TOTAL VIEWS: 162
Eating disorders, including anorexia, bulimia, and binge eating disorder, are serious and growing global health concerns. Cognitive behavioral therapy (CBT), especially its enhanced version (CBT-E), has been widely employed in the treatment of such disorders. This paper reviews research conducted between 2020 and 2023, examining the effectiveness of CBT across various eating disorders, its applicability, and its limitations. Studies have shown that CBT and CBT-E are highly effective in improving patients' body mass index, relieving anxiety and depression symptoms, boosting self-esteem, reducing binge eating, and changing unhealthy behaviors. While CBT is widely used in Western countries and proves effective in individual treatment, its application and spread in Asian countries are limited by cultural differences and the lack of localized approaches. Future studies should advance by exploring the applicability of CBT in Asia and diversify the studied population, particularly by increasing the sample of men, to improve the generalizability of findings. Overall, this review supports the use of CBT-E as an effective treatment for a range of eating disorders in both adults and adolescents, though further comprehensive studies are needed globally to validate its clinical efficacy.
[1] Romano, K. A., Heron, K. E., & Ebener, D. Associations among weight suppression, self-acceptance, negative body image, and eating disorder behaviors among women with eating disorder symptoms. Women Health. 2021;61(8):791-799.
[2] Stein, Kenardy, & Wiseman. What's Driving the Binge in Binge Eating Disorder? A Prospective Examination of Precursors and Consequences. International Journal of Eating Disorders. 2007;40(3):195-203.
[3] American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5™). Arlington, VA: American Psychiatric Association, 2013.
[4] Schumann, A. The epidemiology of eating disorders in the United States. Psychiatric Clinics of North America. 2009;32(2):347-364.
[5] Marie Galmiche, Pierre Déchelotte, Grégory Lambert, Marie Pierre Tavolacci. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. The American Journal of Clinical Nutrition. 2019;109(5):1402-1413.
[6] William Stewart Agras. Cognitive Behavior Therapy for the Eating Disorders. Psychiatric Clinics of North America. 2019.
[7] Christopher Fairburn. A cognitive behavioural approach to the treatment of bulimia. Psychological Medicine. 1981;11:707-71.
[8] de Jong M, Schoori M, Hoek HW. Enhanced cognitive behavioural therapy for patients with eating disorders: a systematic review. Curr Opin Psychiatry. 2018;31(6):436-44.
[9] Gu, L., Zou, Y., Huang, Y., Liu, Q., et al. The effect of group cognitive behavior therapy on Chinese patients with anorexia nervosa: an open label trial. Journal of Eating Disorders. 2021;9(1):1-11.
[10] Roz Shafran, Michelle Lee, Zafra Cooper, et al. Effect of Psychological Treatment on Attentional Bias in Eating Disorders. International Journal of Eating Disorders. 2008;41:4 348-354
[11] Chisato Ohara1, Atsushi Sekiguchi, Shu Takakura, et al. Effectiveness of enhanced cognitive behavior therapy for bulimia nervosa in Japan: a randomized controlled trial protocol. BioPsychoSocial Medicine. 2020;14:2
[12] Camilla Lindvall Dahlgren, Kristin Steda, et al. Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA): clinical norms and functional impairment in male and female adults with eating disorders. Nord J Psychiatry. 2017;71(4):256-261.
[13] Daniel Le Grange, James Lock, W Stewart. Agras Randomized Clinical Trial of Family-Based Treatment and Cognitive-Behavioral Therapy for Adolescent Bulimia Nervosa. J Am Acad Child Adolesc Psychiatry. 2015;54(11):886-94.e2.
[14] Simona Calugi, Massimiliano Sartirana, Chiara Milanese, et al. The clinical impairment assessment questionnaire: validation in Italian patients with eating disorders. Eat Weight Disord. 2018;23(5):685-694.
[15] Kübra Kayaoğlu, Kerim Kaan Göküstün, Eda Ay. Evaluation of the relationship between food addiction and depression, anxiety, and stress in university students: A cross-sectional survey. J Child Adolesc Psychiatr Nurs. 2023;36(3):256-262.
[16] Simona Calugi, Laura Dametti, Anna Dalle Grave. The clinical perfectionism questionnaire: psychometric properties of the Italian version in patients with eating disorders. Eat Weight Disord. 2022;27(8):3439-3448.
[17] D Watson, K Weber, J S Assenheimer. Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. J Abnorm Psychol. 1995;104(1):3-14.
[18] Melisse, B., Dekker, J., Van den Berg, E. et al. Comparing the effectiveness and predictors of cognitive behavioural therapy-enhanced between patients with various eating disorder diagnoses: A naturalistic study. The Cognitive Behaviour Therapist. 2022; 15, E20.
[19] Nora Trompeter, Kay Bussey. et al. Emotion Dysregulation within the CBT‑E Model of Eating Disorders: A Narrative Review. 2021;45:1021–1036.
[20] Martie de Jong Msc, Philip Spinhoven. et al. Effectiveness of enhanced cognitive behavior therapy For eating disorders: A ran-domized controlled trial. Int J Eat Disord. 2020;1-11.
[21] Laura van Riel, Elske van den Berg, Marike Polak, et al. Exploring effectiveness of CBT in obese patients with binge eating disorder: personality functioning is associated with clinically significant change. BMC Psychiatry. 2023;23:136
[22] Treasure, J., Stein, D., Maguire, S. Has the Time Come for a Staging Model to Map the Course of Eating Disorders from High Risk to Severe Enduring Illness? An Examination of the Evidence. Early Interv. Psychiatry. 2015;9:173-184.
[23] van den Berg, E., Schlochtermeier, D., Koenders, J. et al. Effectiveness and cost-effectiveness of cognitive behavior therapy-enhanced compared with treatment-as-usual for anorexia nervosa in an inpatient and outpatient routine setting: a consecutive cohort study. Eat Disord. 2022;10:2.
[24] Calugi, S., Dametti, L., Chimini, M., Dalle Grave, A., & Dalle Grave, R. Change in eating-disorder psychopathology network structure in patients with anorexia nervosa treated with intensive cognitive behavior therapy. International Journal of Eating Disorders. 2021;54(10):1800-1809.
[25] Riccardo Dalle Grave, Maddalena Conti, Simona Calugi. Effectiveness of intensive cognitive behavioral therapy in adolescents and adults with anorexia nervosa. Int J Eat Disord. 2020;53(9):1428-1438
[26] Frostad, S., Calugi, S., Engen, C.B.N. et al. Enhanced cognitive behaviour therapy (CBT-E) for severe and extreme anorexia nervosa in an outpatient eating disorder unit at a public hospital: a quality-assessment study. J Eat Disord. 2021;9:143.
[27] C G Fairburn, P J Cooper, J Kirk, M O'Connor. The significance of the neurotic symptoms of bulimia nervosa. Journal of Psychiatric Research. 1985;19(2-3):135-140.
[28] Dingemans, A., Bruna, M. & van Furth, E. Binge eating disorder: a review. Int J Obes. 2002; 26:299-307.
[29] Butler, R. M., Lampe, E., Trainor, C., & Manasse, S. M. Fear of weight gain during cognitive behavioral therapy for binge-spectrum eating disorders. Eating and Weight Disorders-Studies on Anorexia. Bulimia and Obesity. 2023;28(1):29.
[30] Hay, P., Palavras, M.A., da Luz, F.Q. et al. Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial. BMC Psychiatry. 2022;22:355.
[31] Chen, J., Guo, L., Gu, L., & Han, H. The introduction of treatment and the cultural adaptability of Western psychotherapies for eating disorders in China. International Journal of Eating Disorders. 2021;54(1):102-106.
[32] Le Grange, D., Eckhardt, S., Dalle Grave, R., et al. Enhanced cognitive-behavior therapy and family-based treatment for adolescents with an eating disorder: A non-randomized effectiveness trial. Psychological Medicine. 2022;52(13):2520-2530.
[33] Melisse, B., Blankers, M., van den Berg, E., de Jonge, M., et al. Economic evaluation of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder compared to a waiting list: A randomized controlled trial. International Journal of Eating Disorders. 2023.
[34] Christopher G Fairburn, Zafra Cooper, Helen A Doll, et al. Marianne E O'Connor Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am J Psychiatry. 2009 March;166(3):311-319.
[35] Martie de Jong, Philip Spinhoven, Kees Korrelboom, et al. Effectiveness of enhanced cognitive behavior therapy for eating disor-ders: A randomized controlled trial. J Eat Disord. 2020 May;53(5):447-457.
[36] Milla Kaidesoja, Zafra Cooper, Beth Fordham. Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base. Int J Eat Disord. 2023;56(2):295-313.
[37] Li Ping Su-Kubricht, Hao-Min Chen, Shuiyan Guo, et al. Towards Culturally Sensitive Care: Addressing Challenges in Asian and Asian American Mental Health Services. Contemporary Family Therapy. 2024.
A Review of Studies on the Effectiveness of Cognitive Behavioral Therapy in Treating Eating Disorders
How to cite this paper: Ao Xu, Kun Guo, Ting Liu. (2024) A Review of Studies on the Effectiveness of Cognitive Behavioral Therapy in Treating Eating Disorders. International Journal of Clinical and Experimental Medicine Research, 8(4), 656-662.
DOI: https://dx.doi.org/10.26855/ijcemr.2024.10.020