Cognitive behavior therapy for eating disorders versus normalization of eating behavior.
We examine the science and evidence supporting cognitive behavior therapy (CBT) for the treatment of bulimia nervosa and other eating disorders. Recent trials focusing on the abnormal cognitive and emotional aspects of bulimia have reported a remission rate of about 45%, and a relapse rate of about 30% within one year. However, an early CBT trial that emphasized the normalization of eating behavior had a better outcome than treatment that focused on cognitive intervention. In support of this finding, another treatment, that restores a normal eating behavior using mealtime feedback, has an estimated remission rate of about 75% and a relapse rate of about 10% over five years. Moreover, when eating behavior was normalized, cognitive and emotional abnormalities were resolved at remission without cognitive therapy. The critical aspect of the CBT treatment of bulimia nervosa therefore may actually have been the normalization of eating behavior.
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden. Electronic address: per.sodersten@ki.se.
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Södersten
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden.
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Bergh
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden.
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Leon
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden.
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Brodin
Karolinska Institutet, Section of Applied Neuroendocrinology, Mandometer Clinic, Huddinge, S-14104 Huddinge, Sweden.
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Zandian
D000818:Animals; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005247:Feeding Behavior / Q000502:physiology* / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000534:rehabilitation*; D006801:Humans
Anorexia; Bulimia; Clinical outcomes; Cognitive behavior therapy; Eating behavior; Scientific basis