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Research and Treatment in the Psychobiology of Bulimia Nervosa 1 2 K. M. Pirke and W. Vandereycken When we were preparing this book, the main purpose was to gather the latest in sights from both basic and clinical research in bulimic disorders. The burgeoning scientific interest in eating disorders forced us to restrict the focus in such a way that attention was only paid to psychobiological aspects of (disturbed) nutrition and be havior. This implied that other important aspects, like sociocultural and familial fac tors, had to be excluded. But it turned out that even with such a restricted scope the subject was not an easy one. A review of the contributions to this volume clearly shows that our present understanding of bulimia nervosa is still very small. Reviewing the hypothalamic and especially neuroendocrine regulation of nutrient balance, Bray has emphasized the importance of the autonomic nervous system in regulating food intake and energy expenditure. The role of insulin, adrenal steroids, gonadal steroids, and growth hormone in modulating nutrient intake and storage were discussed. The studies by Jimerson et aI. , Schweiger et aI. , and Fichter et al. show that all these factors are altered in bulimic patients, indicating that the whole system of regulating food intake and storage is severely disturbed in bulimia nervosa. Evidence has been presented that neurotransmitter alterations may occur in bulimia: Jimerson et al.
This innovative scientific reference and clinical tool is virtually two books in one. Part I thoroughly yet succinctly reviews the literature on binge-eating disorder, covering diagnosis and epidemiology, clinical features and course, links to obesity, medical risks, and current treatment data. Part II provides an evidence-based cognitive-behavioral treatment manual. Session-by-session guidelines address how to help individuals or groups change their eating behavior, cope with emotional triggers, restructure problematic thoughts, deal with body image concerns and associated problems, maintain improvement, and prevent relapse. Featured are more than 40 clearly explained homework assignments and handouts, all in a large-size format with permission to photocopy.
Offers a collection of articles which discuss the causes, symptoms, health and psychological effects, and treatments of eating disorders, and provides a directory of facilities and programs designed to help people with these disorders.
As fish must swim so must man drink and eat Titus Petronius Arbiter Examine thy customs of diet Francis Bacon For John eat & drank to drive away Loves pain But all he could do he grew thinner & thinner Tho he eat & drank as much as Ten men for dinner Some said he had a Wolf in his stomach day and night William Blake To paraphrase and cast in contemporary speech observations of the Gothic-era monk Bernard of Clairvaux, the eating disorders may be viewed as a corruption of the social process, a distortion of the body image, and a perversion of bodily processes. It is this multifactorial etiology that makes the diagnosis and treatment of dietary -disorders so difficult and frustrating. Because of social demands and a distorted (body) image, men and women have perverted the simple act of eating into always painful, sometimes tragic, and occasionally deadly outcomes. The eating disorders fall into three categories. There is obesity-the overconsumption of food, and its antithesis, anorexia-the act of vol untary starvation. In true Hegelian fashion, there follows the synthesis, bulimia-the voluntary purging of overconsumed amounts of food to produce an anorectic-like countenance. As the contributing authors em phasize in their chapters, these diseases are not unique to contemporary culture. Rather they are cultural artifacts, created by both men and women, since classical antiquity. The recognition of these diseases is dependent upon recognizing a disease actually exists: that there is a distortion of the eating process.
Bulimia Nervosa is an eating disorder characterised by recurrent episodes of binge-eating followed by inappropriate compensatory behaviour. It affects 1-2% of the population, the majority of cases occurring in women between the ages of 16 and 35. This book provides a comprehensive and detailed review of the key psychological aspects of the disorder and places particular emphasis on cognitive considerations. The coverage includes the key features of Bulimia Nervosa, associated problems, psychological theories and different treatment approaches. There is special focus on cognitive factors with case examples used to illustrate the two most articulated cognitive treatments for the disorder. Emerging topics, such as imagery and metacognition are covered, as are service issues, such as stepped care and practice guidelines. Drawing on research and theory from cognitive and non-clinical areas of psychology, The Psychology of Bulimia Nervosa provides an original and challenging perspective on this debilitating condition. It questions assumptions about cognitive theory of Bulimia Nervosa and the role of standard cognitive therapy in treating the problem, suggests novel ideas, and a revised treatment and outlines areas for further research activity.
Bibliography: p. 149-168.
More and more clinicians as well as researchers realize that anorexia nervosa and bulimia nervosa often are extremely difficult to treat and that the short-term outcome can be very misleading. In many cases these disordersprevail for a long period of time and can have serious consequences for the patient's further life. This book gives a detailed over- view oftoday's knowledge regarding the long-term outcome of the treatment of anorexic and bulimic patients, many of whom were treated in highly spezialized centers. Experts from bo- th Europe and the U.S. report on theirmost recent research. Their studies include medical as well as psychosocial and psychiatric aspects of eating disorders. Clinicians with long experience in the treatment of eating disorder patients discuss the important practical implications of these rese- arch findings. The information given in this book is helpful for both treatment and prevention of eating disorders. Finally, concrete guidelines show as how to conduct further follow-up studies in this field.
A practical guide which describes various therapeutic methods and strategies for treating bulimia nervosa on both an inpatient and an outpatient basis. It presents a multidimensional treatment approach that integrates strategies from different therapeutic models to foster effective intervention.