Overall, Anna was extremely satisfied with the treatment protocol and described it as very beneficial to her overall emotional and weight loss goals. We included core components of traditional BWL treatments in order to alter the calorie balance to produce weight loss, including calorie goals and self-monitoring caloric intake. However, we introduced BWL strategies in a more flexible and gradual manner than in traditional BWL interventions, which, as described above, typically impose low-calorie goals that may promote binge eating in individuals susceptible to BE. Thus, we framed the Phase II strategies and skills as tools to help participants establish healthier eating patterns and prevent BE while also promoting gradual, healthy weight loss over time, rather than a means to achieve a participant’s “ideal” weight. The treatment approach developed by our team is one of the first to alter the dietary and physical activity goals of traditional BWL interventions and incorporate psychological strategies to promote long-term success for individuals with BE. Drawing from ABBT for weight loss (Forman, Butryn, Manasse, & Bradley, 2015), standard BWL treatments (Brownell, 2000; L. A. R. Group, 2006) and the focused version of CBT-E for eating disorders (Fairburn, 2008; Fairburn et al., 1993), we incorporated strategies into a combined ABBT for weight loss and binge eating management.
Therapeutic effects of antidepressant medications in bulimia nervosa are thought to be related to their capacity to restore more normal signaling patterns in serotonergic pathways. Because relapse is the most common outcome of treatment for addictions, it must be addressed, anticipated, and prepared for during treatment. The RP model views relapse not as a failure, but as part of the recovery abstinence violation effect process and an opportunity for learning. Marlatt (1985) describes an abstinence violation effect (AVE) that leads people to respond to any return to drug or alcohol use after a period of abstinence with despair and a sense of failure. By undermining confidence, these negative thoughts and feelings increase the likelihood that an isolated “lapse” will lead to a full-blown relapse.
Self-awareness, task failure, and disinhibition: How attentional focus affects eating
Thus, a biological predisposition toward greater than average weight gain could lead to preoccupation with body weight and food intake in bulimia nervosa. The revised dynamic model of relapse also takes into account the timing and interrelatedness of risk factors, as well as provides for feedback between lower- and higher-level components of the model. For example, based on the dynamic model it is hypothesized that changes in one risk factor (e.g. negative affect) influences changes in drinking behavior and that changes in drinking also influences changes in the risk factors. The dynamic model of relapse has generated enthusiasm among researchers and clinicians who have observed these processes in their data and their clients. On the posttreatment acceptability questionnaire, Sam reported feeling “mostly satisfied” with treatment and “completely satisfied” with her therapist (see Table 3). Although she reported she “disagreed” that treatment helped her with weight control, decreased ED symptoms, or reduced her overall distress, she reported greatly benefitting from the exposures in that they helped increase her awareness of trigger foods.
By weighing yourself regularly (WW encourages weekly weigh-ins instead of daily) you’ll become more in tune with your body and normalize day-to-day ups and downs. While it’s important to celebrate your successes, it’s also important not to bury your head in the sand (hence the name of this principle) when you’re not sure if you’ve been hitting your goals. “What we do is impacted by all sorts of factors — how we’re feeling, the thoughts going through our minds, our past experiences, the habits we’ve developed and the environment around us, just to name a few,” Grupski says.
Family studies have shown that there is an increased rate of eating disorders in first-degree relatives of individuals with anorexia nervosa and bulimia nervosa. Similarly, twin studies have shown a higher concordance for the eating disorders in monozygotic twins in comparison to dizygotic twins. These studies suggest that heritable biological characteristics contribute to the onset of the eating disorders, although the potential role of familial environmental factors must also be considered.