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April 15, 1974

Anorexia Nervosa: Treatment by Behavior Modification

JAMA. 1974;228(3):344. doi:10.1001/jama.1974.03230280046036

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An earlier editorial (220:852-853, 1972) recounted Stunkard's success in treating anorexia nervosa patients by positive reinforcement (granting a "reward" for progress, namely in this instance, weight gain). In the March issue of the Archives of General Psychiatry (30:279-286, 1974), in a series of single-case experiments, Agras et al restudied the influence of positive reinforcement and other variables on whether or not patients with anorexia nervosa gain weight.

In each experiment, the patient first entered a base line period during which conditions were rather Spartan. Each day the patient was confined to her room except for three rigidly scheduled visits to the dayroom where she could talk with other patients and watch television. She was fed four large meals daily (1,500 calories each), was required to record the number of mouthfuls eaten at each meal, was given a card after each meal showing the number of calories consumed, and was weighed