14. cbt for eating disorders

Question 1

what is the central maintenance factors of EDs?

Answer 1

over-evaluation of shape/weight

Question 2

what’s the transdiagnostic approach when discussing EDs?

Answer 2

treating all EDs similarly because they share core features, and patients migrate across diagnoses over time

Question 3

characteristics of “starting well”

Answer 3

• engaging pt in tx
• increase motivation/commitment to tx
• collaboratively create pers formulation
• psychoeducation about tx + EDs
• establish self-monitoring, weekly weighting, reg eating

those with anorexia less motiv, those with binge eating more motiv

Question 4

philosophy of transdiagnotic formulation

Answer 4

• ED vicious cycle
• maintained by interaction among thoughts, behaviours, beliefs
• goal to understand what factors + sx are relevant to pt

Question 5

EDs

what does self-monitoring entail? what’s it for?

Answer 5

• better understanding the processes maintaining the ED
• accurate record of pt food intake
• highlight key behav, feelings, thoughts, contexts (increase pt self-awareness)
• encourage real-time self-monitoring

logging food intake

Question 5

why is weekly weighing important?

Answer 5

help disentangle misinterpretation of weight fluctuations

Question 6

criteria for weekly weighing

Answer 6

• no weighing at home
• weigh pt jointly
• joint plotting of weight graph
• examination of trends over time

Question 7

ED

rules of regular eating

Answer 7

• prescribed patterns of regular eating
• 3 meals + 2-3 planned snacks
• no more than 3-4 hours between food intake
• mechanical, not hunger
• eating takes precedence
• emphasis on when not what
• when urge to eat, surf the urge

Question 8

compensatory ED behaviours and their effectiveness

Answer 8

vomiting
* only rid 30-50% of calories
* review health consequences
* urge surfing
laxatives
* ineffective at preventing caloric absorption

Question 9

2 techniques to address over eval of shape + weight

Answer 9

1. develop new domains for self-evaluation
2. decrease importance of shape + weight (pie chart)

Question 10

2 types of shape checking

Answer 10

1. constantly checking and comparing self to others
2. complete avoidance (baggy clothes, no mirrors)

Question 11

ED tx

questions to ask before looking in the mirror

Answer 11

• what am i trying to find out
• can i find out
• is there a risk that i’ll get unhelpful information

Question 12

ED tx

alternatives to body comparisons

Answer 12

• reduce frequency (awareness)
• behavioural exp to illustrate sample bias (similar to best case/worst case)

Question 13

ED tx

difference between restraint and restriction

Answer 13

retraint: trying (doesn’t mean success)
restriction: stopping fr

Question 14

how to deal with avoidance of certain foods

Answer 14

systematic exposure + food hierarchy