Cognitive behavior therapy is the first-line treatment for most eating disorders, but other therapies have proven effective in certain situations.

Eating disorders, such as anorexia, bulimia, and binge-eating disorder, are serious mental health conditions involving a complex interplay of psychological and physical symptoms.

Cognitive behavioral therapy (CBT) is considered the gold-standard treatment for most eating disorders, as it helps change the underlying thoughts and behaviors that drive the disorder.

But other treatments have proven to be just as effective as CBT in certain circumstances, particularly if another factor (like an unhealthy relationship) is driving the disordered eating behaviors.

If you have an eating disorder, it’s important that you find the therapy that works for you and your specific symptoms.

There are several psychotherapy options for people with eating disorders, including:

Cognitive-behavioral therapy (CBT/ CBT-E)

CBT is the most highly preferred and research-backed type of psychotherapy for all eating disorders. CBT focuses on identifying and changing the unhelpful thought patterns and beliefs that drive disordered eating behaviors.

Enhanced cognitive-behavioral therapy (CBT-E) is a form of CBT designed to specifically address the thought patterns and attitudes behind eating disorders. CBT-E is highly individualized and includes a tailored program specifically designed to match your needs.

A study of 143 adults with eating disorders compared CBT-E to “treatment as usual” (TAU), which generally included CBT principles.

At 20 weeks, the recovery rate of the CBT-E group was significantly higher (57.7%) than the TAU group (36%). CBT-E was also more effective in improving self-esteem even though it was a shorter, less intensive treatment. At 80 weeks, however, no difference was seen between the groups.

This study suggests that both CBT and CBT-E can effectively treat eating disorders; however, positive results may happen faster with CBT-E.

Interpersonal psychotherapy (IPT)

Interpersonal psychotherapy (IPT) is an evidence-based treatment that was first developed to treat major depressive disorder but later adapted to treat eating disorders — particularly binge eating disorder (BED).

IPT helps you address and heal any interpersonal problems that may be triggering or perpetuating your eating disorder. An IPT therapist will help you choose one of four areas on which to focus:

  • grief
  • interpersonal deficits
  • role transitions
  • interpersonal role disputes.

One review evaluated the effectiveness of IPT for eating disorders, such as bulimia and anorexia. The findings show that, among bulimia participants, IPT was slower-acting than CBT but may be just as effective in the long term (8 months).

Among 56 participants with anorexia, IPT was found to be the least effective treatment compared to CBT and a control treatment of clinical management and supportive psychotherapy.

Acceptance and commitment therapy (ACT)

Acceptance and commitment therapy (ACT) is a type of psychological intervention that increases psychological flexibility via mindfulness and behavior-changing strategies.

The theory behind ACT is that human suffering isn’t simply the result of painful experiences. Rather, most suffering comes from struggling against our uncomfortable feelings and thoughts about these events. ACT teaches you that stress and painful feelings are a natural part of the human condition.

ACT focuses on 6 core processes:

  • Acceptance. Accept your thoughts and feelings and give up the struggle against them.
  • Cognitive defusion. Recognize your thoughts as just thoughts, and not facts.
  • Present moment awareness. Focus on what’s happening right now within you and in your environment (not the past or future).
  • Values. Identify your values and recognize what motivates you and gives you meaning.
  • Self-as context. Recognize that you are not your thoughts and feelings.
  • Committed action. Take action on your values to create a fulfilling life.

Dialectical behavior therapy (DBT)

Dialectical behavior therapy (DBT) is a therapeutic technique that helps you develop emotion regulation and relationship skills. Originally developed for borderline personality disorder (BPD), DBT has been adapted to treat eating disorders.

Though generally not as effective as CBT, DBT can be helpful for some people who engage in harmful eating behaviors as a way to deal with negative feelings or relationship stressors.

In a study comparing DBT to CBT for treating people with binge eating disorders, the researchers found that CBT outperformed DBT for reducing binge eating episodes and improving self-esteem. However, CBT is a more time-consuming and intensive program.

Overall, the researchers support using CBT over DBT, but note that DBT is still a viable option as it produces meaningful changes in eating disorder symptoms in a less time-consuming program.

What is the most successful therapy treatment for anorexia?

Cognitive-behavioral therapy (CBT) is considered the gold-standard treatment for anorexia. CBT (or CBT-E) for anorexia can help you develop a healthier relationship with food, your body, and your self-image.

Treatment goals for anorexia include the following:

  • restore to a healthy weight (when applicable)
  • treat physical and psychological effects of malnutrition
  • enhance motivation to develop healthy eating patterns and participate in treatment
  • provide education regarding nutrition and eating patterns
  • help reassess and change core dysfunctional thoughts, attitudes, motives and feelings related to anorexia
  • treat psychiatric symptoms
  • enlist family support and provide family counseling
  • develop healthy eating patterns and behaviors
  • maintain weight and prevent relapse

What is the most successful therapy treatment for bulimia?

CBT (CBT-E) is the most recommended treatment for bulimia.

Treatment goals for bulimia are as follows:

  • reduce and, when possible, eliminate binge eating and purging
  • treat physical complications of bulimia
  • enhance motivation to develop healthy eating patterns and participate in treatment
  • provide nutritional education
  • encourage food variety and minimize food restriction
  • encourage healthy, but not compulsive, exercise patterns
  • address core dysfunctional thoughts, attitudes, motives and feelings related to bulimia
  • address other issues that may underlie disordered eating behaviors
  • treat any other psychiatric conditions
  • enlist family support and provide family counseling
  • prevent relapse

What is the most successful therapy treatment for binge eating disorder?

CBT (or CBT-E) is the preferred psychological treatment for binge eating disorder (BED).

During therapy for BED, you’ll focus on:

  • understanding the disorder
  • reducing binge eating
  • reducing concerns about weight and shape
  • reducing or eliminating the factors that maintain BED, such as dieting

Group therapy and support groups can be very helpful for people with eating disorders.

A meta-analysis found that group psychotherapy for BED was just as effective as other types of treatments (individual therapy and self-help treatment) and was significantly more effective than wait-list controls (no treatment).

Group therapy may also have the added benefit of being cost-effective compared to individual psychotherapy. There are options for both in-person and online group therapy.

There are several treatment facility options for people living with eating disorders. The right option for you depends on your particular disorder and its level of severity.

  • Outpatient care. This includes weekly or monthly appointments with a therapist for individual counseling. Outpatient care may also include group sessions, family therapy and nutritional counseling.
  • Intensive outpatient program (IOP). IOP involves 3-5 days a week for 3-5 hours per day. IOP may involve individual and group therapy, dietary counseling, meal support, and medication management.
  • Partial hospitalization (PHP). In this highly-structured daytime program, you attend 3-7 days a week but go home at night. PHP is recommended for clients who are medically stable but not functioning well enough to participate in daily living activities like work or school.
  • Residential treatment. Treatment occurs in a non-hospital setting, but still involves 24/7 care and medical monitoring. It’s recommended for clients who are medically stable but are still struggling with severe psychiatric symptoms.
  • Inpatient hospitalization. This is the highest level of care available. It requires 24/7 supervision and can take place in a medical hospital, a med-psych unit, or an eating disorder medical unit. It’s recommended for clients who are both medically and psychiatrically unstable.

Family involvement plays a significant role in recovery for young people with severe eating disorders.

The Maudsley method is a specific type of family-based therapy for young people with anorexia and bulimia. It involves a year-long outpatient program where parents play an important role in their child’s recovery.

The goals of the Maudsley method include the following:

  • Restore your weight to original levels.
  • Help you gain back control over your eating behaviors.
  • Establish a healthy adolescent identity.

Eating disorders are serious mental health conditions marked by severe disturbances in eating behaviors as well as related thoughts and emotions.

People with eating disorders are at greater risk for serious medical complications and suicidal behaviors, so treatment should be sought as early as possible. In fact, anorexia has been reported to have one of the highest death rates of any psychiatric disorder.

CBT-E is the preferred treatment for most eating disorders, but if you have other underlying issues driving the behavior, it’s a good idea to look into other options as well, such as DBT, IPT, or ACT.

If you’re experiencing suicidal thoughts, help is available

You can access free support right away with these resources:

  • 988 Suicide and Crisis Lifeline.Call the Lifeline at 988 for English or Spanish, 24 hours a day, 7 days a week.
  • The Crisis Text Line.Text HOME to the Crisis Text Line at 741741.
  • The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text “START” to 678678, or chat online 24/7.
  • Veterans Crisis Line.Call 988 and press 1, text 838255, or chat online 24/7.
  • Deaf Crisis Line.Call 321-800-3323, text “HAND” to 839863, or visit their website.
  • Befrienders Worldwide.This international crisis helpline network can help you find a local helpline.
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