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October 21, 1974

Anorexia Nervosa

Author Affiliations

Michael Reese Hospital Chicago

JAMA. 1974;230(3):372. doi:10.1001/jama.1974.03240030014004

To the Editor.—  It has become apparent to many practitioners that there are now available simple techniques of producing weight gain in patients with anorexia nervosa. Maxmen et al (229:801, 1974) described their technique of high-caloric feeding despite the protests of most of their patients. Psychological issues are not initially discussed and are never emphasized. The authors concentrate on the "primary task of weight production." The negativism characteristic of these patients is considered a peripheral issue and is treated with tranquilizers.In our study of anorectic patients, we have found that these patients are poorly individuated and have not psychically differentiated themselves from others.1 Usually, the patient's mother needs the patient to be a psychological extension of herself and discourages the patient from developing in her (his) own direction. The patient's self-other boundaries are blurred and unstable. The mothers are preoccupied with food, eating, and weight. During adolescence, when