Cognitive behavioral therapy is an increasingly popular treatment option for a wide range of eating disorders. In fact, the UK’s National Institute for Health and Care Excellence views cognitive behavioral therapy as the most effective treatment for adults suffering from bulimia nervosa. This article will explore the utility of cognitive behavioral therapy as a treatment option for anorexia nervosa.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is a discipline of psychology focused on treating distorted patterns of thinking. There are four main cognitive behavioral therapy techniques that can be employed in the treatment of anorexia:

Cognitive Therapy

Cognitive therapy primarily focuses on how a patient thinks, and the potential impact their thought patterns may be having on their emotions, state of mind, and their relationship with food. Mechanically, cognitive therapy tends to focus on changing the negative thought patterns underpinning disordered eating impulses.

Rational Emotive

Rational emotive therapy is an active-directive form of therapy that addresses innate irrational beliefs and self-defeating thoughts and behaviors. A therapist will help the patient to identify any self-defeating or irrational beliefs and will actively question and dispute them. In turn, these negative ways of thinking can be replaced with a more constructive and rational thought process.

Multimodal Therapy

Multimodal therapy requires a therapist to address the multiple modalities of a person in order to treat mental illness. These modalities, defined by the acronym BASIC I.D., include behavior, affect, sensation, imagery, cognition, interpersonal relationships and drugs or biology. The key to treating anorexia is to determine which modality influences anorexic behavioral signals.

Behavior Therapy

Behavior therapy relies on recognizing and reorienting stimuli responses to offset or treat neurotic eating disorder symptoms.

Enhanced Cognitive Behavioral Therapy (CBT-E) For Treating Anorexia

Through the lens of CBT-E, anorexia is a cognitive disorder caused by over-evaluation of the body, an unwillingness to yield control, and perfectionistic physical standards. The success of using the previously listed CBT-E techniques to treat anorexia nervosa is contingent on the following stages:

Stage 1: Begin a structured, fixed-length intervention period with an honest clinical assessment.

Stage 2: Keep the patient engaged in positive dialogue and build a trusting therapeutic relationship

Stage 3: Focus on identifying the processes that maintain and reinforce the targeted psychopathology (e.g. eating disorder behaviors).

Stage 4: Begin implementing self-monitoring strategies. Review, discuss and refine the success of each strategy in weekly sessions.

Stage 5: When disordered eating habits start to recede, begin planning a relapse prevention strategy. Central to this strategy is the identification of behavioral triggers and obstacles to recovery.

Sources: Mirror Mirror, Very Well Mind, Eating Disorder Hope, National Institutes of Health

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