Cognitive-behavioral therapy (CBT) is a popular treatment for bulimia nervosa, but it has been less successful in treatment of anorexia nervosa. General wisdom states that those with anorexia have a difficult time responding to CBT or any other form of treatment because their bodies are simply too ravaged by starvation. The brain suffers physically, leaving the person unable to process information well and absorb the impact of psychotherapy.
Dr. Jacqueline Carter of Toronto General Hospital's Department of Psychiatry studied the effectiveness of CBT on those who had already gained weight in recovery from anorexia. She sought to determine whether CBT would be effective in helping these persons avoid relapse.
CBT's Effectiveness as a Maintenance Treatment for Anorexia
The results are encouraging. The study compared a group receiving CBT to a control group receiving "maintenance treatment as usual" -- standard follow-up support after regaining weight. After one year of treatment, the relapse rate of those in the CBT group was just 32.5%, less than half the rate of those receiving maintenance treatment (65.6%). These results confirm earlier research findings suggesting that CBT is helpful once the initial physical crisis created by anorexia is over.Staying With the Program Encourages Success
The study is also significant because of its length. Some research projects have ended after a few months of therapy. Researchers have suggested employing a full year of treatment for those who have regained an appropriate weight, and this study conforms to that recommendation.CBT Keeps Those Recovering From Anorexia Engaged With People
In my opinion, one of the best indicators of a treatment's ability to help is its ability to keep people coming. Obviously, more treatment should lead to more success. But I also believe that it's extremely important for those with eating disorders, and particularly anorexia, to be in contact with other people. The more healthy contact there is, the less isolation there is. This cuts off one of the eating disorder's key weapons -- the message that no one cares.When any kind of therapy can help keep a recovering person in front of the face of someone who cares, that's a victory. CBT apparently shows an ability to do this -- others, such as nutritional therapy, have not. So, CBT should be a frequent choice for therapists working with those with anorexia who have regained a normal weight.
Sources:
Carter JC. Effectiveness of two maintenance treatments for weight-restored anorexia nervosa. Proceedings of the International Conference on Eating Disorders. Academy for Eating Disorders, 2008.
Wilson GT, Grilo CM, and Vitousek KM. Psychological treatment of eating disorders. American Psychologist 62 (2007): 199-216.
