Cognitive-Behavioral Therapy
for Eating Disorders

Treatment Overview

Cognitive-behavioral therapy is a very active type of counseling. During cognitive-behavioral therapy for anorexia, the counselor:

• Teaches you about your illness, its symptoms, and how to predict when symptoms will most likely recur.

• Teaches you to keep a diary of eating episodes, binge eating, purging, and the events that may have triggered these episodes.

• Helps you eat more regularly, with meals or snacks spaced no more than 3 or 4 hours apart.

• Helps change incorrect beliefs about your symptoms, which reduces the power the symptoms have over you.

• Helps change ineffective or self-defeating thought patterns into patterns that are more helpful. This improves mood, provides a sense of mastery over your life, and helps reduce the effect or stops the development of future episodes of symptoms.

• Teaches ways to handle daily problems differently. Sometimes the way a person handles problems increases the likelihood of developing the illness again.

• Helps change behaviors that do not work to behaviors that help deal with the symptoms. Changing behaviors often changes the number and severity of illness episodes.

• Teaches exercises that reduce fears and concerns about physical symptoms that develop during emotional stress. These exercises help a person bring physical symptoms such as irregular or fast breathing under control.

What To Expect After Treatment

Cognitive-behavioral therapy sessions usually are held once a week for up to 20 weeks. Individual sessions last 1 hour, and group sessions last 2 hours. Some people may need additional sessions to learn and be able to use the new skills.

You will learn how to better handle stressful situations to avoid triggering eating disorder behaviors.

Sometimes you may also need to take medications to treat symptoms of other conditions that often occur with eating disorders, such as depression or obsessive-compulsive disorder.

Why It Is Done

Cognitive-behavioral therapy is a very effective form of counseling used to treat the mental and emotional elements of an eating disorder. This type of therapy is done to correct poor eating habits, prevent relapse, and change attitudes about food, eating, and body image.

How Well It Works

Cognitive-behavioral therapy is considered very effective for the long-term treatment of eating disorders. However, because eating disorder behaviors can endure for a long period of time, ongoing psychological treatment is usually required for at least a year and may be needed for up to 6 years.1 Cognitive-behavioral therapy may be more effective in treating bulimia nervosa rather than anorexia nervosa.

Risks

There are no known risks associated with cognitive-behavioral therapy.

What To Think About

For cognitive-behavioral therapy to be most effective, you need to work together with your counselor toward common goals. If you think you are not working well with your counselor, discuss your concerns with him or her or your primary doctor.

Complete the special treatment information form to help you understand this treatment.

References

Citations Steering Committee on Practice Guidelines, American Psychiatric Association (2000). Practice guidelines for the treatment of patients with eating disorders (revision). Supplement to American Journal of Psychiatry, 157(1). Washington, DC: American Psychiatric Association.

Credits

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