Therapy for Eating Disorders

Preface
Acknowledgements
What is an eating disorder?
A note about psychiatric diagnosis
Eating Disorders in the twenty first century
The relationship between weight and eating disorder
Anorexia nervosa
Bulimia nervosa
Binge Eating Disorder
Feeding and Eating disorders not elsewhere classified
Other causes of weight loss or gain or unusual eating behaviours
Causes of the Eating Disorders
Psychobiological mechanisms
Psychosomatic theories
Looking for an explanation in the past
Eating disorder and other psychiatric diagnoses: is there a genetic susceptibility?
Anorexia and bulimia nervosa as sociocultural phenomena
Eating disorder as learned behavior
Eating disorder as a corollary to dieting and food deprivation
Conclusions
Treatment for the Eating Disorders
Psychodynamic therapies
Family therapies
The use of psychotropic medication
Cognitive behaviour therapy
An outline of the characteristics of CBT
How effective is CBT for eating disorders?
Conclusions
A Cognitive Behavioural and Integrative Approach to Eating Disorders
The theoretical basis of a cognitive behaviour therapy approach to the eating disorders
The structure of cognitive therapy for eating disorders
The acceptability of cognitive therapy for eating disorders
A broad interpretation of cognitive therapy for the eating disorders
Conclusions
Beginning the Therapy Process
The initial stages
Some questions to ask when assessing the person with an eating disorder
The use of questionnaires in the assessment of eating disorder
Is this the right time for therapy?
Conclusion
Preparing for change
Presenting the cognitive behavioural view and formulating the problem
Assessment of motivational stage in people with an eating disorder
Self-monitoring by the client
Setting the agenda for therapy
A focus on emotions and coping strategies
Psychoeducation
Nutritional Aspects of Helping the Eating-Disordered Client
Nutritional knowledge of eating-disordered clients
Nutritional counselling
The body's need for good nutrition
Knowledge about energy balance and weight regulation
Information about the specific effects of bingeing and purging
Information about the effects of food and eating on metabolism
Establishing a normal eating pattern with obese binge eaters: to diet or not?
Establishing weight gain with anorexics
Behavioural Techniques
Self-monitoring
Target setting
Behavioural experiments
Self-reward
Scheduling pleasant events
Behavioural techniques for controlling overeating (self-control)
Taking exercise
Practising 'normal' eating
Exposure
Assertiveness around food
Relaxation and stress management
Conclusion
Cognitive Techniques
Identifying negative thoughts
Answering negative thoughts
Homework
Identifying and dealing with dysfunctional assumptions and core beliefs
Modifying assumptions and core beliefs
Exploring the meaning of eating disorder symptoms
Getting 'stuck'
Conclusion
Adapting to Different Situations and Dealing with Endings
Working with severe and complex cases
The end of the therapy relationship
Preventing relapse
Involving family members in the therapy process
Working with groups
Working in parallel with other treatments
Conclusion
Conclusion
Appendix 1: Some useful web pages
Appendix 2: Eating Problems: Resources for Clients
Appendix 3: Eating Disorders and their Effects
Appendix 4: Guidelines for Normal Healthy Eating
Appendix 5: The Effects of Strict Dieting and Starvation and of Giving Them Up
Appendix 6: Medical and Physical Problems Caused by the Symptoms of Eating Disorders
Appendix 7: Controlling What You Eat
Appendix 8: Giving Up Vomiting as a Way to Control Your Weight or Deal with Stress
Appendix 9: Learning to be Assertive about What You Eat: A Bill of Rights
References
Index