| One of the most striking characteristics of anorexia | | | | to treatment, I will get fat. |
| nervosa is the intensity and importance of the | | | | 2. I am fat (even though I weigh 90 pounds). |
| patients dysfunctional beliefs and values concerning | | | | 3. I am not allowed to eat anything until after 9:00PM. |
| their weight and shape. The patients beliefs and | | | | If I do, I will be out of control. |
| values can be viewed and understood in cognitive | | | | 4. Once I begin to eat normal foods, I will lose control |
| terms. | | | | and not be able to stop. |
| Anorexia nervosa may be seen as a behavioral | | | | 5. If I eat any fat, it will go right to my thighs. |
| coping skill. Like all coping skills, it develops out of | | | | 6. I love to wear tank tops to the mall because |
| attempts to deal with life events. The poor coping | | | | people stare at me. I know that they are just jealous |
| skills that develop may include fears ofgrowing up | | | | because I look so good. |
| and fears of being on ones own (separating from | | | | 7. I feel more powerful when I do not eat. |
| parents, having a boyfriend, sexuality); feelings of | | | | 8. I like the way I feel when I am thin. |
| ineffectiveness, helplessness, and poor self-esteem; | | | | 9. I can keep people at a distance. |
| and often disturbed or dysfunctional relationships with | | | | 10. I am more confident and capable when I am thin. |
| people close to the person. The anorexic becomes | | | | Many researchers have elaborated on the |
| preoccupied with food and weight to distract the self | | | | cognitive-behavioral model and suggested their own |
| from overwhelming feelings of anxiety, fear, and | | | | extensions of the cognitive-behavioral model that |
| depression, triggered by these events. Then, the | | | | integrates sociocultural and biological influences which |
| habit of food restriction and rituals become so | | | | may lead to the initiation and maintenance of the |
| entrenched that this set of behaviors can become | | | | habits of the anorexic. They proposed that |
| split off from their original causes and exist by | | | | predisposing factors were genetic and nutritional. |
| themselves, maintaining themselves as functionally | | | | Affective disorders such as anxiety and depression |
| autonomous behaviors. | | | | were prominent etiological factors along with family |
| The distorted beliefs, values, and behaviors or | | | | dysfunction and personality variables. Their models |
| cognitive distortions of the patient are more than | | | | include obesity and binge eating. In their model, the |
| just symptoms and can assume primary importance | | | | weight gain from binge eating leads to the perception |
| in the maintenance of the eating disorder. A | | | | of being fat, and anorexia may develop out of |
| requirement for full recovery is to change these | | | | extreme weight control behaviors in response to the |
| cognitive distortions. For this reason, Christopher | | | | fat perception. One prediction from the model is that |
| Fairburn in 1981 developed a cognitive-behavioral | | | | anorexia is a weight phobia. |
| model of treatment for anorexia nervosa and bulimia | | | | Cognitive-behavioral therapy has been thought of as |
| nervosa. This model utilizes behavioral interventions | | | | the gold standard in the treatment of anorexia. It is |
| and formal cognitive restructuring. | | | | still extremely effective but the addition of |
| A few of the cognitive distortions a patient may | | | | experiential and physiological therapies dramatically |
| develop are: | | | | increases its effectiveness. |
| 1. I do not need treatment. If I see a therapist or go | | | | |