Seven Reasons You Should Eat When You’re Not Hungry

7 Reasons to Eat When Not Hungry

One of the cardinal rules of dieting is “Eat only when you’re hungry.” I often find that the fear of eating when not hungry is one of the most difficult bits of dogma to overcome. People with eating disorders and good dieters everywhere have been taught that this is all that stands in the way …

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Participating on an FBT Team

Family-Based Treatment Teams

Family-based treatment (FBT) is the leading evidence-based treatment for teens with anorexia nervosa and bulimia nervosa. While in an ideal world, every person with an eating disorder would have access to a full treatment team including a therapist, a dietitian, a medical doctor, and a psychiatrist, FBT calls only for a therapist to guide the …

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This Halloween, Serve Candy to Your Teen in Recovery

Halloween Candy

A Family-Based Treatment (FBT)-approach For teens with eating disorders, Halloween can be scary for the wrong reason: the candy! Most teens with eating disorders are only willing to eat a restricted range of foods. Expanding this range is an important goal of treatment, with the reintroduction of fear foods being a key step. Candy tends …

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Phobia Exposure Therapy

Virtual Reality Exposure Therapy for Phobias in Los Angeles

We are excited to announce that we are now providing virtual reality phobia exposure therapy –partnering with Psious. Psious is one of the pioneering companies in the development of Virtual Reality for therapeutc purposes. The Spanish company offers immersive 3D simulations designed to treat a variety of mental disorders. A multidisciplinary team of psychologists, 3D …

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FBT Meal Strategies Gleaned from Ziplining

FBT Meal Strategies Gleaned from Ziplining

Understanding and Responding to Your Youngster’s Fear: A Metaphor I often explain to parents that for a youngster suffering from an eating disorder, a meal can feel dangerous – like jumping out of an airplane. A couple of years ago I had the opportunity to (almost) live out this metaphor on a family vacation. This …

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ICED 2012

Two weeks ago I attended the International Conference on Eating Disorders, a conference sponsored by the Academy for Eating Disorders.  My attendance at the annual conference allow me to stay up to date on the most recent advances in treatment and provide the best and most recent treatments in my practice.  My involvement in the Academy allows me to connect with clinicians and researchers from all over the world and participate in AED committees and special interest groups.  I also keep up to date through the International Journal of Eating Disorders, the AED listserve, and AED’s social media sites.

Highlights from the International Conference on Eating Disorders 2012

  • Meeting and spending time with some of the major family and patient advocates, other FBT providers, and clinicians and researchers from around the world all coming together to improve treatment for patients suffering from eating disorders.
  • The opportunity to meet and learn from some of the leading researchers in the area of eating disorders.
  • Learning about the most recent and ongoing studies. 

A synopsis of one of my favorite talks below:

Tidbits from Tim Walsh and his group at Columbia:  A New Model for Understanding Anorexia Nervosa and Implications for Treatment

In anorexia, dieting begets weight loss which begets more dieting… why is dieting such a persistent behavior?  Tim Walsh and his group believe that operant conditioning, which is implicated in habit formation, offers an explanation.

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Exposure in the treatment of Eating Disorders

Exposure therapy is widely recognized as a necessary (and sometimes sufficient) ingredient of treatment for most of the anxiety disorders including phobias, panic disorder, and obsessive compulsive disorder.  Anxiety is a core psychological feature of anorexia nervosa and bulimia nervosa.  However, instead of being afraid of heights, speaking in public, having a heart attack, or contamination, individuals with eating disorders are primarily afraid of food, eating, and shape and weight.

Both cognitive-behavioral therapy and family based treatment, two empirically validated treatments for eating disorders, employ exposure techniques.  Exposure works through the process of habituation, the natural neurologically-based tendency to get used to things to which you are exposed for a long time.   During exposure, habituation occurs as people acclimate to their fear and come to realize that nothing actually dangerous is occurring. Habituation promotes new learning of safety, tolerance of fear feelings, and extinction of the fear avoidance urge. 

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