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Handbook of Behavior Therapy in the Psychiatric Setting pp 477–497Cite as

Eating Disorders

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Part of the book series: Critical Issues in Psychiatry ((CIPS))

Abstract

Eating disorders are associated with a significant morbidity and, in the case of anorexia nervosa, a high risk of mortality (18%) over the course of the illness (Theander, 1985). Although it is widely accepted that the majority of eating-disordered patients can be managed effectively as outpatients, most clinicians would agree that there is a subgroup of patients who either require or greatly benefit from inpatient treatment. The main objectives of hospitalization for eating-disordered patients are (1) weight restoration, or the interruption of steady weight loss in the case of anorexia nervosa; (2) the interruption of unremitting binging and vomiting; (3) the evaluation and treatment of medical complications; (4) the management of associated conditions, such as severe depression, suicidal behavior, and substance abuse; (5) addressing the psychological and interpersonal factors that have initiated or maintained the eating disorder; and (6) occasionally, the disengagement of patients from a social system that both contributes to the maintenance of the disorder and disrupts outpatient treatment. Although there is still a divergence of opinion regarding the etiology of eating disorders, considerable agreement exists on the parameters of inpatient management (Andersen, 1985; Andersen, Morse, & Santmyer, 1985; Garfinkel & Garner, 1982; Mitchell, 1990; Russell, 1970; Strober & Yager, 1985; Vandereycken & Meermann, 1984).

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References

  • American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed.; DSM-ni-R). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association (1991). DSM-IV options book: Work in progress 9/1/91 task force of DSM-IV. Washington, DC: Author.

    Google Scholar 

  • Andersen, A.E. (1985). Practical comprehensive treatment of anorexia nervosa and bulimia. Baltimore: Johns Hopkins Press.

    Google Scholar 

  • Andersen, A.E., Morse, C., & Santmyer, K. (1985). Inpatient treatment for anorexia nervosa. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press.

    Google Scholar 

  • Bachrach, A.J., Erwin, W.J., & Mohr, J.P. (1965). The control of eating behavior in an anorexic by operant conditioning techniques. In L.P. Ullmann & L. Krasner (Eds.), Case studies in behavior modification. New York: Holt, Rinehart & Winston.

    Google Scholar 

  • Bemis, K.M. (1987). The present status of operant conditioning for the treatment of anorexia nervosa. Behavior Modification, 77(4), 432–463.

    Article  Google Scholar 

  • Brotman, A.W., Stern, T.A., & Herzog, D.B. (1984) Emotional reactions of house officers to patients with anorexia nervosa, diabetes, and obesity. International Journal of Eating Disorders, 3, 71–77.

    Article  Google Scholar 

  • Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa and the person within. New York: Basic Books.

    Google Scholar 

  • Bruch, H. (1974) Perils of behavior modification in treatment of anorexia nervosa. Journal of American Medical Association, 230, 1419–1422.

    Article  Google Scholar 

  • Casper, R.C. (1987). The psychopathology of anorexia nervosa: The pathological psychodynamic processes. In P.J. V. Beaumont, G.D. Burrows, & R.C. Casper (Eds.), Handbook of eating disorders. Amsterdam: Elsevier.

    Google Scholar 

  • Cornerci, G.D. (1990). Medical complications of anorexia nervosa and bulimia nervosa. Medical Clinics of North America, 74(5), 1293–1310.

    Google Scholar 

  • Craighead, L.W., & Agras, W.S. (1991). Mechanisms of action in cognitive-behavioral and pharmacological interventions for obesity and bulimia nervosa. Journal of Consulting and Clinical Psychology, 59(1), 115–125.

    Article  PubMed  Google Scholar 

  • Crisp, A.H. (1980). Anorexia nervosa. New York: Grune & Stratton.

    Google Scholar 

  • Fairburn, C.G. (1987) The definition of bulimia nervosa: Guidelines for clinicians and research workers. Annals of Behavioral Medicine, 9, 3–7.

    Article  Google Scholar 

  • Fairburn, C.G., & Garner, D.M. (Eds.). (1988). Diagnostic criteria for anorexia nervosa and bulimia nervosa: The importance of attitudes to shape and weight. New York: Brunner/Mazel.

    Google Scholar 

  • Fairburn, C.G., Cooper, P.J., Kirk, J., & O’Connor, M. (1985) The significance of the neurotic symptoms of bulimia nervosa. Journal of Psychiatric Research, 19, 135–140.

    Article  PubMed  Google Scholar 

  • Foreyt, J.P., & McGavin, J.K. (1988). Anorexia nervosa and bulimia. In E.J. Marsh & L.G. Tudal (Ed.), Behavioral assessment of childhood disorders (pp. 776–805). New York: Guilford Press.

    Google Scholar 

  • Garfinkel, P.E., & Garner, D.M. (1982). Anorexia nervosa: A multidimensional perspective. New York: Brunner/Mazel.

    Google Scholar 

  • Garfinkel, P.E., & Garner, D.M. (1987). Psychotropic drug therapies for eating disorders. New York: Brunner/Mazel.

    Google Scholar 

  • Garfinkel, P.E., Kaplan, A.S., Garner, D.M., & Darby, P.L. (1983) The differentiation of vomiting/weight loss as a conversion disorder from anorexia nervosa. American Journal of Psychiatry, 140, 1019–1022.

    PubMed  Google Scholar 

  • Garner, D.M. (1991). Eating disorder inventory: 2. Professional manual. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Garner, D.M., & Bemis, K.M. (1982) A cognitive-behavioral approach to anorexia nervosa. Cognitive Therapy and Research, 6, 123–150.

    Article  Google Scholar 

  • Garner, D.M., & Bemis, K.M. (1985). Cognitive therapy for anorexia nervosa. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 107–146). New York: Guilford Press.

    Google Scholar 

  • Garner, D.M., & Garfinkel, P.E. (1985). Handbook of psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press.

    Google Scholar 

  • Garner, D.M., & Garfinkel, P.E. (1988). Diagnostic issues in anorexia nervosa and bulimia nervosa. New York: Brunner/Mazel.

    Google Scholar 

  • Garner, D.M., & Rosen, L.W. (1990). Anorexia nervosa and bulimia nervosa (pp. 805–817) In A.S. Bellack, M. Hersen, & A.E. Kazdin (Eds.), International Handbook of Behavior Modification and Therapy (2nd ed.). New York: Plenum Press.

    Chapter  Google Scholar 

  • Garner, D.M., & Wooley, S.C. (1991) Confronting the failure of behavioral and dietary treatments for obesity. Clinical Psychology Review, 11, 729–780.

    Article  Google Scholar 

  • Garner, D.M., Garfinkel, P.E., & Bemis, K.M. (1982) A multidimensional psychotherapy for anorexia nervosa. International Journal of Eating Disorders, 1, 3–46.

    Article  Google Scholar 

  • Garner, D.M., Garfinkel, P.E., & O’Shaughnessy, M. (1985a) The validity of the distinction between bulimia with and without anorexia nervosa. American Journal of Psychiatry, 142, 581–587.

    PubMed  Google Scholar 

  • Garner, D.M., Rockert, W., Olmsted, M.P., Johnson, C.L., & Coscina, D.V. (1985b). Psychoeducational principles in the treatment of bulimia and anorexia nervosa. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 513–572). New York: Guilford Press.

    Google Scholar 

  • Garner, D.M., Garfinkel, P.E. & Irvine, M.J. (1986) Integration and sequencing of treatment approaches for eating disorders. Psychotherapy and Psychosomatics, 46, 67–75.

    Article  PubMed  Google Scholar 

  • Garner, D.M., Olmsted, M.P., Davis, R., Rockert, W., Goldbloom, D., & Eagle, M. (1990) The association between bulimic symptoms and reported psychopathology. International Journal of Eating Disorders, 9, 1–15.

    Article  Google Scholar 

  • Garner, D.M., Shafer, C.L., & Rosen, L.W. (1992). Critical appraisal of the DSM-III-R diagnostic criteria for eating disorders. In S.R. Hooper, G.W. Hynd, & R.E. Mattison (Eds.), Child psychopathology, diagnostic criteria and clinical assessment (pp. 261–303). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Garner, D.M. Garner, M.V., & Rosen, L.W. (in press). Anorexia nervosa “restrictors” who purge: Implications for subtyping anorexia nervosa. International Journal of Eating Disorders.

    Google Scholar 

  • Geller, J.L. (1975) Treatment of anorexia nervosa by the integration of behavior therapy and psychotherapy. Psychotherapy and Psychosomatics, 26, 167–177.

    Article  PubMed  Google Scholar 

  • Giles, T.R., Young, R.R., & Young, D.E. (1985) Case studies and clinical replication series: Behavioral treatment of severe bulimia. Behavioral Therapy, 16, 393–405.

    Article  Google Scholar 

  • Goldner, E. (1989) Treatment refusal in anorexia nervosa. International Journal of Eating Disorders, 8, 297–306.

    Article  PubMed  Google Scholar 

  • Goodsitt, A. (1985). Self psychology and the treatment of anorexia nervosa. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 55–84). New York: Guilford Press.

    Google Scholar 

  • Guidano, V.F., & Liotti, G. (1983). Cognitive processes and emotional disorders: A structural approach to psychotherapy. New York: Guilford Press.

    Google Scholar 

  • Hall, A. (1985). Group psychotherapy for anorexia nervosa. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 213–239). New York: Guilford Press.

    Google Scholar 

  • Hallsten, E.A., Jr. (1965). Adolescent anorexia nervosa treated by desensitization. Behavior Research and Therapy, 3(87), 87–91.

    Article  Google Scholar 

  • Hamburg, P., & Herzog, D. (1990). Supervising the therapy of patients with eating disorders. American Journal of Psychotherapy, XLIV(3), 369–380.

    Google Scholar 

  • Hersen, M., & Detre, T. (1980). The behavioral psychotherapy of anorexia nervosa. In T.B. Karasu, & L. Bellak (Eds.), Specialized techniques in individual psychotherapy (pp. 295–304). New York: Brunner/Mazel.

    Google Scholar 

  • Humphrey, L.L. (1989). Is there a causal link between disturbed family processes and eating disorders? In W.G. Johnson (Ed.), Bulimia nervosa: Perspectives on clinical research and therapy. New York: JAI Press.

    Google Scholar 

  • Johnson, C. (1991). Psychodynamic treatment of anorexia nervosa and bulimia. New York: Guilford Press.

    Google Scholar 

  • Johnson, C., & Connors, M.E. (1987). The etiology and treatment of bulimia nervosa: A biopsychosocial perspective. New York: Basic Books.

    Google Scholar 

  • Kalucy, R.S., Gilchrist, P.N., McFarlane, C.M., & McFarlane, A.C. (1985). The evolution of a multitherapy orientation. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa. New York: Guilford Press.

    Google Scholar 

  • Lucas, A.R., Duncan, J.W., & Piens, V. (1976) The treatment of anorexia nervosa. American Journal of Psychiatry, 133, 1034–1038.

    PubMed  Google Scholar 

  • Millon, T. (1982). Millon Clinical Multiaxial Inventory Manual (3rd ed.). Minneapolis: National Computer Systems.

    Google Scholar 

  • Minuchin, S., Rosman, B.L., & Baker, L. (1978). Psychosomatic families: Anorexia nervosa in context. Cambridge: Harvard University Press.

    Google Scholar 

  • Mitchell, J.E. (1990). Bulimia nervosa. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Mitchell, J.E., & Boutacoff, L.I. (1986) Laxative abuse complicating bulimia: Medical and treatment implications. International Journal of Eating Disorders, 5, 325–334.

    Article  Google Scholar 

  • Mitchell, J.E., Pomery, C., & Huber, M. (1988) A clinician’s guide to the eating disorders medicine cabinet. International Journal of Eating Disorders, 2, 211–223.

    Article  Google Scholar 

  • Mitchell, J.E., Pyle, R.L., Eckert, E.D., Hatsukami, D., Pomeroy, C., & Zimmerman, R. (1990) A comparison study of antidepressants and structured intensive group psychotherapy in the treatment of bulimia nervosa. Archives of General Psychiatry, 47, 149–157.

    Article  PubMed  Google Scholar 

  • Mitchell, P.B. (1988). The pharmacological management of bulimia nervosa: A critical review. International Journal of Eating Disorders, 7(1), 29–41.

    Article  Google Scholar 

  • Olmsted, M.P., Davis, R., Rockert, W., Irvine, M.J., Eagle, M., & Garner, D.M. (1991) Efficacy of a brief group psychoeducational intervention for bulimia nervosa. Behavior Research and Therapy, 29, 71–83.

    Article  Google Scholar 

  • Piran, N., Kaplan, A., Kerr, A., Shekter-Wolfson, L., Winocur, J., Gold, E., & Garfinkel, P.E. (1989). A day hospital program for anorexia nervosa and bulimia. International Journal of Eating Disorders, 8(5), 511–521.

    Article  Google Scholar 

  • Root, M.M.P., Fallon, P., & Friedrich, W.N. (1985). Bulimia: A systems approach to treatment. New York: W. W. Norton.

    Google Scholar 

  • Rosen, J.C. (1987). A review of behavioral treatments for bulimia nervosa. Behavior Modification, 11(4), 464–486.

    Article  PubMed  Google Scholar 

  • Russell, G. (1979) Bulimia nervosa: An ominous variant of anorexia nervosa. Psychological Medicine, 9, 429–448.

    Article  PubMed  Google Scholar 

  • Russell, G.F. M. (1970). Anorexia nervosa: Its identity as an illness and its treatment. In J.H. Price (Ed.), Modern trends in psychological medicine (Vol. 2, pp. 131–164). London: Butterworth’s.

    Google Scholar 

  • Russell, G.J. M. (1973). The management of anorexia nervosa. In Symposium on Anorexia Nervosa and Obesity (pp. 44–62). Edinburgh: Royal College of Physicians.

    Google Scholar 

  • Russell, G.F.M., Szmukler, G.I., Dare, C., & Eisler, I. (1987) An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44, 1047–1056.

    Article  PubMed  Google Scholar 

  • Sansone, R.A., Fine, M.A., & Chew, R. (1988). A longitudinal analysis of the experiences of nursing staff on an inpatient eating disorders unit. International Journal of Eating Disorders, 7(1), 125–131.

    Article  Google Scholar 

  • Schwartz, R.C., Barrett, M.J., & Saba, G. (1985). Family therapy for bulimia. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press.

    Google Scholar 

  • Selvini-Palazzoli, M.P. (1974). Self-starvation. London: Chaucer Publishing.

    Google Scholar 

  • Shisslak, C.M., Gary, N., & Crago, M. (1989). Health care professionals’ reactions to working with eating disorder patients. International Journal of Eating Disorders, 8(6), 689–694.

    Article  Google Scholar 

  • Spitzer, R.L., Devlin, M., Walsh, B.T., Hasin, D., Wing, R., Marcus, M., Stunkard, A., Wadden, T., Yanovski, S., Agras, S., Mitchell, J., & Nonas, C. (1992) Binge eating disorder: A multisite field trial of the diagnostic criteria. International Journal of Eating Disorders, 11, 191–203.

    Article  Google Scholar 

  • Stern, S. (1986). The dynamics of clinical management in the treatment of anorexia nervosa and bulimia: An organizing theory. International Journal of Eating Disorders, 5(2), 233–254.

    Article  Google Scholar 

  • Strober, M., & Humphrey, L.L. (1987) Familial contributions to the etiology and course of anorexia nervosa and bulimia. Journal of Consulting and Clinical Psychology, 55, 654–659.

    Article  PubMed  Google Scholar 

  • Strober, M., & Yager, J. (1985). A developmental perspective on the treatment of anorexia nervosa in adolescents. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia (pp. 363–390). New York: Guilford Press.

    Google Scholar 

  • Theander, S. (1985) Outcome and prognosis in anorexia nervosa and bulimia: Some results of previous investigations, compared with those of a Swedish long-term study. Journal of Psychiatric Research, 19, 493–508.

    Article  PubMed  Google Scholar 

  • Tobin, D.L., & Johnson, C.L. (1991). The integration of psychodynamic and behavior therapy in the treatment of eating disorders: Clinical issues versus theoretical mystique. In C.L. Johnson (Ed.), Psychodynamic treatment of anorexia nervosa and bulimia (pp. 374–397). New York: The Guilford Press.

    Google Scholar 

  • Tobin, D.L., Johnson, C., Steinberg, S., Staats, M., & Dennis, A.B. (1991). Multifactorial assessment of bulimia nervosa. Journal of Abnormal Psychology, 100(1), 4–21.

    Article  Google Scholar 

  • Touyz, S.W., Beumont, P.J.V., Glaun, D., Phillips, T., & Cowie, J. (1984) A comparison of lenient and strict operant conditioning programmes in refeeding patients with anorexia nervosa. British Journal of Psychiatry, 144, 512–520.

    Google Scholar 

  • Vandereycken, W., & Meermann, R. (1984). Anorexia nervosa: A clinician’s guide to treatment. New York: Walter de Gruyter.

    Google Scholar 

  • Vandereycken, W., Kog, E., & Vanderlinden, J. (1989). The family approach to eating disorders. New York: PMA Publishing Corp.

    Google Scholar 

  • Walsh, B.T., Hadigan, C.M., Devlin, M.J., Gladis, M., & Roose, S.P. (1991) Long-term outcome of antidepressant treatment for bulimia nervosa. American Journal of Psychiatry, 148, 1206–1212.

    PubMed  Google Scholar 

  • Welch, G.W., Hall, A., & Renner, R. (1990) Patient subgrouping in anorexia nervosa using psychologically-based classification. International Journal of Eating Disorders, 9, 311–322.

    Article  Google Scholar 

  • Wooley, S.C., & Wooley, O.W. (1985). Intensive outpatient and residential treatment for bulimia. In D.M. Garner & P.E. Garfinkel (Eds.), Handbook of psychotherapy for anorexia nervosa and bulimia. New York: Guilford Press.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Michigan State University, East Lansing, Michigan, 48824-1316, USA

    David M. Garner

  2. Eating Disorder Program, Beaumont Hospital, Royal Oak, Michigan, 48073, USA

    Alexander H. Sackeyfio

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  1. David M. Garner
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  2. Alexander H. Sackeyfio
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Editor information

Editors and Affiliations

  1. Medical College of Pennsylvania at EPPI, Philadelphia, Pennsylvania, USA

    Alan S. Bellack Ph.D.

  2. School of Psychology, Nova University, Fort Lauderdale, Florida, USA

    Michel Hersen Ph.D.

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Garner, D.M., Sackeyfio, A.H. (1993). Eating Disorders. In: Bellack, A.S., Hersen, M. (eds) Handbook of Behavior Therapy in the Psychiatric Setting. Critical Issues in Psychiatry. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-2430-8_23

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  • DOI: https://doi.org/10.1007/978-1-4899-2430-8_23

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