The need for complex ideas in anorexia nervosa: Why biology, environment, and psyche all matter, why therapists make mistakes, and why clinical benchmarks are needed for managing weight correction


  • Michael Strober PhD, ABPP,

    Corresponding author
    1. Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience, David Geffen School of Medicine at UCLA, Los Angeles, California
    2. Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA, Los Angeles, California
    • Michael Strober, PhD, UCLA Semel Institute, 760 Westwood Plaza, Los Angeles, CA 90024
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  • Craig Johnson PhD

    1. Eating Recovery Center of Denver, Denver, Colorado
    2. Department of Psychiatry, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
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  • Dr. Strober receives support from the Franklin Mint Chair in Eating Disorders. Both authors receive support from the National Institute of Mental Health. Dr. Strober has received support from SmithKline Beecham and Abbott Laboratories. The authors thank Dr. Cynthia Pikus for editorial comments.


Anorexia nervosa remains an enigma and its clinical challenge is intimidating. But the potential for new insights has been advancing, largely as a result of elegant research in the neurosciences that has modeled behavioral processes resembling key features of the illness. Unfortunately, many in the eating disorder field seem to know little of this work or the implication it holds for treatment philosophy. Instead, the knowledge void has been taken up recently by a host of misguided notions about etiology, blatantly dismissive attitudes toward psychological concepts, and ill-conceived beliefs about therapy priorities. This article is a clinical perspective on these issues. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)