Using Cognitive-Behavioral Therapy to Treat Eating Disorders

By Meghan Vivo

What is the best way to treat individuals suffering from eating disorders? While experts probably wouldn’t agree on one single answer to this question, they would likely agree that cognitive-behavioral therapy (CBT) is one critical piece of a comprehensive eating disorder treatment plan.

What Is CBT?

CBT is a type of therapy – often used to treat addiction, depression, anxiety, phobias and eating disorders – that helps patients understand the thoughts and feelings that influence their behaviors.

When things go wrong, we often look to people, events or situations to place blame. What cognitive-behavioral therapy teaches is that our thoughts produce our feelings and behaviors. While this knowledge puts the responsibility on us to choose how we feel and respond by changing the way we think, it also frees us to feel better even if the external forces in our lives never change.

This is good news, especially for people struggling with eating disorders and other forms of mental illness. Eating disorder sufferers tend to feel out of control, withdrawn and depressed, often because of childhood events, traumatic experiences or unhealthy relationships. Despite being unable to change the past, CBT allows patients to see themselves as powerful and capable of choosing a better path going forward.

CBT produces quick results compared to other therapies, in part because of the strong, trusting relationship established between the therapist and patient, and the way CBT helps the patient learn how to think and act differently. By providing education and encouragement, the therapist helps the patient to set goals and learn new ways of interpreting things that will help them get what they want in life.

According to the website of the Association for Behavioral and Cognitive Therapies, CBT helps patients learn to:

  • Distinguish between thoughts and feelings
  • Become aware of the ways in which thoughts can influence feelings in ways that sometimes are not helpful
  • Learn about thoughts that seem to occur automatically, without even realizing how they may affect emotions
  • Evaluate critically whether these "automatic" thoughts and assumptions are accurate, or perhaps biased
  • Develop the skills to notice, interrupt and correct these biased thoughts independently

What the Research Says

CBT has empirical support as a method for treating eating disorders, particularly bulimia and binge eating disorder. In a study by researchers at the University of Western Sydney in Australia, 37 percent of individuals treated with CBT stopped their binging and purging behaviors, while only 3 percent of those not receiving any therapy stopped their disordered eating behaviors.

The researchers concluded that therapy that focuses on dietary habits, fear of weight gain, and ways to "normalize" thoughts about food and body image may be the treatment of choice for these eating disorders. Achieving the results took an average of four to five months of CBT whereas other psychotherapies, such as interpersonal, psychoanalytic and hypnosis, generally took about one year. Still, the researchers lent their support for a combined approach that included both CBT and other psychotherapies.

Finding Effective Eating Disorder Treatment

Eating disorders are complex mental illnesses that require multidisciplinary treatment. The best eating disorder treatment facilities will offer CBT in combination with other interventions, including dialectical behavior therapy (DBT), group processing work, nutrition counseling and culinary therapy.

CRC Health Group, the nation’s leading provider of behavioral health care, has a number of cutting-edge, research-based eating disorder treatment programs that incorporate cognitive-behavioral therapy.

Montecatini, an eating disorder program for girls and women in Southern California, has an interdisciplinary team that is skilled in using CBT, DBT, interpersonal therapy, expressive therapies and other modalities to treat the psychological, biological and social aspects of each patient. Patients participate in individual sessions with a psychiatrist, dietician and primary therapist, as well as family therapy, restaurant outings, fitness classes and relapse prevention planning.

Because eating disorders often present along with drug addiction and/or alcoholism, CRC Health also offers programs designed to treat these co-occurring issues. The Victorian is an exclusive facility for the treatment of women with eating disorders and co-occurring substance abuse issues in Newport Beach, Calif. Patients spend their days practicing new life skills and setting goals, attending individual and group therapy with some of the nation’s foremost experts in eating disorder treatment, and exploring new ways of seeing themselves and their bodies.

Sierra Tucson is another world-renowned eating disorder treatment program that specializes in treating both men and women with dual diagnoses. The caring staff treats the deep emotional pain associated with eating disorders and chemical dependency using individualized treatment plans designed to break through denial while offering unconditional acceptance and guidance. Unique offerings at Sierra Tucson include Eye Movement Desensitization and Reprocessing (EMDR), Somatic Experiencing®, equine therapy, and integrative therapies such as acupuncture, massage therapy, yoga and Zero Balancing.

Eating disorders are some of the most difficult illnesses to treat, but research shows that thousands of men and women have won their battle with a blend of cognitive-behavioral therapy and other treatment approaches. In the process, you will discover that you alone can change the way you see yourself and the world around you – and, with the support of a multidisciplinary treatment team, you, too, can heal in mind, body and spirit.


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