Change in eating‐disorder psychopathology network structure in patients with anorexia nervosa treated with intensive cognitive behavior therapy

Cognitive behavior Therapy (CBT) has been shown to be more effective or at least as effective as other psychotherapies in the treatment of bulimia nervosa with change being maintained 5 years after the end of treatment. Additionally, empirical studies demonstrate that CBT is superior to antidepressant medications in the treatment of bulimia nervosa. Less is known about CBT for anorexia nervosa but initial research suggests it may play a prominent role in treatment. CBT can influence changes in negative thoughts and schemas in anorexia nervosa as well as influence core eating disorder psychopathology and alter depressed mood. CBT may prevent relapse in the treatment of anorexia nervosa. More research is needed on the use of CBT in anorexia nervosa.

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The effect of group cognitive behavior therapy on Chinese patients with anorexia nervosa: an open label trial

Journal of Eating Disorders ◽

10.1186/s40337-021-00469-7 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Lian Gu ◽

Yunling Zou ◽

Yue Huang ◽

Qiang Liu ◽

Han Chen ◽

...

Keyword(s):

Anorexia Nervosa ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Weight Regain ◽

Symptom Improvement ◽

Cognitive Behavior ◽

Open Label ◽

Cost Of Treatment ◽

Open Label Trial

Abstract Background The high cost of treatment for anorexia nervosa (AN) and lack of trained specialists have resulted in limited accessibility of effective treatment to patients with AN, which is particularly problematic in China. To increase the accessibility of evidence-based treatment and reduce the cost of treatment, this study aimed to explore the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy for eating disorders (CBT-E) in Chinese AN patients. Method A total of 78 patients with AN were assigned to G-CBT or individual outpatient treatment (IOT) and received three months of treatment for AN in each condition. Measures of eating pathology, depression and anxiety were administrated to both intervention groups at three time points: baseline, one month of treatment, and end of treatment; results were compared between groups and over time. Results There were 70 participants included in the final analysis. Both G-CBT and IOT groups showed significant improvement in eating pathology and associated psychopathology (ps < .001) over the course of treatment, but no significant difference in symptom improvement was found between the two groups (ps > .05). G-CBT resulted in additional significant improvement in ED psychopathology over the last two months of treatment, and its overall therapeutic effect was influenced by baseline weight and early symptom improvement. Conclusion Preliminary findings from this open label trial suggest that G-CBT adapted from CBT-E is feasible in an outpatient setting and as effective as IOT in facilitating weight regain and reducing psychopathology in Chinese AN patients with little evidence for the superiority of either intervention. Trial registration: The current study was registered at clinical trials.gov on September 23, 2018 (registration number NCT03684239). Plain English summary People with anorexia nervosa (AN) are known to be unmotivated for treatment and prone to relapse. Recovery from AN often needs intensive, long-term treatment from a specialized multidisciplinary team, which is not accessible for most people in China. Given the increasing incidence of AN and lack of eating disorder (ED) specialists in China, it is important to develop short-term cost-effective treatments for AN. In this study, we explored the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy (CBT-E) for people with AN from China. We found that G-CBT was as effective as individual outpatient treatment (IOT) typically provided to AN patients at the research site in facilitating weight regain, improving eating behaviors, and reducing ED and other symptoms. We also found that patients receiving G-CBT made more improvements in cognitive symptoms of the ED, which might help maintain treatment gains and prevent relapse in the long run. This potential long-term advantage of G-CBT needs to be verified in long-term follow-up.

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Assessing the distinctiveness of psychotherapies and examining change over treatment for anorexia nervosa with cognitive-behavior therapy, interpersonal psychotherapy, and specialist supportive clinical management

International Journal of Eating Disorders ◽

10.1002/eat.22555 ◽

2016 ◽

Vol 49 (10) ◽

pp. 958-962 ◽

Cited By ~ 2

Author(s):

Virginia V.W. McIntosh ◽

Jennifer Jordan ◽

Janet D. Carter ◽

Suzanne E. Luty ◽

Frances A. Carter ◽

...

Keyword(s):

Anorexia Nervosa ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Clinical Management ◽

Interpersonal Psychotherapy ◽

Cognitive Behavior ◽

Specialist Supportive Clinical Management

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Enhanced cognitive-behavior therapy and family-based treatment for adolescents with an eating disorder: a non-randomized effectiveness trial

Psychological Medicine ◽

10.1017/s0033291720004407 ◽

2020 ◽

pp. 1-11

Author(s):

Daniel Le Grange ◽

Sarah Eckhardt ◽

Riccardo Dalle Grave ◽

Ross D. Crosby ◽

Carol B. Peterson ◽

...

Keyword(s):

Eating Disorder ◽

Weight Gain ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Behavior ◽

Global Score ◽

Lower Weight ◽

Family Based Treatment ◽

Family Based

Abstract Background Family-based treatment (FBT) is an efficacious intervention for adolescents with an eating disorder. Evaluated to a lesser degree among adolescents, enhanced cognitive-behavior therapy (CBT-E) has shown promising results. This study compared the relative effectiveness of FBT and CBT-E, and as per manualized CBT-E, the sample was divided into a lower weight [<90% median body mass index (mBMI)], and higher weight cohort (⩾90%mBMI). Method Participants (N = 97) aged 12–18 years, with a DSM-5 eating disorder diagnosis (largely restrictive, excluding Avoidant Restrictive Food Intake Disorder), and their parents, chose between FBT and CBT-E. Assessments were administered at baseline, end-of-treatment (EOT), and follow-up (6 and 12 months). Treatment comprised of 20 sessions over 6 months, except for the lower weight cohort where CBT-E comprised 40 sessions over 9–12 months. Primary outcomes were slope of weight gain and change in Eating Disorder Examination (EDE) Global Score at EOT. Results Slope of weight gain at EOT was significantly higher for FBT than for CBT-E (lower weight, est. = 0.597, s.e. = 0.096, p < 0.001; higher weight, est. = 0.495, s.e. = 0.83, p < 0.001), but not at follow-up. There were no differences in the EDE Global Score or most secondary outcome measures at any time-point. Several baseline variables emerged as potential treatment effect moderators at EOT. Choosing between FBT and CBT-E resulted in older and less well participants opting for CBT-E. Conclusions Results underscore the efficiency of FBT to facilitate weight gain among underweight adolescents. FBT and CBT-E achieved similar outcomes in other domains assessed, making CBT-E a viable treatment for adolescents with an eating disorder. Clinical Trial Registration Information: Treatment Outcome in Eating Disorders; https://clinicaltrials.gov/; NCT03599921.

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