2014 conference video
KELLY VITOUSEK KEYNOTE ADDRESS
More similar than strange: The power of “normal” explanations in the treatment of eating disorders
In recent years, the field has favored models and metaphors that highlight the alien quality of eating disorder (ED) symptoms, invoking brain anomalies or takeover by an “anorexic invader” to explain the perplexing patterns we observe. While such constructs may have scientific or clinical merit, there is also much to be gained from closer study of the “normal” processes through which ED behavior is shaped and sustained. Three will be featured: the effects of long-term, hard-core restriction; the incessant work required to impose it; and the positive valuation of symptoms. The first of these is widely acknowledged in the ED field but only partially appreciated; the latter two have been persistently - and perhaps purposefully - neglected. Interactions among these elements help to account for the most “mysterious” and recalcitrant symptoms in the presenting clinical picture; in addition, each holds direct implications for the development of more effective treatments. Increased conceptual, clinical, and research attention to these salient characteristics is long overdue, beginning with an examination of parallels between the EDs and non-clinical forms of effortful, overvalued behavior in other domains.
Kelly Bemis Vitousek is an Associate Professor of Psychology at the University of Hawaii, where she also serves as Co-Director of the Center for Cognitive Behavior Therapy and Director of the Eating Disorder Program. Her interests include motivational issues in the treatment of eating disorders, cognitive-behavioral therapy for anorexia nervosa, and patterns of extreme overvalued behavior in non-clinical populations, including high-altitude mountain climbers, birders, and practitioners of calorie restriction for longevity.