Abnormal Psychology

Eating Disorders 469

P S

FEEDBACK LOOPS IN TREATMENT: Eating Disorders N

With all eating disorders, successful treatment should resolve medical crises and

normalize eating and nutrition, whether directly or indirectly. For a person with

anorexia, this means increasing her eating. Better nutrition means improved brain

functioning (neurological factor) and cognitive functioning (psychological factor).

For a person with bulimia, it means normalizing her meals—making sure that she is

not only eating adequately throughout the day but also getting enough of the vari-

ous food groups. Eating in this way will decrease the likelihood of extreme hunger,

binges, or eating that feels out of control (psychological factor) (Shah et al., 2005).

In most cases, enduring changes in eating arise from changes in the way the indi-

vidual thinks about food, her beliefs about weight, appearance, femininity, effi cacy, and

control. These enduring changes may come about, in part, through CBT (psychologi-

cal factor). In addition, the individual is not isolated from her social context. The sup-

port of family and friends and the improved quality of these relationships, which may

arise from IPT or family therapy (social factor), can help her reject an overvaluation of

appearance, weight, and body shape. Improved family interaction patterns can increase

mood and satisfaction with relationships, which can decrease the level of attention that

the person pays to cultural pressures toward an ideal body shape (psychological factor).

The feedback loops involved in treating eating disorders are shown in Figure 10.8.

10.8 • Feedback Loops in

Treatment: Eating Disorders

Figure 10.8

TT

g

Treatments Targeting

Psychological Factors

CBT: Psychoeducation,

cognitive restructuring,

self-monitoring,

relaxation, exposure

with response

prevention

Treatments Targeting

Social Factors

IPT

Family Therapy

(including Maudsley

approach for anorexia)

Group therapy

Psychiatric Hospitalization

Treatments Targeting

Neurological and Other

Biological Factors

Medication:SSRIs

Medical hospitalization

Nutritional counseling

Changes weight,

nutrition, medical

functioning, and

neural activity

Changes thoughts,

feelings, and behaviors

Decreases shame and

isolation

Decreases familial

focus on appearance

Improves social and

family interactions