title: Evolution of cognitive-behavioral therapy for eating disorders.
abstract: The evolution of cognitive-behavioral therapy (CBT) for the treatment of bulimic disorders is described in this review. The impacts of successive attempts to enhance CBT such as the addition of exposure and response prevention; the development of enhanced CBT; and broadening the treatment from bulimia nervosa to binge eating disorder are considered. In addition to developing advanced forms of CBT, shortening treatment to guided self-help was the first step in broadening access to treatment. The use of technology such as computer-based therapy and more recently the Internet, promises further broadening of access to self-help and to therapist guided treatment. Controlled studies in this area are reviewed, and the balance of risks and benefits that accompany the use of technology and lessened therapist input are considered. Looking into the future, more sophisticated forms of treatment delivered as mobile applications ("apps") may lead to more personalized and efficacious treatments for bulimic disorders, thus enhancing the delivery of treatments for eating disorders.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA. Electronic address: sagras@stanford.edu.
authors.forename: W Stewart
authors.initials: WS
authors.lastname: Agras
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA. Electronic address: fitzsimmonscrafte@psychiatry.wustl.edu.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Fitzsimmons-Craft
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA. Electronic address: wilfleyd@psychiatry.wustl.edu.
authors.forename: Denise E
authors.initials: DE
authors.lastname: Wilfley
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000639:trends*; D001068:Feeding and Eating Disorders / Q000628:therapy*; D006801:Humans; D020407:Internet; D013813:Therapy, Computer-Assisted
keywords: Cognitive-behavioral therapy; Eating disorder; Guided self-help; Internet-based treatment; Technology-based treatment