Harvard Mental Health Letter

In brief: Study suggests how to tailor cognitive behavioral therapy for patients with eating disorders

In brief

Study suggests how to tailor cognitive behavioral therapy for patients with eating disorders

Cognitive behavioral therapy (CBT) is often used in the treatment of patients with eating disorders. A randomized controlled study published in December 2008 suggests that more complex treatment is needed for some patients.

Researchers at Oxford University enrolled 154 patients at two sites in England and randomly assigned them to 20 weeks of treatment with two forms of CBT enhanced for the treatment of eating disorders. One intervention focused only on addressing the eating disorder, while the other addressed related psychological issues such as perfectionism and self-esteem. Participants suffered from bulimia or from eating disorders not otherwise specified (which did not have the typical features of bulimia or anorexia nervosa). All participants had a body mass index greater than 17.5 — meaning that patients with anorexia nervosa were excluded. (A separate study of patients with anorexia nervosa is underway.)

At a follow-up assessment conducted 60 weeks after treatment ended, the researchers found that about half of participants had improved to the point that their eating levels were considered normal. Patients with eating disorders who also demonstrated mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties were more likely to respond to CBT that also addressed underlying psychological issues, while the remaining patients responded better to CBT alone.

To continue reading this article, you must login.
  • Research health conditions
  • Check your symptoms
  • Prepare for a doctor's visit or test
  • Find the best treatments and procedures for you
  • Explore options for better nutrition and exercise
Learn more about the many benefits and features of joining Harvard Health Online »