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Bulimia Nervosa in Gorenstein and Comer

The connection between each theoretical orientation

Dr. Heston used a variety of theoretical interventions, all of which were connected. In total, Rita was educated about eating disorders through four different interventions. Doctor Heston began by teaching Rita about the etiology of her illness. At this point, Rita was reading therapy books and psycho-educational notes as part of the second rehabilitation stage. Rita was also obliged to keep a food diary as another type of intervention. Finally, Dr. Heston provided Rita with information on dealing with her problematic thinking. Dr. Heston worked with her to help her acquire better coping and thinking skills.

A model of the maintenance of bulimia nervosa

Dr. Heston employed the cognitive-behavioral model for therapy purposes to keep track of the disorder’s feelings and actions. Knowing how binges and purges occur and how they influence a person’s capacity to lead a normal life is easier using the cognitive-behavioral approach. According to the cognitive-behavioral paradigm, a person with bulimia nervosa exhibits obsessive thoughts about food, purging, binge eating, etc. The majority of those that fall under this category have a low opinion of their attractiveness (Waller G, 2014). Rita is the person in the case study who is experiencing this issue. Because of her binge eating, she turned to unhealthy eating habits, including overeating followed by purging. Dr. Heston attempted to influence Rita’s level of cognition by making her focus on the flaws in other women. His doctor, Dr. Heston, told Rita that she had to have lunch every day and not skip it.

Rita’s reluctancy to participate in Dr. Heston’s request

Dr. Heston asked Rita to keep a log of her eating habits. Her eating habits were brought to light, and she could take responsibility for them. It will be helpful for Dr. Heston to keep track of his patient’s eating habits to pinpoint the exact problem. It was difficult for Rita to let go of her obsession with food and dieting, as she had done so before. According to the article “perplexities of treatment resistance in eating disorders,” treatment resistance is a very common problem among patients with eating disorders. Treatment resistance is influenced by a person’s preoccupation with weight, body image, exercise, and food. Those with bulimia nervosa avoid treatment because they fear that treatment will fail or become more depressed, anxious, or socially unable if they do not control their eating habits. In the case of Rita, extreme perfectionism is a major contributor to treatment resistance. Genetic factors are also important (Halmi, 2013). Rita’s mother, like her daughter, seemed to be preoccupied with how she looked. It’s hard for her to stop when she’s in the middle of something.

Achieving Rita’s treatment goals

Article “supporting optimal collaboration between mental health practitioners and nutritionists in the treatment of eating disorders” reveals that a nutritionist’s and a mental health provider’s working together is crucial. The therapeutic procedure relies heavily on the integrity of this relationship. It’s possible that treatment’s interprofessional education and training may take center stage. Dieticians and mental health practitioners were questioned as part of the study to learn about the challenges they confront in the intervention process for eating disorders (DeJesse & Zelman, 2013). Dr. Heston should collaborate with nutritionists, social workers, dieticians, or nutritionists. As a mental health provider, you may not have the time or expertise to help a patient develop a healthy food plan. Social workers have the power to influence public perceptions of physical beauty and the pursuit of perfection.

Ethical issues and challenges that Dr. Heston may encounter

Dr. Heston may have a moral dilemma while interacting with other professionals who use evidence-based therapies that differ from his own. The use of evidence-based therapies by clinicians ensures that therapies are used correctly. They employ the association hypothesis to assess the general efficacy of each treatment for patients. The attitude of each specialist greatly influences the therapy process. Evidence-based therapies are used in a variety of ways by different professionals. Some adhere more strictly to the rules and principles of therapy, while others establish their theories. A medical professional’s perspective on a problem or an outcome is unique. Professionals have varying approaches to dealing with patients. It can be seen that Dr. Heston allowed Rita to choose the most appropriate treatment for her in this circumstance. Including other medical professionals, on the other hand, would allow them to approach her in their way. All of these ethical and moral dilemmas could impede the healing process.

Evaluation of Dr.Heston’s therapy methods

Dr. Heston’s therapeutic methods have been proven to be effective. To help the patient, Dr. Heston tried to alter the patient’s thinking patterns and cognitions. When he saw Rita’s eating habits, he wanted to show her how harmful they were. Rita was invited to attend a course on eating disorders by him. The focus of the study was on strange ways of thinking. In various articles, the cognitive-behavioral method is effective (Waller et al., 2014).

Three additional therapy options could be used in this situation

Medications, family counseling, and group cognitive behavior therapy effectively treat eating problems when nothing else works. We can see that family therapy can help people like Rita, who have issues with their perceptions of their appearance or diet. Because of her mother’s perfectionist mentality, Rita was influenced. In the same way, a close family member might influence our way of thinking. Family members of patients undergoing family therapy receive instruction on assisting their loved ones. In a group treatment session, the patient learns that they are not the only one who suffers from an eating disorder and are not alone. If antidepressants and psychological theories are provided to patients simultaneously, it can be more beneficial to the patient.

To conclude, anorexia nervosa, often known as bulimia, is a mental illness characterized by binge eating. Those who have bulimia are prone to binge eating and then purging, using laxatives, fasting, or engaging in excessive physical activity to lose weight. Among females and girls, bulimia is more common. Despite the seriousness of the condition, those with bulimia can recover with the proper care. Among women, bulimia is far more common than among men. Women of various races and ethnicities are affected by this condition, which affects up to 2% of the female population. Bulimia affects young women and girls more than older women. Women in their teens and early twenties are more vulnerable to sexual assaults. An eating disorder is an issue for older women since they are more likely to develop one.


DeJesse, L. D., & Zelman, D. C. (2013). Promoting optimal collaboration between mental health providers and nutritionists in the treatment of eating disorders. Eating Disorders21(3), 185–205.

Halmi, K. A. (2013). Perplexities of treatment resistence in eating disorders. BMC Psychiatry13(1), 1–6.

Waller, G., Gray, E., Hinrichsen, H., Mountford, V., Lawson, R., & Patient, E. (2014). Cognitive-behavioral therapy for bulimia nervosa and atypical bulimic nervosa: Effectiveness in clinical settings. International Journal of Eating Disorders47(1), 13–17.


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