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Cited by 45Eating Disorders and BehaviorsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNutrition, Health and Food Behavior

Overcoming fear of eating: A case study of a novel use of exposure and response prevention.

Open access
Glasofer, Deborah R., Albano, Anne Marie, Simpson, H. Blair, Steinglass, Joanna E.·2016·Psychotherapy
DOI 10.1037/pst0000048PMC PMC4902164
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Abstract

Even after successful weight restoration, many patients with anorexia nervosa (AN) continue to exhibit maladaptive eating including repetitive behaviors (i.e., food rituals) used to decrease anxiety about food, and to describe fears related to food content, including its effect on shape and weight. Although there are important differences between eating disorders and anxiety disorders, the shared clinical phenomena suggest potentially useful overlap in treatment strategies. This case study will describe treatment of a woman with AN using Exposure and Response Prevention for Anorexia Nervosa (AN-EXRP) as an adjunct to concurrent inpatient treatment. This is a novel use of a treatment approach with established efficacy in the treatment of anxiety disorders. AN-EXRP specifically targets eating-related anxiety with the intent to improve the restrictive eating patterns that persist after acute weight restoration. The case study described includes descriptions of (a) the treatment rationale and its phases of implementation, (b) illustrative sample dialogue between the patient and therapist, (c) pre- and posttreatment data on outcome measures of interest (e.g., food intake at a laboratory meal, self-report anxiety ratings, self-report eating-related rituals, and preoccupations), and (d) therapist considerations (e.g., maintaining alliance, adhering to treatment frame). (PsycINFO Database Record

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  • Exposure therapy can also be relevant in the treatment of fears seen in anorexia nervosa.

    “Its effectiveness is primarily known from the treatment of anxiety disorders, but an emerging line of research shows that it can also be relevant in the treatment of fears seen in anorexia nervosa (e.g. [16, 25, 35–43].”

    From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [39]

  • The current findings add to prior research by showing the potential and success of exposure therapy in the treatment of anorectic fears.

    “On the other hand, the current findings add to prior research by showing the potential and success of exposure therapy in the treatment of anorectic fears (e.g. [26, 37, 39, 41–43, 64, 66].”

    From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [39]

  • The finding that anxiety is highest before the breakfast begins, followed by a drop in fear, supports previous suggestions to specifically focus on pre-meal anxiety when treating eating related fears.

    “Finding that anxiety is highest before the breakfast begins, which is followed by a drop in fear, for instance, supports previous suggestions to specifically focus on pre-meal anxiety when treating eating related fears [37, 39, 42].”

    From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [39]

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Research works printed but not linked: 5

  1. Beidel DC Turner SM Jacob RG Cooley MR 1989 Assessment of social phobia: Reliability of an impromptu speech task Journal of Anxiety Disorders 3 149 158
  2. Fairburn CG 2008 Cognitive Behavior Therapy and Eating Disorders New York Guilford Press
  3. Kozak MJ Foa EB 1997 Mastery of Obsessive-Compulsive Disorder New York Oxford University Press
  4. Spielberger CD Gorsuch RL Lushene RE 1970 Manual for the state-trait inventory Palo Alto, CA Consulting Psychologists Press
  5. Thompson-Brenner H 2015 Casebook of Evidence-Based Therapy for Eating Disorders New York, NY Guilford Press

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Authors
Glasofer, D. R., Albano, A. M., Simpson, H. B., & Steinglass, J. E.
Affiliations
  • New York State Psychiatric Institute (US)
  • Columbia University (US)
ORCID
Venue
Psychotherapy
Publisher
American Psychological Association (APA)
Published
2016
Volume
53
Issue
2
Pages
223-231
ISSN
  • 0033-3204 (ISSN-L)
  • 1939-1536
DOI
10.1037/pst0000048
PMC
PMC4902164
OpenAlex
W2473311281
Cited by
45
References
19
Citations by year
2026: 2 · 2025: 2 · 2024: 26 · 2023: 3 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 1
FWCI
2.23
Type
journal article
Language
en
Open access
Locations
  • Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH082736)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
anorexia nervosa, exposure and response prevention, food rituals, weight restoration, restrictive eating, eating disorder treatment, inpatient care, food preoccupation
MeSH terms
Adaptation, Psychological, Anorexia Nervosa, Anxiety Disorders, Behavior Therapy, Body Image, Body Weight, Combined Modality Therapy, Culture, Eating, Fear, Feeding Behavior, Female, Humans, Implosive Therapy, Patient Admission, Comorbidity, Young Adult

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