First published in 1986. Routledge is an imprint of Taylor & Francis, an informa company.

PREFACE -- ACKNOWLEDGEMENTS -- INTRODUCTION -- Case of Jan -- Session 2 -- Session 3 -- Session 4 -- Session 5 -- Session 6 -- 1 EPIDEMIC OF THE 80s -- What is Bulimia? -- What Causes Bulimia? -- Case of Jane -- Session 2 -- Session 3 -- Session 4 -- Session 5 -- Session 6 -- For Whom is this Book Intended? -- Do Men Have Bulimia? -- 2 MEDICAL ASPECTS OF BULIMIA -- Case of Sherri -- Case of Karen -- What are the Demographic Features? -- What is the Clinical Syndrome? -- What are the Medical Complications of Bulimia? -- Intentional malnutrition -- Binge eating -- Self-induced vomiting -- Cathartic drug abuse -- Diuretic drug abuse -- Strenuous exercise -- Case of Laurie -- Case of Sharon -- What are Medical Treatments? -- 3 INDIVIDUAL DIFFERENCES -- Does the Body Have a Self-regulator for Weight Control? -- What Is the Set-point Concept? -- Does Weight Vary from Person to Person as Height Does? -- Does Binge Eating Occur Among People of Different Weight Levels? -- Case of Rita -- Case of Diane -- Case of Karen -- 4 THE FANATICAL PURSUIT OF THINNESS -- Is Thinness Becoming More Fashionable? -- Is Dieting an Answer? -- Is Thinness Related to Social Class? -- Has a Recent Evolution Occurred in the Ideal Body Shape of Women? -- Is the Fear of Fat a Major Factor in Bulimia? -- Case of Polly -- What Have Women with Bulimia Said About Being F at? -- What Are Consequences of Fear of Fat? -- Case of Jan -- Does Dieting Generally Precede Bulimia? -- What Sequence of Events Leads to Bulimia? -- Effects of Overcontrol -- Is the Need for Control Frequent in Women with Bulimia? -- Do Obese and Normal Weight Persons Differ in Response to Food? -- Are Binges Caused by Functioning Below Normal Set-point? -- Case of Vickie -- What Are some National Steps that Would Reduce Causes for Bulimia? -- 5 DIETING AND DEPRESSION: EMOTIONAL RESPONSES TO DIETING -- Does a State of Semi-Starvation and Dieting Produce Similar Behavioral Characteristics? -- Are Personality Tests Scores Different for Women with Bulimia? -- Are Suicide Attempts Common Among Women with Bulimia? -- What Are the Symptoms Associated with Loss of Weight? -- Which Comes First, The Depression or the Eating Disorder? -- Have Studies Other Than Personality Tests Shown Behavioral Abnormalities? -- Triggers for Binging -- Is Weight Control Self Control? -- Do Women Weighing Near Their Set-Point Regulate Calorie Intake Better? -- What Is The Typical Pattern Leading to Bulimia? -- Is the Restraint-Binge-Purge Cycle Repetitive? -- Taste and Hunger -- Is Our Taste for Food Determined by Food Deprivation? -- What Kinds of Foods A re Generally Eaten During Binging? -- 6 PERSONALITY DYNAMICS -- Case of Ruth -- What Are Common Family Characteristics? -- What Role Does the Child with Bulimia Play in the Family? -- Case of Wendy -- Is the Girl with Bulimia Often the "Good Child?** -- In Childhood Did She Receive the Nurturing She Wanted? -- Personal Dynamics -- What Is their Need for Control Like? -- Do Clients with Bulimia Hold to a "Right Way** to Do Things? -- Do These Clients Think in Terms of Good and Bad? -- Do Women with Bulimia Have Difficulty Dealing With Men? -- Do Women with Bulimia Dislike Their Bodies? -- Is Childhood Obesity a Common Characteristic? -- Can Being a Tall Child Be a Problem? -- Have Many Women with Bulimia Had a Chronic Medical Problem Which Made Them Different Than Other Children? -- What Influence Might Childhood Abuse Have on These Clients? -- 7 EARLY STAGES OF TREATMENT -- What Are Some Expectations In The Initial Phase of Therapy? -- When and How Is the Bulimia Revealed? -- Early Session Issues -- Will Mood Swings Be Considered Early in Therapy? -- How Do the Therapist and Physician Work Together? -- Are Ambivalent Feelings Natural During Therapy? -- Some Therapists Reframe the Behavior. Why? -- Why Do Therapists Sometimes Prescribe Binging? -- How Long Does Therapy Take? -- In Summary, What Are Some Therapy Procedures Used Early In Treatment? -- 8 LATER ISSUES IN THERAPY -- Modifying the Thinking -- How Is the Need for Control Treated? -- Can the Therapist Help Overcome the Absolutes? -- What is Magical Thinking? -- How is the Fear of Becoming Fat Treated? -- Can the Therapist Help With Calories and Meal Planning? -- Summary of Maladaptive Cognitive Patterns Treated -- Teaching Coping Skills -- What Are the Rewards for Binging? -- What is a Major Goal of Therapy and Why? -- H ow ls "Thought Stopping" Taught? -- Relaxation training -- Case of J ill -- How Can the Therapist Help in Decision-making Skills? -- How Does Keeping a Journal Help? -- Can Assertiveness Training Assist? -- Is Talking to Friends Recommended? -- 9 PHYSICAL EXERCISE: A COMPONENT OF TREATMENT -- How Much Exercise is Recommended? -- What Exercises Are Suggested? -- Does Exercise Help in Weight Loss? -- What About Exercise for Women with Bulimia? -- Summary -- 10 GROUP THERAPY -- Who Is Qualified to Lead Group Therapy? -- Screening Group M embers -- Are Women with Anorexia Admitted to the Group? -- Is Confidentiality Discussed During Screening? -- Are Women Who Don't Purge Allowed in the Group? -- Is a Commitment to Attend More Than One Session Essential? -- How Does the Therapist Encourage New Members to Join the Group? -- Structuring the Group -- What is the Group Leader's R ole? -- Are Individual Sessions Interwoven with Group Sessions? -- Are New Members Paired with On-going Group Members? -- Advantages of Group Therapy -- What Are Some Advantages to Joining a Group? -- Self-Criticism -- Is Self-criticism Common? -- Are Compliments Difficult to Accept? -- Can the Group Help Overcome the Self-Denial of Success? -- Personal Issues -- Are Troubles with Parents and Siblings Discussed? -- Sexual Traumas -- Can Group Therapy Help with Sexual Traumas? -- Group Support -- How Do Group Members Show Support? -- How Can the Therapist Help the Individual Accept the Group Support? -- Do Members Ever Get Discouraged? -- Do Group Members Support One Another Through Telephone Calls? -- Do Social Contacts Increase as a Result of Group Therapy? -- Do Members Help Each Other Reach Out, Explore Alternatives? -- 11 FAMILY ISSUES IN THERAPY -- Family Characteristics -- What are the Characteristics of the Enmeshed Family? -- What Is Mother Like in an Enmeshed Family? -- What Is Father Like in an Enmeshed Family? -- What Kind of Expectations Are Conveyed to Children in Enmeshed Families? -- What Are Characteristics of the Chaotic Family? -- Who Are "Irregular People?" How Do They Hurt Women with Bulimia? -- Can the Joyce Landorf Book and Tape Be Helpful in Therapy? -- Family Interventions -- When Are the Parents Brought into the Counseling Sessions? -- Why Do Adolescents Fear the Therapist? -- What if Parents Are Unavailable for Family Sessions? -- Do Parents Have Mixed Emotions About Becoming Members of the Counseling Sessions? -- What Are Some of the First Issues the Therapist Will Discuss in Family Therapy? -- Is the Family Attitude about Food and Eating Part of Family Therapy? -- Is the Responsibility Which Is Placed on or Assumed by the Client Discussed Openly in Family Therapy? -- Is One Sibling Sometimes Placed in the Responsible Role by Other Siblings? -- When the Symptomatic Child Leaves the Family, Does Another Family Member Develop a Problem? -- Will The Therapist Assist with Communication Problems Among Family Members? -- Listening and Acting, Can the Therapist Help? -- Will Parents Learn to Give Praise More Effectively? -- Summary Comments on Communication Skills -- Spouse/Partner Relationship Issues: Marital Therapy -- How Do Couples Relate When She Has Bulimia? -- How Can the Partner Help? -- Can the Therapist Help the Partner Understand the Bigger Problem-Emotional Issues? -- Do the Client, Partner, and Children Meet in Marital Therapy? -- Summary -- 12 RECOVERY ISSUES -- What Constitutes Recovery? -- What Happens When the Binges Stop Working? -- What Other Emotions Arise as the Binging Behavior Becomes Less Effective? -- How Does Recovery Affect the Need to Eat? -- Can Retaining Food in the Stomach Become a Problem During Recovery? -- As Recovery Progresses, How Can Use of Other Coping Skills Be Encouraged? -- H