To the Editor.—
Anorexia nervosa is a serious emotional illness resulting in severe nutritional crises, usually in adolescent girls. At best, treatment is long and difficult.A recent editorial (228:344, 1974) describing the use of behavior modification in anorexia nervosa reviewed an article in the Archives of General Psychiatry that simplifies a most complicated illness into a system of positive and negative reinforcements. As the treatment developed, it became clear that "informational feedback" or communicating with the patient was most important to the treatment.I have been consulted about two patients in recent months who were subjected to behavior modification techniques by well-meaning physicians. In both cases, valuable time was lost because the physicians were drawn into the serious problem of the patient whose whole existence involves pathological object relationships that were based on food intake becoming the coin of exchange. In both articles mentioned,1,2 no followup studies were
Feinstein SC. Anorexia Nervosa. JAMA. 1974;228(10):1230. doi:10.1001/jama.1974.03230350020018
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