Behavioral Interventions

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Volume 12 Issue 4 (October 1997), Pages 157-207

A seven year follow‐up of treating rumination with dietary satiation (pages 163-172)

Abstract

”Fred“, a man with profound mental retardation who was 24 years old at the beginning of this study, was referred for treatment of rumination. A number of minimally restrictive interventions, including administration of Zantac, extra fluids, and delivery of peanut butter after meals, had been used without success.

In April of 1989 Fred began a satiation diet with ad libitum access to starchy foods or to fruits and vegetables, in addition to his regular meals. His baseline weight was 82 pounds and he ruminated during 58% of 10 s intervals measured during 20 min post‐meal observations. During the first month of the satiation diet, Fred's ruminating declined to 6% of measured intervals, he consumed a mean of 163 fluid ounces of extra food per day, and his weight increased to 90 pounds. After 4 months' treatment, Fred's ruminating had declined to zero, his food consumption had stabilized at approximately 65 extra ounces of food per day, and his weight had stabilized at about 120 pounds.

Starting in August 1990, in an effort to minimize weight gain, extra food was limited to 50% of Fred's ad libitum food consumption (averaged over the previous 6 weeks). Fred's weight gradually declined to about 100 pounds with zero rumination over the next two years. In August 1992 Fred's ruminating accelerated to 17% of intervals and he was again offered ad libitum food access. Over the next 7 months, rumination declined to zero and his weight increased slightly to about 105 pounds.

This study shows that rumination that had not responded to less restrictive procedures was suppressed for 7 years via dietary satiation. Although dietary satiation is not without some risk, Fred has suffered no adverse effects from the procedure, other than gaining approximately one‐third of his baseline weight. © 1997 John Wiley & Sons, Ltd.

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