CBT for Anorexia – Does it work?
The recent ANTOP study, published in the Lancet at the end of last year, is a welcome review of treatments for anorexia nervosa.
The National Institute for Clinical Excellence (NICE) suggests that 1.6 million suffer with an eating disorder in the UK. Of that 1.6 million, 10% are diagnosed with anorexia nervosa, which remains the psychiatric disorder with the highest rate of mortality. NICE guidelines urge psychological interventions on an outpatient basis as these will help to address the unhelpful behavioural patterns in patients with anorexia.
Professor Wolfgang Herzog, one of the ANTOP authors, underlined the urgent need for further study into treatment for this illness: “In up to 20% of the cases, anorexia leads to death…Patients with anorexia often suffer from the psychological or physical consequences of the disease their entire lives.”
In a comparison of standard psychotherapy, focal psychodynamic therapy and Cognitive Behavioural Therapy (CBT), 242 women engaged in 10 months of therapy and 12 months of follow-up observation. All patients made significant weight gains and their BMI increased, on average, by 1.4 BMI points.
While each therapy obtained good results, overall, CBT was more effective in speed of weight gain and improvement in eating disorder psychopathology.
CBT for anorexia aims to alter the unhealthy and unrealistic thoughts and beliefs regarding body image, food and diet restriction. This type of thinking often leads to behaviour that is unbalanced and results in a compulsion to control diet and weight at all costs.
CBT assists patients to identify trigger thoughts for compulsive behaviour towards food and exercise, and patient and therapist work together to identify unhelpful thinking and change dysfunctional behavioural patterns.
With some studies indicating a 60% success rate for CBT, and reduced relapse rates, ANTOP goes a long way towards reinforcing the usefulness of CBT with this difficult issue.