The Present Status of Operant Conditioning for the Treatment of Anorexia Nervosa

Abstract

Operant conditioning appears to be an effective short-term method of weight restoration in anorexia nervosa, although it may offer only modest advantages over alternative methods of inducing weight gain. Programs differ widely in the selection of treatment setting, target behaviors, positive and negative reinforcers, reinforcement schedules, facilitating conditions, and supplementary modalities employed, and it remains unclear how each of these variables may contribute to treatment outcome. The scarcity of long-term follow-up data after 20 years of investigation is puzzling; by default, the calculation of risk/benefit ratios has depended on the theoretical biases of the observer. The accumulation of clinical experience does appear to have had some moderating effect on the polarized positions initially assumed by the advocates and opponents of operant conditioning. The approach has gained acceptance as a useful but circumscribed component of multimodal treatment programs, and in recent years is often supplemented with a variety of behavioral and cognitive-behavioral strategies designed to deal with a broader range of anorexic symptomatology.