Enhanced Cognitive Behavior Therapy (CBT-E) for Eating Disorders

CBT-E is an empirically supported treatment for all forms of eating disorders encountered in adults.

  1. Fairburn, C. G., Cooper, Z., Doll, H. A., O'Connor, M. E., Bohn, K., Hawker, D. M., . . . Palmer, R. L. (2009). Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: A two-site trial with 60-week follow-up. American Journal of Psychiatry, 166, 311-319.

  2. Fairburn, C. G., Cooper, Z., Doll, H. A., Palmer, R. L., & Dalle Grave, R. (2013). Enhanced cognitive behaviour therapy for adults with anorexia nervosa: a UK-Italy study. Behaviour Research and Therapy, 51, R2-R8.

  3. Sophie C. Dahlenburg, David H. Gleaves & Amanda D. Hutchinson. (2019). Treatment outcome research of enhanced cognitive behaviour therapy for eating disorders: a systematic review with narrative and meta-analytic synthesis. Eating Disorders, 27(5), 482-502.

In a randomized controlled trial of well-delivered CBT-E, it was found to be more effective than 100 sessions of psychoanalytic psychotherapy delivered over two years.

  1. Poulsen S, Lunn S, Daniel SIF, Folke S, Mathiesen BB, Katznelson H, Fairburn CG. (2014). A randomized controlled trial of psychoanalytic psychotherapy versus cognitive behavior therapy for bulimia nervosa. American Journal of Psychiatry, 171, 109-116.

CBT-E has shown promising results in cohort studies of patients between ages 11 and 19 years. It is recommended for children and young people with eating disorders when family therapy is unacceptable, contraindicated, or ineffective.

  1. Dalle Grave, R., Eckhardt, S., Calugi, S., & Le Grange, D. (2019). A conceptual comparison of family-based treatment and enhanced cognitive behavior therapy in the treatment of adolescents with eating disorders. Journal of Eating Disorders, 7(1), 1-9.

Family-Based Treatment (FBT)

FBT is the leading recommended empirically- supported intervention for adolescents with eating disorders. 

  1. Dalle Grave, R., Eckhardt, S., Calugi, S., & Le Grange, D. (2019). A conceptual comparison of family-based treatment and enhanced cognitive behavior therapy in the treatment of adolescents with eating disorders. Journal of Eating Disorders, 7(1), 1-9.

Randomized controlled trials have found that adolescents who receive FBT recover faster and at a higher rate than teens who receive traditional individual therapy.

  1. Lock, J., D. Le Grange, W. S. Agras, A. Moye, S. W. Bryson, and B. Jo. (2010). Randomized clinical trial comparing family-based treatment to adolescent focused individual therapy for adolescents with anorexia nervosa. Archives of General Psychiatry, 67(10), 1,025-32.

  2. Le Grange, D., R. D. Crosby, P. J. Rathouz, and B. L. Leventhal. (2007). A randomized controlled comparison of family-based treatment and supportive psychotherapy for adolescent bulimia nervosa. Archives of General Psychiatry, 64(9), 1,049-56.

Practice guidelines for the treatment of eating disorders prescribe that parents be routinely included in the treatment of adolescents.

  1. Yager, J., M. J. Devlin, K. A. Halmi, D. B. Herzog, J. E. Mitchell, P. Powers, K. Zerbe. (2012). Guideline Watch: Practice Guideline for the Treatment of Patients with Eating Disorders, 3rd. ed. Washington, D.C.: American Psychological Association.

The Body Project

The Body Project has the most empirical support of any eating disorder prevention program. This includes randomized (efficacy, effectiveness, and comparative) trials and rigorous tests of the intervention theory carried out by multiple, independent research labs and teams.

  1. Dakanalis, A., Clerici, M., and Stice, E. (2019). Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 24, 597.

It has been shown to produce the largest reductions in ED symptoms compared to any other prevention program, and it has been found to significantly reduce future onset of eating disorders.

  1. Dakanalis, A., Clerici, M., and Stice, E. (2019). Prevention of eating disorders: current evidence-base for dissonance-based programmes and future directions. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 24, 597.

  2. Further information - The Body Project website

Acceptance-based Mirror Exposure Treatment

Mirror exposure therapy has been shown to be effective for the treatment of body image disturbances in four randomized, controlled trials.

  1. Delinsky, S. S. & Wilson, G. T. (2006). Mirror exposure for the treatment of body image disturbance. International Journal of Eating Disorders, 39(2): 108-116.

  2. Glashouwer, K. A., Jonker, N. C., Thomassen, K. & de Jong, P. J. (2016). Take a look at the bright side: Effects of positive body exposure on selective visual attention in women with high body dissatisfaction. Behaviour Research and Therapy, 83: 19-25.

  3. Hildebrandt, T., Loeb, K., Troupe, S., & Delinsky, S. (2012). Adjunctive mirror exposure for eating disorders: A randomized controlled pilot study. Behaviour research and therapy, 50(12), 797-804.

  4. Moreno-Domínguez, S., Rodríguez-Ruiz, S., Fernández-Santaella, M.C., Jansen, A. & Tuschen-Caffier B. (2012). Pure versus guided mirror exposure to reduce body dissatisfaction: A preliminary study with university women. Body Image, 9(2): 285-288.