Cognitive-behavioral therapy for eating disorders

Treatment Overview

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Cognitive-behavioral therapy is an active type of counseling. Sessions usually are held once a week for as long as you need to master new skills. Individual sessions last 1 hour, and group sessions may be longer.

During cognitive-behavioral therapy for anorexia, you learn:

• About your illness, its symptoms, and how to predict when symptoms will most likely recur.
• To keep a diary of eating episodes, binge eating, purging, and the events that may have triggered these episodes.
• To eat more regularly, with meals or snacks spaced no more than 3 or 4 hours apart.
• How to change the way you think about your symptoms—this reduces the power the symptoms have over you.
• How to change self-defeating thought patterns into patterns that are more helpful. This improves mood and your sense of mastery over your life. This helps you avoid future episodes.
• Ways to handle daily problems differently.
• Breathing exercises for controlling physical symptoms of stress. When you calm your breathing, your body and mind also become calm.

What To Expect After Treatment

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You can use your cognitive-behavioral skills throughout your life. You may find that additional "tune up" sessions help you stay on track with your new skills.

Why It Is Done

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Cognitive-behavioral therapy is used to treat the mental and emotional elements of an eating disorder. This type of therapy is done to change attitudes about food, eating, and body image; help correct poor eating habits; and prevent relapse.

How Well It Works

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Cognitive-behavioral therapy is considered effective for the treatment of eating disorders.¹ However, because eating disorder behaviors can endure for a long period of time, ongoing psychological treatment is usually required for at least a year and may be needed for several years.² Cognitive-behavioral therapy may be more effective in treating bulimia nervosa rather than anorexia nervosa.

Risks

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There are no known risks associated with cognitive-behavioral therapy.

What To Think About

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For cognitive-behavioral therapy to be most effective, be sure to work together with your counselor toward common goals. If you think you are not working well with your counselor, discuss your concerns with him or her or your primary doctor.

If you have a mental health condition along with an eating disorder, your health professional may suggest medication. Treating a problem such as depression or obsessive-compulsive disorder may help you recover from an eating disorder.

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

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Citations

1. Andersen AE, Yager J (2005). Eating disorders. In BJ Sadock, VA Sadock, eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 8th ed., vol. 1, pp. 2002–2021. Philadelphia: Lippincott Williams and Wilkins.

2. Steering Committee on Practice Guidelines, American Psychiatric Association (2000). Practice guidelines for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157(1, Suppl): 1–39.

Credits

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Author	Kathe Gallagher, MSW
Associate Editor	Lisa Shaw
Associate Editor	Terrina Vail
Primary Medical Reviewer	Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer	W. Stewart Agras, MD - Psychiatry
Last Updated	October 11, 2005