[Behavior therapy in disorders of dietary behavior]

Behaviour therapies using conditioning principles have been successful in the treatment of some psychopatological eating behaviours. Such have been the cases for anorexia nervosae in adolescents and adults, refusal to eat in the young child and difficulties of swallowing. Some of these cases are described. Research has been done in different countries on the applications of these methods to the treatment of obesity caused by overeating which appears very frequently in our societies. Systematic and covert desensitization and operant conditioning using positive reinforcements are more frequently used in these behaviour modification procedures than aversive methods. More recently, researches on self-control (self-reward and self-punishment) have shown it as a very efficient tool for inducing weight loss. These methods using self-control have been applied to large populations: after a first, careful examination of the patient's eating behaviour, the program of reinforcement is established. It can be partially controlled by written instructions and letters. Results are already encouraging although they need to be followed up. But more research should be done on overeating behaviours, the way they appear and are maintained and on different programs of reinforcement for weight loss.