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1/4. Psychological treatment of obesity with phentermine resin as an adjunct.

    The author treated 12 patients who had demonstrated only a minimal response to psychiatric treatment alone for their obesity with a combination of psychotherapy and an anorectic, phentermine resin. psychotherapy was directed toward developing an awareness of the underlying anxiety related to the problem of obesity and fostering the subsequent ability to change the pattern of overeating. All 12 patients were treated successfully, and 9 reached ideal weight. weight loss was maintained or additional weight was lost when the medication was discontinued.
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keywords = psychotherapy
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2/4. Treatment of severe weight loss in anorexia nervosa with hyperalimentation and psychotherapy.

    Hyperalimentation is a feeding technique in which all essential nutrients are infused intravenously to sustain patients who cannot eat. Although no panacea for anorexia nervosa, hyperalimentation can provide calories for intractable, malnourished patients. The authors describe the psychiatric and hyperalimentation treatment for four severely anorectic patients who had lost up to 44% of their body weight before entering the study. With treatment their percentage of ideal weight rose from a mean of 59% to a mean of 81% during hospitalization, and to a mean of 94% on outpatient follow-up of 5--16 months. The authors discuss the indications, limitations, and need for interdisciplinary collaboration in this treatment.
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keywords = psychotherapy
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3/4. anorexia nervosa and diabetes mellitus.

    Four patients who developed anorexia nervosa after the onset of diabetes mellitus are described. It is postulated that the co-occurrence of the two conditions was not coincidental, but that each contributed to the development of the other. The nature and treatment of diabetes offer numerous opportunities for the anorexic patient to lose weight by a variety of dangerous maneuvers, including adjustment of the insulin dose, failure to inject insulin, secret vomiting, and failure to provide urine samples. Treatment of patients with both conditions is a therapeutic challenge to the psychiatrist and diabetologist. A behavior management program combined with psychotherapy is most often effective.
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keywords = psychotherapy
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4/4. Excessive food aversion, compulsive exercise and decreased height gain due to fear of obesity in a prepubertal girl.

    A case of a 7-year-old girl with a remarkable food aversion and excessive weight reduction caused by fear of obesity, which has been demonstrated in pubertal girls with symptoms partly similar to anorexia nervosa, is reported. Although the patient's weight was reduced to the upper limits of the normal range with diet and exercise, she reduced her food intake more strictly and did not at all eat food consisting of carbohydrates. exercise was performed longer than before. Her weight continued to decrease and height velocity lowered from 6.0 to 4.1 cm/year (mean /- SD of the age-matched normal girls: 5.5 /- 0.74 cm/year). Her eating behavior was normalized without specific psychotherapy for anorexia nervosa. It is suggested that food aversion with weight loss and decrease in height gain due to fear of obesity may occur in prepubertal children as well as in adolescent girls.
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keywords = psychotherapy
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