The Psychology of Eating: From Healthy to Disordered Behavior

Treating Eating Disorders 269

behavior change (see figure 11.2). Using a stages of change approach
involves the nurse eliciting where the patient is in terms of their desire to
change their behavior, accessing the patient’s perceived obstacles to chang-
ing their behavior, and asking them about the pros and cons of not eating
and eating. In particular, within the context of both cognitive restructur-
ing and motivational interviewing the nurse may address the meanings
associated with food avoidance, being thin, and the implications of weight
gain.

Weight restoration

Starvation brings with it a preoccupation with food and cognitive distor-
tions. It is also life threatening. Weight restoration is therefore essential to
the health of the patient and to their ability to engage in other forms of
therapy. Inpatient weight restoration involves encouraging the patient to
eat regularly, to eat small meals and snacks, and to limit exercise. Food intake
usually starts at about 1,000 kcals a day, which is gradually increased to
3,000 kcals, and a target weight range is set according to the patient’s pre-
morbid weight, taking into account their age of illness onset. A weight increase

Figure 11.2 The stages of change model. (Source: After J.O. Prochaska and
C.C. DiClemente, The Transtheoretical Approach: Crossing Traditional
Boundaries of Therapy, Homewood, Ill.: Dow Jones Irwin, 1984.)

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