Answer to Question 1
Cognitive-behavioral treatment (CBT) focuses on patterns of thinking as they influence eating patterns. The cognitive-behavioral model focuses on distorted cognitions about body shape, weight, eating, and personal control that lead to and maintain unhealthy eating and weight related behaviors. Proponents of the model emphasize the power of thoughts to influence feelings and behaviors in eating disorders. The therapist addresses both relatively easily accessible thoughts (automatic thoughts) and deeper core beliefs. Treatment involves challenging distorted cognitions and replacing them with health-promoting alternatives. The cognitive component of CBT appears to be the most critical for behavior change.
In the treatment of bulimia, self-monitoring is a primary focus. Patients keep track of what they ate, whether it was a binge or purge episode, the situation they were in, who else was present, and their thoughts and feelings. By analyzing the data, high risk situations for binge eating and purging may be identified. Subsequent steps involve mastering the language and concepts of CBT, including recognizing thoughts, feelings, and behaviors that are associated with unhealthy eating behavior; learning to recognize cues for and consequences of disordered eating; learning to control automatic thoughts; and learning to restructure distorted cognitions that perpetuate unhealthy eating behaviors.
Answer to Question 2
FALSE