient is able to discover the false attitudes about body image and the unattainable perfectionism that underlies the opposition to food and health.
- Once these habits are recognized, food choices are broadened, and the patient begins to challenge any entrenched and automatic ideas and responses. The patient then replaces them with a set of realistic beliefs along with actions based on reasonable self-expectations.
Interpersonal Therapy
Interpersonal therapy deals with depression or anxiety that might underlie the eating disorders along with social factors that influence eating behavior. This therapy does not deal with weight, food, or body image at all.
Previous Section
Review Date: 02/18/2011
Reviewed By: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry,
Department of Psychiatry, Columbia University Medical Center, New
York, NY. Also reviewed by Harvey Simon, MD, Editor-in-Chief,
Associate Professor of Medicine, Harvard Medical School; Physician,
Massachusetts General Hospital; and David Zieve, MD, MHA, Medical
Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
