Internet-based CBT Skills for Parents or Partners of Individuals with Anorexia Nervosa

Anorexia nervosa (AN) poses a major burden on families. Carers (e.g. parents or partners) of people with AN are often highly distressed and may inadvertently respond in ways that can contribute to the maintenance of the disorder, e.g. through high levels of over-involvement and criticism [also known as expressed emotion (EE)]. This study aimed to evaluate the efficacy of a novel web-based systemic cognitive-behavioral (CBT) intervention for carers of people with AN, designed to reduce carer distress and teach skills in how to offer effective support. Carers of people with AN (n=64) were randomly allocated to either the web-intervention, overcoming anorexia online, with limited clinician supportive guidance (by email or phone), or to ad-hoc usual support from the UK patient and carer organization Beat. Carer outcomes were assessed at post-treatment (4 months) and follow-up (6 months). Compared with the control intervention, web-based treatment significantly reduced carers’ anxiety and depression (primary outcome) at post-treatment, with a similar trend in carers’ EE. Other secondary outcomes did not favor the online intervention. Gains were maintained at follow-up. This is the first ever study to use an online CBT program to successfully reduce carer distress and improve carers’ ability to support the person with AN.

Grover, M., Naumann, U., Mohammad-Dar, L., Glennon, D., Ringwood, S., Eisler, I., Williams, C., … Schmidt, U. (December 01, 2011). A randomized controlled trial of an Internet-based cognitive-behavioural skills package for carers of people with anorexia nervosa. Psychological Medicine, 41(12), 2581-2591.


CBT is Effective for Bulimia Nervosa

According to a new study published in the American Journal of Psychiatry, cognitive behavior therapy (CBT) is a more effective and efficient treatment for binging and purging associated with bulimia nervosa than psychoanalytic psychotherapy. In the current study, 70 patients with bulimia nervosa were randomized to receive either 2 years of weekly psychoanalytic psychotherapy (n=34) or 20 sessions of CBT during a 5-month period (n=36). The Eating Disorder Examination Interview was administered to measure participant progress, before treatment at baseline, after 5 months, and after 2 years. While both treatments resulted in improvement, there was a significant difference in outcome between the two groups. After 5 months of treatment, 42% of patients in the CBT group had stopped binging and purging compared to 6% of patients in the psychoanalytic psychotherapy group. At 2 years, 44% in the CBT group and 15% in the psychoanalytic psychotherapy group had stopped binging and purging. Despite the considerable difference in treatment duration, CBT was more effective and generally faster in relieving binging and purging.

Poulsen, S, Lunn, S. Daniel S.I., Folke, S. Mathiesen, B.B., Katznelson, H. Fairburn, C.G. (2013). A Randomized Controlled Trial of Psychoanalytic Psychotherapy or Cognitive-Behavioral Therapy for Bulimia Nervosa. American Journal of Psychiatry, doi:10.1176/appi.ajp.2013.12121511

Men Have Eating Disorders – Cognitive Therapy Can Help

Anorexia and bulimia are not just affecting women. A recent Harvard Medical School survey showed that nationally, 25% of those with anorexia or bulimia and 40% of those who binge eat are male. The reported prevalence of eating disorders among men was much higher than previously expected.

This article in the Washington Post discusses the survey, and notes that, “Treatment for males and females involves cognitive therapy to overcome a distorted body image, which is at the core of eating disorders.”