In these cases, treatment plans often are tailored to the patient's individual needs that may include medical care and monitoring; medications; nutritional counseling; and individual, group and/or family psychotherapy. Some patients may also need to be hospitalized to treat malnutrition or to gain weight, or for other reasons.
So it seems the effects of reducing food intake for a period of time are powerful, and what makes these experiments interesting is that the first described the experience of men who are not unduly concerned about food and weight. They experienced feelings and thoughts which are not unlike those experienced by people with anorexia – with their concerns about hoarding food and seeing themselves to be fatter than they were. What is more, the experience of dieting in itself – irrespective of personality and background engendered in the men in the Keys experiment, a concern about food and weight which they had not experienced previously. It is not unfair to assume that dieting will create these effects in all who try it out.
National Centre for Eating Disorders - The Psychology …
Researchers are unsure of the underlying causes and nature of eating disorders. Unlike a neurological disorder, which generally can be pinpointed to a specific lesion on the brain, an eating disorder likely involves abnormal activity distributed across brain systems. With increased recognition that mental disorders are brain disorders, more researchers are using tools from both modern neuroscience and modern psychology to better understand eating disorders.
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To reduce or eliminate binge and purge behavior, a patient may undergo nutritional counseling and psychotherapy, especially cognitive behavioral therapy (CBT), or be prescribed medication. Some antidepressants, such as fluoxetine (Prozac), which is the only medication approved by the U.S. Food and Drug Administration for treating bulimia, may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behavior, reduces the chance of relapse, and improves eating attitudes.
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At the very least, there are some facts about the experience of dieting and its psychology which women with anorexia, bulimia, binge eating or obesity should understand, if they wish to overcome their eating problem or lose weight successfully. This will explain why dieting is so difficult and why when weight is lost most people cannot keep it down.
Philip Frank, Ph.D. - Allenmore Counseling
Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week. Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.
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Also, as we diet our body shuts down, adjusts to surviving on less energy and our metabolic rate, the rate at which we use up energy – goes down. The more weight we lose the less food we need, and at a lower weight we may have to continue eating at least a bit less than we did when we were heavier. Also significant weight loss leads to lethargy which slows down the metabolic rate still further. So at the end of a diet we cannot necessarily go back to eating as much as we did before. We can unwittingly make the situation even worse by losing weight too fast. If we lose at a rate of a pound or two a week we are likely to lose mostly fat, but if we lose weight faster we are likely to lose lean tissue or muscle as well as fat. This is important because our metabolic rate is determined by the amount of lean tissue we have; the less we have the lower our metabolic rate goes and the less we need to eat. So the optimum way to lose weight is slowly.