In psychiatric-mental health, eating disorders are characterized by abnormal eating patterns that cause physiological changes and psychological distress. Women are the most commonly affected due to the pressures of attaining the “ideal body weight and appearance”; however, there are also incidences of men who were found to have eating disorders. It is not only through commercialism and social media that individuals are influenced to work hard to attain that most desired physical appearance.
No one would choose to have an eating disorder. You wouldn’t make the choice to lose all of your friends because you can’t eat at restaurants, to exercise obsessively despite pain and injuries, or to binge eat until you feel like your stomach is going to burst. — Jennifer Rollin MSW, LCSW-C
Psychologists and medical experts also believe that eating disorders are caused by having a dysfunctional family where the mother usually presents as a perfectionist and the father has a passive attitude. Impaired self-esteem is also a significant factor in the development of eating disorders. The good news is this condition is highly treatable if assessed and managed early. The physical complications can be handled in the hospital setting, while the psychological disturbances are addressed through cognitive-behavioral therapy.
What Is The Effectiveness Of CBT In Eating Disorders?
In 2014, a study published in The American Journal of Psychiatry proved the effectiveness of CBT in relieving binging and purging and was found to be faster in improving eating disorder features (Poulson et al., 2014). The study was a randomized controlled trial conducted in 70 women who received 20 sessions of CBT for five months. After the indicated period, 36 of these women (42%) proved to have stopped binging and purging behaviors and improved their eating habits.
When a patient presents with a moderate to high level of anxiety or depression, it is often difficult to initially engage or engagement takes a really long time. — Judy Scheel Ph.D., L.C.S.W., CEDS
Another study was conducted in 2015 measuring the effectiveness of enhanced CBT (CBT-E) in eating disorders (Fairburn et al., 2015). This time, the sample population was much more significant, with 130 adult patients randomly assigned to receive CBT-E and interpersonal therapy (IPT). At the end of 5 months, 66% of the population group who received CBT-E were found to follow the remission of symptoms, and this was even higher when a follow-up was conducted after that. This goes to show that the effects of CBT-E post-treatment are significant and sustained even after the treatment period.
The Components Of CBT
When a person decides to undergo CBT, there will be 20 sessions to complete over the span of 5 months. The meetings are done in an office setting or can be accomplished online. Online therapy for eating disorders is an ongoing and well-accepted mode of treatment for those who have problems with being physically present in the doctor’s office or for convenience reasons.
CBT involves the following components:
- Psychoeducation. The therapist provides information to understand why eating disorders happen and the accompanying complications they bring if not treated immediately.
- Guiding the person to replace the usual dieting methods with regular eating habits. The therapist allows independence for the person to select their food as long as it follows the three meals with two or three snacks in a day.
- Helping the person to plan his or her meals. This will empower the person to prepare ahead of time and know what to eat and when to have their next meal.
- Documenting their food intake and completion of food records. This activity does not only highlight the type of food that was taken but will also allow recording of thoughts, feelings, and behaviors while they were eating the meal.
- Monitoring of weight once per week to review progress and plan for further steps if there is no progress recorded.
- Planning for strategies to curb binges and compensatory behaviors to include a problem-solving approach.
- Challenging the person on their beliefs about food intake. For example, encouraging to take a cupcake to prove if it can cause a five-pound weight gain.
- Re-introduction to feared foods. The person must have a well-established eating pattern and compensatory behaviors in place before being exposed to the dreaded foods once again.
- Teaching strategies to prevent relapse. The person is guided to become his or her own therapist after the completion of the sessions.
In addition to the above components, persons with eating disorders are also imparted with strategies to stop body checking, development of self-esteem, and enhancement of social or interpersonal skills.
There are different levels and intensity of eating disorder treatment that depend on various factors such as how long you’ve been struggling with the disorder and how medically compromised you are. — Susan Albers Psy.D.
Conclusion
A licensed and trained therapist does CBT. It is the most effective and the leading evidence-based treatment for persons with eating disorders at present. There can be other factors that are linked to make the treatment process successful; nonetheless, the therapy, in general, has been proven through many research and clinical trials that it can treat eating disorders in any variant or type.
References:
Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., … & Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behavior therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behavior research and therapy, 70, 64-71.
Poulsen, S., Lunn, S., Daniel, S. I., Folke, S., Mathiesen, B. B., Katznelson, H., & Fairburn, C. G. (2014). A randomized controlled trial of psychoanalytic psychotherapy or cognitive-behavioral therapy for bulimia nervosa. American Journal of Psychiatry, 171(1), 109-116.