CBT for eating disorders does not really work

 In Week in Review

A recent study reports that more than 30% of the patients did not complete outpatient CBT for anorexia nervosa. Fewer than 40% of the patients remitted, although only partially, relapse was masked by adding patient who improved after treatment, possibly because they received additional treatments (1). Because this is the manner in which outcomes of CBT have been described since this treatment was launched in 1981, we don´t really know if it works (2).
A not so recent study showed that treating eating behavior directly has a better effect than CBT (3). This report has been hibernating, but Mandometer has now confirmed the results in so many patients that it is about time to give up using CBT, which has remained at a standstill since 1981.

  1. Byrne, S. et al. A randomised controlled trial of three psychological treatments for anorexia nervosa. Psychol. Med. 1–11 (2017). doi:10.1017/S0033291717001349
  2. Södersten, P., Bergh, C., Leon, M., Brodin, U. & Zandian, M. Cognitive behavior therapy for eating disorders versus normalization of eating behavior. Physiol. Behav. 174, 178–190 (2017).
  3. Freeman, C. P. L., Barry, F., Dunkeld-Turnbull, J. & Henderson, A. Controlled trial of psychotherapy for bulimia nervosa. Br. Med. J. Clin. Res. Ed 296, 521-525 (1988).