Enhanced Therapy Effective for Eating Disorders
> 12/17/2008 9:55:44 AM

Eating disorders, those chronic body-image afflictions notoriously resistant to all forms of treatment, may have met their (therapeutic) match: a newly published study concludes that an enhanced version of the Cognitive Behavioral Therapy regimen approved for the treatment of bulimia nervosa is not only more efficient than its predecessor but may be effectively applied to 80% of all eating disorder cases. And it hasn’t even been tested on anorexic patients yet. The reason most eating disorders prove so difficult to treat is that they stem from personal issues that persist even after the related behaviors have become somewhat normalized. The vast majority of affected subjects relapse, their disorders operating in wave-like phases as they consistently return to the same personal justifications for their self-destructive behaviors.

One may have difficulty discerning the specifics of the new CBT-E (the “e” stands for “enhanced”) approach from the available press releases. We will certainly glean more information as further studies test the method’s effectiveness among larger, more diverse subject groups. The primary researchers behind this study, based at the University of Oxford, have long believed that the established CBT model was ineffective because it focused too much on individual diagnoses and did not pay enough attention to the “core pathology” of each subject. They argued for a “transdiagnostic” approach designed to address behaviors common to all eating disorders, and this idea formed the model they eventually used in a 7-year research project culminating in this study. 

While earlier treatments focused strictly on the disordered behavior itself, this new, more comprehensive regimen also considers the disorders’ most common roots: low-self esteem and extreme perfectionism. It makes for a more comprehensive and flexible CBT that could, ideally, work for a large variety of subjects. The trials in question consisted of 20 50-minute therapy sessions performed over a 20-week period on a 154-strong subject pool. The study divided its subjects into three groups: controls, those receiving the newly developed CBT-E treatment and those receiving an even more complex model. Subjects represented 2 of the 3 major eating disorder categories: bulimia nervosa, which accounts for a third of all cases, and atypical ED, a mixed-symptoms classification that may be applied to nearly half of all affected subjects (including those with binge eating disorder).

The results, recorded after follow-ups at the 60-week mark, are encouraging. The vast majority displayed marked improvement and 2 out of 3 demonstrated a “complete and lasting response” to the treatments. These numbers are far better than those achieved by any current CBT eating-disorder regimens. And patients responded well regardless of their condition. Subsequent sub-analysis showed that, unsurprisingly, those with “particularly complex clinical features” did better when treated under the more elaborate plan. Researchers have yet to finalize the results of a similar experiment focusing on subjects with anorexia nervosa, but they report that the project is going well so far. We certainly hope so – most past clinical ED-treatment approaches have proven less than inspiring, and any positive news on this front is a welcome development.

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