1932

Abstract

Research findings strongly suggest that cognitive behavioral therapy for the eating disorders (CBT-ED) is more effective than other treatments for bulimia nervosa (BN) and for binge eating disorder (BED), although interpersonal psychotherapy appears to be equally effective for BED. Evidence for the effectiveness of CBT-ED for the persistent (adult) form of anorexia nervosa (AN) is insufficient at present and is essentially absent for AN in adolescents except for some evidence from uncontrolled trials. This article begins with an overview of the early studies in the development of CBT-ED that showed a similar effectiveness of other symptom-focused psychotherapies—a finding that was neglected at the time. Later developments are then considered, including comparisons of CBT-ED with other psychotherapies, efforts to develop Internet-based training and treatment, and electronic applications for treatment. Finally, implications of the findings for future short- and long-term research and for clinical practice are considered.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-clinpsy-081219-110907
2021-05-07
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/clinpsy/17/1/annurev-clinpsy-081219-110907.html?itemId=/content/journals/10.1146/annurev-clinpsy-081219-110907&mimeType=html&fmt=ahah

Literature Cited

  1. Aardoom JJ, Dingemans AE, Spinhoven P, van Ginkel JR, de Rooij M et al. 2016. Web-based fully automated self-help with different levels of therapist support for individuals with eating disorder symptoms: a randomized controlled trial. J. Med. Internet Res. 18:e159
    [Google Scholar]
  2. Agras WS, Crow S, Mitchell JE, Halmi K, Bryson S 2009. A 4-year prospective study of eating disorder NOS compared with full eating disorder syndrome. Int. J. Eat. Disord 42:565–70
    [Google Scholar]
  3. Agras WS, Fitzsimmons-Craft EE, Wilfley DE 2017. Evolution of cognitive-behavioral therapy for eating disorders. Behav. Res. Ther 88:26–36
    [Google Scholar]
  4. Agras WS, Walsh BT, Fairburn CG, Wilson GT, Kraemer HC 2000. A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for BN. Arch. Gen. Psychiatry 57:459–66
    [Google Scholar]
  5. Am. Psychiatr. Assoc 1980. Diagnostic and Statistical Manual of Mental Disorders Washington, DC: Am. Psychiatr. Publ. , 3rd ed.. [DSM-III]
  6. Am. Psychiatr. Assoc 1987. Diagnostic and Statistical Manual of Mental Disorders Washington, DC: Am. Psychiatr. Publ. , 3rd ed.. , rev.
  7. Am. Psychiatr. Assoc 1994. Diagnostic and Statistical Manual of Mental Disorders Washington, DC: Am. Psychiatr. Publ. , 4th ed..
  8. Am. Psychiatr. Assoc 2013. Diagnostic and Statistical Manual of Mental Disorders Arlington, VA: Am. Psychiatr. Publ. , 5th ed..
  9. Atwood ME, Friedman A. 2020. A systematic review of enhanced cognitive behavioral therapy (CBT-E) for eating disorders. Int. J. Eat. Disord. 53:311–30
    [Google Scholar]
  10. Bailer U, de Zwaan M, Leisch F, Strnad A, Lennkh-Wolfsberg C et al. 2004. Guided self-help versus cognitive-behavioral group therapy in the treatment of bulimia nervosa. Int. J. Eat. Disord 35:522–37
    [Google Scholar]
  11. Beck AT. 1976. Cognitive Therapy and the Emotional Disorders New York: Int. Univ. Press
  12. Beck AT. 2008. The evolution of the cognitive model of depression and its neurobiological correlates. Am. J. Psychiatry 165:969–77
    [Google Scholar]
  13. Brown CE, Perry KN. 2018. Cognitive behavioural therapy for eating disorders: How do clinician characteristics impact on treatment fidelity?. Int. J. Eat. Disord. 6:19–29
    [Google Scholar]
  14. Byrne S, Wade T, Hay P, Touyz C, Fairburn CG et al. 2017. A randomized controlled trial of three psychological treatments for anorexia nervosa. Psychol. Med 47:2823–33
    [Google Scholar]
  15. Carrard I, Crépin C, Rouget P, Lam T, Golay A et al. 2011. Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder. Behav. Res. Ther. 49:482–91
    [Google Scholar]
  16. Chakrabarti S. 2015. Usefulness of telepsychiatry: a critical evaluation of videoconferencing-based approaches. World J. Psychiatry 22:286–304
    [Google Scholar]
  17. Chen EY, Casioppo J, Fettich K, Gallop R, McCloskey A et al. 2017. An adaptive randomized trial of dialectical behavior therapy and cognitive behavior therapy for binge-eating. Psychol. Med. 47:703–17
    [Google Scholar]
  18. Clark DM 2018. Realizing the mass public benefit of evidence-based psychological therapies: the IAPT program. Annu. Rev. Clin. Psychol 14:159–83
    [Google Scholar]
  19. Cooper Z, Bailey-Straebler S, O'Connor E, Caddy C, Fairburn CG 2017. Using the Internet to train therapists: randomized comparison of two scalable methods. J. Med. Internet Res. 19:e355
    [Google Scholar]
  20. De Zwaan M, Herpertz S, Zipfel S 2017. Effect of internet-based guided self-help versus individual face-to-face treatment on full or subsyndromal binge eating disorder in overweight or obese patients: the INTERBED randomized clinical trial. JAMA Psychiatry 74:987–95
    [Google Scholar]
  21. Eysenck HJ. 1952. The effects of psychotherapy: an evaluation. J. Consult. Psychol. 16:319–24This paper, which suggested that psychotherapy was not more effective than passage of time, spurred the development of behavior therapy.
    [Google Scholar]
  22. Eysenck HJ. 1966. The Effects of Psychotherapy. New York: Int. Sci.
    [Google Scholar]
  23. Fairburn CG. 1981. A cognitive-behavioural approach in the management of bulimia. Psychol. Med. 11:707–11
    [Google Scholar]
  24. Fairburn CG. 1995. Overcoming Binge Eating New York: GuilfordThis book, which is often given to patients, forms the basis for treatment with guided self-help.
  25. Fairburn CG, Allen E, Bailey-Straebler S, O'Connor ME, Cooper Z 2017. Scaling up psychological treatments: a countrywide test of the online training of therapists. J. Med. Internet Res. 19:e214
    [Google Scholar]
  26. Fairburn CG, Bailey-Straebler S, Basden S, Doll H 2015. A transdiagnostic comparison of enhanced cognitive-behavioral therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behav. Res. Ther. 70:64–71
    [Google Scholar]
  27. Fairburn CG, Cooper Z. 1993. The Eating Disorder Examination. Binge Eating: Nature, Assessment and Treatment CG Fairburn, GT Wilson 317–60 New York: GuilfordThe Eating Disorder Examination (EDE) is now the gold standard for the assessment of eating disorders.
    [Google Scholar]
  28. Fairburn CG, Cooper Z, Doll HA, O'Connor ME, Bohn K et al. 2009. Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am. J. Psychiatry 166:31119
    [Google Scholar]
  29. Fairburn CG, Cooper Z, Shafran R 2003. Cognitive behaviour therapy for the eating disorders: a transdiagnostic theory and treatment. Behav. Ther. 41:509–28
    [Google Scholar]
  30. Fairburn CG, Jones R, Peveler RC, Carr SJ, Solomon RA et al. 1991. Three psychological treatments for BN: a comparative trial. Arch. Gen. Psychiatry 48:463–69
    [Google Scholar]
  31. Fairburn CG, Jones R, Peveler RC, Hope RA, O'Connor M 1993. Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive-behavior therapy. Arch. Gen. Psychiatry 50:410–28
    [Google Scholar]
  32. Fairburn CG, Kirk J, O'Connor M, Cooper PJ 1986. A comparison of two psychological treatments for BN. Behav. Res. Ther. 24:629–43
    [Google Scholar]
  33. Freeman CPL, Barry F, Dunkeld-Turnbull J, Henderson A 1988. Controlled trial of psychotherapy for BN. BMJ 296:521–25
    [Google Scholar]
  34. Garner DM, Rockert W, Davis R, Garner MV, Olmsted MP, Eagle M 1993. Comparison of cognitive-behavioral and supportive-expressive therapy for BN. Am. J. Psychiatry 150:37–46
    [Google Scholar]
  35. Ghaderi A, Odeberg J, Gustafsson S, Råstam M, Brolund A et al. 2018. Psychological. pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis. PeerJ 6:e5113
    [Google Scholar]
  36. Grilo CM, Masheb RM, Gurorguieva R, Wilson GT, White MA 2011. Cognitive-behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: a randomized controlled trial. J. Consult. Clin. Psychol. 79:675–85
    [Google Scholar]
  37. Hart LM, Granillo MT, Jorm AF, Paxton SJ 2011. Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clin. Psychol. Rev. 32:727–35
    [Google Scholar]
  38. Hilbert A, Hildebrandt T, Agras WS, Wilfley DE, Wilson GT 2015. Rapid response in psychological treatments for binge eating disorder. J. Consult. Clin. Psychol. 83:649–54
    [Google Scholar]
  39. Hilbert A, Petroff D, Herpetz S, Pietrowsky R, Tuschen-Caffier, et al. 2019. Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder. J. Consult. Clin. Psychol. 87:91–105
    [Google Scholar]
  40. Hildebrandt T, Michaelides A, Mackinnon D, Greif R, DeBar L, Sysko R 2017. Randomized controlled trial comparing smartphone assisted versus traditional guided self-help for adults with binge eating. Int. J. Eat. Disord. 50:1313–22
    [Google Scholar]
  41. Jarrett RB, Vittengl JR. 2016. The efficacy of cognitive behaviour therapy for depression. Treating Depression: MCT, CBT, and Third Wave Therapies A Wells, P Fisher 52–80 Chichester, UK: Wiley
    [Google Scholar]
  42. Kirkley BG, Schneider JA, Agras WS, Bachman JA 1985. Comparison of two group treatments for bulimia. J. Consult. Clin. Psychol. 53:43–48
    [Google Scholar]
  43. Kraemer H, Thiemann S. 1987. How Many Subjects? Statistical Power Analysis in Research Newbury Park, CA: Sage
  44. Le Grange D, Lock J, Agras WS, Bryson SW, Jo B 2015. Randomized clinical trial of family-based treatment and cognitive-behavioral therapy for adolescent BN. J. Am. Acad. Child Adolesc. Psychiatry 54:866–94
    [Google Scholar]
  45. Linardon J, de la Piedad Garcia X, Brennan L 2017a. Predictors, moderators, and mediators of treatment outcome following manualised cognitive-behavioural therapy for eating disorders: a systematic review. Eur. Eat. Disord. Rev. 25:3–12
    [Google Scholar]
  46. Linardon J, Wade TD, de la Piedad Garcia X, Brennan L 2017b. The efficacy of cognitive-behavioral therapy for eating disorders: a systematic review and meta-analysis. J. Consult. Clin. Psychol. 85:1080–94
    [Google Scholar]
  47. Linardon J, Messer M, Fuller-Tyszkiewicz M 2018. Meta-analysis of the effects of cognitive-behavioral therapy for binge-eating-type disorders on abstinence rates in nonrandomized effectiveness studies: comparable outcomes to randomized, controlled trials. ? Int. J. Eat. Disord. 51:1303–11
    [Google Scholar]
  48. Lock J, Kraemer HC, Jo B, Couturier J 2019. When meta-analyses get it wrong: response to ‘Treatment outcomes for anorexia nervosa: a systematic review and meta-analysis of randomized controlled trials.. Psychol. Med. 49:697–98An important critique outlining some of the limitations of meta-analysis based on a particular analysis.
    [Google Scholar]
  49. Mitchell JE, Crosby RD, Wonderlich SA, Crow S, Lancaster K et al. 2008. A randomized trial comparing the efficacy of cognitive-behavioral therapy for BN delivered via telemedicine versus face-to-face. Behav. Res. Ther. 46:581–92
    [Google Scholar]
  50. Mussell MP, Crosby RD, Crow SJ, Knopke AJ, Peterson CB et al. 2000. Utilization of empirically supported psychotherapy treatments for individuals with eating disorders: a survey of psychologists. Int. J. Eat. Disord. 27:230–37
    [Google Scholar]
  51. NICE (Natl. Inst. Health Care Excell.) 2017. Eating disorders: recognition and treatment NICE Guideline 69, NICE London:
  52. O'Connor M, Morgan KE, Bailey-Straebler S, Fairburn CG, Cooper Z 2018. Increasing the availability of psychological treatments: a multinational study of a scalable method for training therapists. J. Med. Internet Res. 20:e10386
    [Google Scholar]
  53. Poulsen S, Lunn S, Daniel SI, Folke S, Mathiesen BB et al. 2014. A randomized controlled trial of psychoanalytic psychotherapy or cognitive-behavioral therapy for BN. Am. J. Psychiatry 171:109–16
    [Google Scholar]
  54. Ruwaard J, Lange A, Broeksteeg J, Renteria-Agirre A, Schrieken B 2013. Online cognitive-behavioural treatment of bulimic symptoms: a randomized controlled trial. Clin. Psychol. Psychother. 20:308–18
    [Google Scholar]
  55. Sánchez-Ortiz VC, Munro C, Stahl D, House J, Startup H et al. 2011. A randomized controlled trial of internet-based cognitive-behavioural therapy for BN or related disorders in a student population. Psychol. Med. 41:407–17
    [Google Scholar]
  56. Sarwer DB, Polonsky HM. 2016. The psychosocial burden of obesity. Endocrinol. Metab. Clin. N. Am. 45:677–88
    [Google Scholar]
  57. Schmidt U, Lee S, Beecham J, Perkins S, Treasure J, Yi I 2007. A randomized controlled trial of family therapy and cognitive-behavior therapy guided self-care for adolescents with BN and related disorders. Am. J. Psychiatry 164:591–98
    [Google Scholar]
  58. Schmidt U, Wade TD, Treasure J 2014. The Maudsley model of anorexia nervosa treatment for adults (MANTRA): development, key features and preliminary evidence. J. Cogn. Psychother 28:48–71
    [Google Scholar]
  59. Skinner BF. 1938. The Behavior of Organisms: An Experimental Analysis New York: Appleton-Century-CroftsSkinner's work demonstrating environmental control of behavior formed the basis for the development of behavior therapy in the United States.
  60. Slade E, Keeney E, Mavranezouli I, Dias S, Fou L, Stockton S 2018. Treatments for BN: a network meta-analysis. Psychol. Med. 48:2629–36
    [Google Scholar]
  61. Spangler DL, Baldwin SA, Agras WS 2004. An examination of the mechanisms of action in cognitive behavioral therapy for BN. Behav. Ther. 35:537–60
    [Google Scholar]
  62. Spielmans GI, Benish SG, Marin C, Bowman WM, Menster M, Wheeler AJ 2013. Specificity of psychological treatments for BN and binge eating disorder? A meta-analysis of direct comparisons. Clin. Psychol. Rev. 33:460–69
    [Google Scholar]
  63. Stefini A, Salzer S, Reich G, Horn H, Winkelmann F 2017. Cognitive-behavioral and psychodynamic therapy in female adolescents with BN: a randomized controlled trial. J. Am. Acad. Child Adolesc. Psychiatry 56:329–35
    [Google Scholar]
  64. Steinert C, Munder T, Rabung S, Hoyer J, Falk L 2017. Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. Am. J. Psychiatry 174:943–53
    [Google Scholar]
  65. Tasca GA, Hilsenroth M, Thompson-Brenner H 2014. Psychoanalytic psychotherapy or cognitive-behavioral therapy for BN. Am. J. Psychiatry 171:583–84
    [Google Scholar]
  66. Telch CF, Agras WS. 1993. The effects of a very low calorie diet on binge eating. Behav. Ther. 24:177–93
    [Google Scholar]
  67. ter Huurne ED, de Haan HA, Postel MG, van der Palen J, VanDerNagel J et al. 2015. Web-based cognitive behavioral therapy for female patients with eating disorders: randomized controlled trial. J. Med. Internet Res. 17:e152
    [Google Scholar]
  68. Thompson-Brenner H, Shingleton RM, Thompson DR, Satir DA, Richards LK et al. 2016. Focused vs. broad enhanced cognitive behavioral therapy for bulimia nervosa with comorbid borderline personality: a randomized controlled trial. Int. J. Eat. Disord 49:36–49
    [Google Scholar]
  69. Traviss-Turner GD, West RM, Hill AJ 2017. Guided self-help for eating disorders: a systematic review and metaregression. Eur. Eat. Disord. Rev. 25:148–64
    [Google Scholar]
  70. Tregarthen J, Kim PJ, Sadeh-Sharvit S, Neri E, Welch H, Lock J 2019. Comparing a tailored self-help mobile app with a standard self-monitoring app for the treatment of eating disorder symptoms: randomized controlled trial. JMIR Ment. Health 6:e14972
    [Google Scholar]
  71. Upadhyay J, Farr O, Perakakis N, Ghaly W, Mantzoros C 2018. Obesity as a disease. Med. Clin. N. Am. 102:13–33
    [Google Scholar]
  72. Wagner B, Nagl M, Dölemeyer R, Klinitzke G, Steinig J et al. 2016. Randomized controlled trial of an Internet-based cognitive-behavioral treatment program for binge-eating disorder. Behav. Ther. 47:500–14
    [Google Scholar]
  73. Wagner G, Penelo E, Wanner C, Gwinner P, Trofaier M et al. 2013. Internet-delivered cognitive-behavioural therapy v. conventional guided self-help for BN: long-term evaluation of a randomised controlled trial. Br. J. Psychiatry 202:135–41
    [Google Scholar]
  74. Waller G, Stringer H, Meyer C 2012. What cognitive behavioral techniques do therapists report using when delivering cognitive behavioral therapy for the eating disorders. ? J. Consult. Clin. Psychol. 80:171–75
    [Google Scholar]
  75. Watson HJ, McLagan N, Zerwas SC, Crosby RD, Levine MD et al. 2018. Cost-effectiveness of Internet-based cognitive-behavioral treatment for BN: results of a randomized controlled trial. J. Clin. Psychiatry 79:16m11314
    [Google Scholar]
  76. Wilfley DE, Agras WS, Fitzsimmons-Craft EE, Bohon C, Eichen DM et al. 2020. Training models for implementing evidence-based psychological treatment: a cluster-randomized trial in college counseling centers. JAMA Psychiatry 77:139–47
    [Google Scholar]
  77. Wilfley DE, Welch RR, Stein RI 2002. Cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Arch. Gen. Psychiatry 59:713–21
    [Google Scholar]
  78. Wilson GT, Fairburn CG, Agras WS, Walsh BT, Kraemer HC 2002. Cognitive-behavioral therapy for BN: time course and mechanisms of change. J. Consult. Clin. Psychol. 70:267–74
    [Google Scholar]
  79. Wilson GT, Vitousek KM 1999. Self-monitoring in the assessment of eating disorders. Psychol. Assess. 11:480–89
    [Google Scholar]
  80. Wilson GT, Wilfley DE, Agras WS, Bryson SW 2010. Psychological treatments for binge eating disorder. Arch. Gen. Psychiatry 67:94–101
    [Google Scholar]
  81. Wonderlich SA, Peterson CB, Crosby RD, Smith TL, Klein MH et al. 2014. A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for BN. Psychol. Med. 44:543–53
    [Google Scholar]
  82. Zerwas SC, Watson HJ, Hofmeier SM, Levine MD, Hamer RM et al. 2017. CBT4BN: a randomized controlled trial of online chat and face-to-face group therapy for BN. Psychother. Psychosom. 86:47–53
    [Google Scholar]
  83. Zipfel S, Wild B, Groß G, Friederich HC, Teufel M et al. 2014. Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial. Lancet 383:127–37
    [Google Scholar]
/content/journals/10.1146/annurev-clinpsy-081219-110907
Loading
  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error