Eating disorders — such as anorexia, bulimia or compulsive overeating — are often challenging to treat. Many people turn to 30-day inpatient treatment after finding little success with outpatient psychotherapy.

Part of the problem, too, is that treatment studies, whether for therapy or medications, often stop at an arbitrary 8- or 12-week cutoff date, with little followup. (Few people in the real world are seen for only 8 weeks of treatment.) Sometimes you’ll see a 4- or 12-week followup, but rarely do you find a study that examines whether the treatment lasts long-term.

So a new study that not only provided one 20-week cognitive behavioral therapy (CBT) treatment arm, but offered a more complex treatment arm for patients with more complex eating disorders, and a wait-list control arm (roughly equivalent to a placebo in therapy studies), and did a 60-week followup (that’s more than a year later) is a welcomed addition to the literature. The study demonstrated the effectiveness of the two types of cognitive behavioral therapy offered (which offered significantly more change in eating disorder symptoms than the control group), not only in the short term, but also in the long-term:

At the 60-week follow-up assessment, 51.3% of the sample had a level of eating disorder features less than one standard deviation above the community mean.

Now, obviously, that’s not ideal. Only half the people who were treated remained relatively eating disorder-free after a year. But it shows that cognitive behavioral therapy, in experienced, well-trained hands, is an effective outpatient treatment for eating disorders of all types — even the most severe, complex types. As the researchers note, “Patients with marked mood intolerance, clinical perfectionism, low self-esteem, or interpersonal difficulties appeared to respond better to the more complex treatment,” while those without those complex features did well with a standard cognitive-behavioral treatment.


Fairburn et al. (2008). Transdiagnostic Cognitive-Behavioral Therapy for Patients With Eating Disorders: A Two-Site Trial With 60-Week Follow-Up. Am J Psychiatry, 10.1176/appi.ajp.2008.08040608.