Contrast and comparison of behavioral, cognitive-behavioral, and comprehensive treatment methods for anorexia nervosa and bulimia nervosa.
Match each eating-disorder symptom to its best tool: behavioral for actions, CBT for thoughts, broad plans for mood.
01Research in Context
What this study did
The author looked at three ways to treat anorexia and bulimia.
He compared pure behavioral tricks, cognitive-behavioral therapy, and broad programs that mix many tools.
The paper is a think-piece, not new data.
What they found
Behavioral tactics work best for clear, countable acts like refusing meals or vomiting.
CBT helps when the client has twisted thoughts about body image.
Big, life-focused plans are saved for mood or meaning-of-life issues.
Pick the tool that matches the symptom you see.
How this fits with other research
Geckeler et al. (2000) later used the same logic for obesity. They showed self-monitoring and stimulus control still shrink portions.
Alfonsson et al. (2015) tested one slice—behavioral activation—in binge-eating adults. Mood rose, but binge counts barely moved. This supports the paper’s warning: use the right slice for the right problem.
Morris et al. (1982) argued against adding “mind” talk to behavior analysis. The 1987 paper keeps that line: use CBT only for thoughts, keep behavioral methods clean.
Why it matters
You already match interventions to function. This paper gives you a quick map for eating issues: behavior for actions, CBT for thoughts, broader plans for mood. When a client both binges and says “I’m fat,” mix the tools instead of picking just one.
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02At a glance
03Original abstract
Eating disorders present with a variety of abnormal beliefs, attitudes, and behaviors that originate from a combination of the central features of the illness itself and the physiological response to starvation or binge-purge activity. Behavioral methods, cognitive-behavioral methods, and comprehensive approaches (which include psychodynamic and pharmacological treatments) all make important contributions to care of patients. Each of these methods has strengths and weaknesses that need to be appreciated to understand which approach is ideal for each of the multiple symptoms present. Psychiatric thinking has often been marked by "either-or" approaches to treatment based on theoretical dogmatism. Pragmatic strategies employ a variety of methods, with a "both-and" attitude toward complementary approaches. In general, the more specific the behavioral abnormality, the more likely behavioral methods with contingencies and reinforcements will apply. Behaviors growing out of irrational concepts respond to cognitive-behavioral therapy. Treatment of associated mood disorders, resolution of central dynamic issues, and development of existential meaning require comprehensive approaches. An understanding and rational application of integrated methods leads to effective treatment.
Behavior modification, 1987 · doi:10.1177/01454455870114006