Therapy
Eating disorders are nearly always treated with some form of psychiatric or psychologic treatment. Depending on the problem, different psychologic 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 to 6 months the patient builds up to 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.
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An interesting Swedish study reported significant success in a small group of patients with anorexia and bulimia using specific behavioral techniques that were based on the premises that dieting and exercise stimulate regions in the brain to produce feelings of pleasure and reward.
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