There is a sizeable body of research that supports this cognitive view on the maintenance of anorexia nervosa and bulimia nervosa. (7) This includes descriptive and experimental studies of the clinical characteristics of these patients and the research on dietary restraint and 'counter-regulation' (a possible analogue of binge eating).(8) However, it is the research on the effects of treatment that provides the strongest support. Thus indirect support comes from the large body of research indicating that cognitive-behaviour therapy has a major and lasting impact on bulimia nervosa (see ChapteL4.10,2). Further support comes from the finding that 'dismantling' cognitive-behaviour therapy by removing those procedures designed to produce cognitive change attenuates its effects and results in patients being markedly prone to relapse.(9) The most direct support comes from the finding that, among patients who have recovered in behavioural terms, the severity of concerns about shape and weight at the end of treatment predicts the likelihood of subsequent relapse. (!°)
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