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To the Editor.—
I appreciated the article "Pigging Out" (1982;247:82). I wish that every physician in the country would read and remember it. Women who control their weight through fasting, vomiting, or purging tend to be extremely secretive and ashamed, and, therefore, their eating disorders may not be detected by their busy physicians.However, I take exception to two statements made by Dr Lucas. First, I disagree that "the vast majority of persons affected are satisfactorily adjusted...." The methods discussed are rather drastic ways to achieve a satisfactory life! These women report a driven quality associated with their food behaviors, and most realize that their weight control strategies are tragic and self-destructive ways to achieve thinness (which to them is equated with perfection and control of their lives). Second, I disagree that psychotherapy is necessary "only if there are specific problems (eg, great anxiety or depression)...." How many physicians have
Rubel J. Weight Control. JAMA. 1982;248(2):170. doi:10.1001/jama.1982.03330020016010