Eating Disorder Therapy Practices

Eating disorders are complex mental health conditions that significantly impact an individual’s relationship with food and body image. Eating disorder therapy practices are essential for recovery because they tackle underlying issues and promote healthier coping mechanisms. Key therapeutic approaches for treating eating disorders include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Family-Based Therapy (FBT), Interpersonal Psychotherapy (IPT), Art Therapy, and Exposure Therapy. Each of these therapies offers unique strategies to support individuals on their journey to recovery.

What Are Eating Disorders and Why Is Therapy Important?

Eating disorders are serious mental health conditions that affect a person’s relationship with food and body image. They can involve extreme behaviors related to eating, such as overeating, undereating, or purging. Therapy is important because it helps individuals understand the underlying issues contributing to their eating disorder and provides recovery support. Through therapy, people can develop healthier coping strategies and improve their self-esteem.

What Are the Common Types of Eating Disorders?

The most common types of eating disorders are Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). According to Feng B,’s 2023 study, ‘Current Discoveries and Future Implications of Eating Disorders’, here are the eating disorders in detail:

• Anorexia Nervosa (AN) is characterized by severe food restriction, leading to low body weight and fear of gaining weight. It affects individuals of all ages and genders, with high mortality risk. AN involves psychological, genetic, and physiological factors, including bone density loss and hormonal imbalances.
• Bulimia Nervosa (BN) involves binge eating followed by compensatory behaviors. It predominantly affects females and young adults, with neural and hormonal factors contributing to its pathophysiology. Family dynamics play a significant role in BN.
• Binge Eating Disorder (BED) involves recurrent episodes of excessive food consumption, leading to distress and obesity. It affects around 5% of American adults, with links to impaired serotonin signaling and various psychiatric conditions. Effective treatment options remain limited, emphasizing the need for multidisciplinary approaches.

What Types of Therapy Practices Available for Eating Disorders?

The common types of therapy practices for eating disorders include evidence-based approaches that focus on changing negative thought patterns, enhancing emotional regulation skills, fostering family involvement, improving interpersonal relationships, and encouraging self-acceptance. 

Here are the common therapies available for treating eating disorders:

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) for eating disorders is a clinically proven, evidence-based treatment that focuses on behaviors, thoughts, and feelings related to eating disorders. It helps individuals gain healthy eating behaviors and learn to recognize and change distorted thoughts that lead to eating disorder behaviors.

According to Baile JI’s 2022 study, ‘Cognitive Behavioural Therapy for an Adolescent with Anorexia Nervosa’, CBT can be effective for physical and psychological recovery in anorexia nervosa, contributing to evidence supporting this therapeutic approach for certain eating disorders.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) has shown promise in treating eating disorders, particularly in individuals with borderline personality disorder and eating disorder symptoms. According to Cerolini S’s 2024 study, DBT showed significant reductions in binge-eating symptoms and general psychopathology, along with increased self-esteem and eating self-efficacy compared to the treatment-as-usual group (22 individuals) after nine sessions. These improvements were maintained one-month post-intervention, highlighting the effectiveness of this brief web-based DBT approach as an accessible and sustainable resource for addressing dysregulated eating behaviors in clinical settings.

Acceptance and Commitment Therapy (ACT)

ACT helps reduce eating disorder symptoms by focusing on acceptance, cognitive defusion, and present-moment awareness. This approach encourages individuals to accept their thoughts and feelings about food, rather than being controlled by them, and to commit to actions that align with their values. 

According to Di Sante J’s 2022 study, ‘Efficacy of ACT-based treatments for dysregulated eating behaviors’, indicated that ACT-based treatments were moderately effective in decreasing dysregulated eating behaviors and enhancing psychological flexibility, with similar effects observed for binge eating and emotional eating across various intervention formats (face-to-face, web-based, and self-help). Longer treatment durations correlated with larger effect sizes, but changes in psychological flexibility did not directly relate to improvements in eating outcomes.

Family-Based Therapy (FBT)

Family-based therapy (FBT) is a leading treatment for adolescent eating disorders. FBT is a time-limited, behavioral intervention where caregivers are charged with re-feeding their child to normalize eating. FBT is a culturally sensitive method that keeps a child in their family environment.

According to a study by Oshukova, S in 2023, FBT has been effective in achieving significant weight restoration, with 61.5% of adolescents reaching full weight restoration at the end of treatment, and reducing eating disorder symptoms, particularly for those with milder weight deficits and less severe psychiatric comorbidities, evidenced by 42.3% requiring no further treatment after FBT.

Interpersonal Psychotherapy (IPT)

Interpersonal Psychotherapy (IPT) has been systematically reviewed as a treatment for eating disorders (EDs) and is recognized as a viable and cost-effective alternative to cognitive-behavioral therapy (CBT). 

According to Miniati M’s 2018 study, ‘Interpersonal psychotherapy for eating disorders: current perspectives’, IPT showed no significant differences in effectiveness compared to CBT for anorexia nervosa. IPT is well-supported as an effective treatment for bulimia nervosa and binge-eating disorder.

Notably, patients with bulimia who achieved remission through IPT experienced longer durations of clinical remission during long-term follow-ups. IPT is characterized by gradual improvements over time, maintaining efficacy in the long term, while group IPT for binge eating disorder demonstrated stable abstinence from binge eating. Overall, IPT offers a valuable therapeutic approach within the spectrum of eating disorders, emphasizing interpersonal relationships and life events.

Art Therapy

Art therapy helps individuals with eating disorders express difficult emotions visually.  Art therapists use art-making as a tool to understand and process feelings that contribute to eating disorders. This process facilitates self-awareness and coping mechanisms, promoting healthier emotional management and recovery.

According to Eren N’s 2023 study, ‘Effect of a long-term art-based group therapy with eating disorders’, participants who engaged in long-term art-based group therapy (ABGT) showed significantly improved functioning and reduced severity of eating disorder (ED) symptoms compared to the control group. There was a notable decrease in the severity of the three most critical issues reported by patients after ABGT, along with a reduction in the negative effects of these problems on their social and private lives. The therapy provided benefits such as catharsis, universality, self-understanding, and family re-enactment, helping participants recognize and address the mental conflicts behind their ED symptoms. These findings suggest that art-based interventions effectively enhance ED treatment by improving both functioning and symptoms.

Exposure Therapy

Exposure therapy aids eating disorders by diminishing anxiety and fear related to food and body image. It involves gradual exposure to feared stimuli, which lessens the negative associations and reduces avoidance behaviors. This process enhances emotional regulation and decreases disordered behaviors. Additionally, cognitive restructuring helps improve the individual’s relationship with food and body image.

According to Griffen TC,’s 2018 study, ‘Mirror exposure therapy for body image disturbances and eating disorders: A review’, Mirror Exposure Therapy (MET) improves body image and satisfaction in individuals with body dissatisfaction and eating disorders. Validated in clinical trials, MET is often used within Cognitive Behavioral Therapy (CBT), but further research is needed due to limited trial sizes and reported adverse events.

What Should I Expect During Therapy for Eating Disorders?

During therapy for eating disorders, expect a combination of therapy, nutritional counseling, and medical monitoring. Sessions focus on addressing disordered thoughts about food, body image, and behaviors. Cognitive-behavioral therapy (CBT) is often used to change harmful patterns, while interpersonal therapy helps improve relationships. Medical professionals monitor your physical health, ensuring recovery. Nutritional education supports developing healthier eating habits.