Lionel W. Rosen

Pathogenic weight-control behavior in female athletes

In brief: Athletes have gone to extraordinary lengths to reduce their body fat stores in an effort to improve performance. To identify athletes who need help, a questionnaire was administered to 182 female collegiate athletes. Results showed that 32% practiced at least one of the weight-control behaviors defined as pathogenic, which include self-induced vomiting; binges more than twice weekly; and the use of laxatives, diet pills, and/or diuretics. A number of steps are suggested to alert coaches, trainers, and team physicians to the high-risk athlete who requires special attention or treatment to correct this disorder.

Pathogenic Weight-Control Behaviors of Female College Gymnasts.

In brief: To study the methods and extent to which iemale college gymnasts diet, data were collected from 42 gymnasts aged 17 to 22 years, who represented five teams in a major athletic conference. The survey showed that (1) all the participants were dieting; (2) 26 were using at least one form of pathogenic weight-control behavior; and (3) 21 of the 28 competitors who were told by their coaches that they were too heavy resorted to using pathogenic weight-control behaviors. The authors discuss the implications of the demands of gymnastics and the additional social pressure to maintain exceptional thinness.

Prevalence of pathogenic weight‐control behaviors among native American women and girls

Results of a survey administered to 85 Native American girls and women, aged 12–55, revealed that 74% were trying to lose weight and that 75% of those who were dieting to lose weight were employing potentially hazardous techniques. The results also showed that 24% of the dieters used one or more purging behaviors. The mean age of those using pathogenic weight-control methods was 28.8 years. Subjects with higher body mass indexes were more likely to use dangerous weightcontrol methods. These findings suggest that Native American women should be included among the groups at risk for eating disorders and that older and heavier women in this population also should receive attention.

Exercise training and severe caloric restriction: Effect on lean body mass in the obese

The purpose of this study was to investigate the effects of exercise intensity on the body composition of obese subjects during severe caloric restriction. Forty obese subjects (33 women, 7 men; 41 +/- 7.7 years; 106 +/- 26kg; body fat > 25% men, > 30% women) on a commercially prepared OPTIFAST 420kcal/day supplemented fast were randomized into groups that exercised at target heart rates corresponding to 40% and 60% of the heart rate reserve (HRR) at the start of the program. Training volume was similar for both groups at approximately 300kcal per session three times per week for 12 weeks. Body weight, body fat, and lean weight were similar for both exercise intensity groups at week one. Overall, body weight decreased by 15.3 +/- 6.7 kg (p < or = .05), and body fat decreased by 14.9 +/- 5.0 kg (p < or = .05) for the 40 subjects, whereas lean weight remained unchanged. No significant differences in body weight, body fat, or lean weight were observed between the two groups. The results of the current study indicated that while on a supplemented 420-kcal/day fast, exercise at 40% and 60% of the HRR affected body composition similarly when total training volume was held constant at 900kcal/week. Lean weight remained unchanged and accompanied a 14.9 +/- 5.0-kg decrease in body fat, which may have resulted when the volume of exercise (ie, 900kcals/wk) was factored into the exercise prescriptions. These results suggest that exercising at 60% of the HRR offers no advantages for body composition changes over those obtained from exercising at 40% of HRR when the total volume of exercise training is controlled.

A controlled therapeutic study of the irritable-bowel syndrome: effect of diphenylhydantoin.

Abstract Treatment of the irritable-bowel syndrome has not been subjected to adequately controlled studies. Diphenylhydantoin has been reported to be effective. Twelve patients were treated for 20 weeks with 300 mg of diphenylhydantoin daily and with placebo in a randomized double-blind crossover study. Six manifestations scored daily were used as assessment criteria. Psychologic tests were performed. No significant differences (p less than 0.05) between diphenylhydantoin and placebo in any of these manifestations were found. There were positive correlations between frequency and severity of pain and disability but not between frequency, and consistence of stools and pain or disability. These manifestations were strikingly consistent for each patient between biweekly periods. Six of seven patients with the most pain had abnormal scores for neuroticism. There appears to be a rationale for dealing with psychologic factors as well as gut pain in the syndrome. This experimental design should be useful for eva...

Treatment technique for chronic wrist cutters.

A treatment technique is presented which has been developed to eliminate chronic self-induced wrist cutting behavior. The technique substitutes painful but non-injurious exercises for self-cutting behavior when the urge to self-cut emerges. The rationale for initiating this approach is described.

Use of Feral Cats in Psychotherapy

Animal-assisted therapy typically involves the use of domesticated, well controlled animals that are trained to permit approach behavior and interaction by patients. This report describes the use of undomesticated, feral cats as adjuncts to psychotherapy. This approach provides advantages not attainable when domesticated pets are used. Case examples are provided to illuminate the various applications of this unique therapeutic technique.

Self-control program in the treatment of obesity.

In a pilot study utilizing self-control techniques for the purpose of modifying the cue-reactive eating habits of obese patients, three subjects maintained a continuous weight loss throughout the first year of treatment. Techniques included goal setting, self-monitoring, brief delay and self-confrontation prior to eating unauthorized food and direct observation of oneself in a mirror when eating unauthorized food. All patients are expected to remain in treatment for the foreseeable future with no termination of the program despite apparent success with regard to control of their feeding disturbance. The rationale for this approach is discussed.

Modification of secretive or ritualized eating behavior in anorexia nervosa

Abstract Behavioral procedures are described which are directed toward the treatment of the residual idiosyncratic, unacceptable eating patterns of patients who have attained normal weight following the treatment of the acute phase of anorexia nervosa. This program prescribes that maladaptive eating behaviors become the sole and mandatory mode of food consumption. All patients rapidly abandoned their unacceptable eating behavior and thereafter sustained acceptable patterns of eating.

Evaluation System in a Psychiatric Residency Training Program

An evaluation system developed at Michigan State University is designed to provide residents with a clear view of their strengths and weaknesses in a variety of areas. The instruments used in the evaluation system include supervisory rating forms that incorporate the objectives of the residency program, standard exercises for behavioral observation and factual information, and a standardized assessment of interview skills. Use of this system has resulted in a number of changes in curriculum on an individual and group basis, as well as changes in teaching techniques among the faculty. The initial high attrition rate among residents corresponding with initiation of the system is discussed.