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A systematic review of enhanced cognitive behavioral therapy (CBT‐E) for eating disorders
Author(s) -
Atwood Molly E.,
Friedman Aliza
Publication year - 2020
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.23206
Subject(s) - eating disorders , psycinfo , cognitive behavioral therapy , randomized controlled trial , psychopathology , binge eating , clinical psychology , psychology , binge eating disorder , cognitive therapy , systematic review , psychiatry , bulimia nervosa , medline , cognition , medicine , political science , law
Objective To review the literature examining the efficacy and effectiveness of enhanced cognitive behavioral therapy (CBT‐E) for adults and older adolescents with eating disorders. Method A systematic search of the literature (using PsycINFO and PubMed) was conducted in order to identify relevant publications (randomized controlled trials [RCTs] and uncontrolled trials) up to June 2019. Effect sizes were reported for outcomes including treatment attrition and remission rates, eating disorder behaviors, body mass index (BMI), and core eating disorder psychopathology. The Downs and Black checklist was used to assess the quality of included studies. Results Twenty studies (10 RCTs and 10 uncontrolled trials) met criteria for inclusion. Support was found for the efficacy and effectiveness of CBT‐E for the full spectrum of eating disorders, with respect to reducing eating disorder behaviors and core psychopathology. BMI also increased, with large effects, for individuals with AN. However, the majority of the randomized trials included in this review did not demonstrate superiority of CBT‐E over comparison treatments, particularly in the longer‐term. Furthermore, rates of attrition and remission for CBT‐E among individuals without AN did not appear to differ from rates for CBT‐BN. Discussion There is evidence to support CBT‐E as an efficacious and effective treatment for adults and older adolescents with a range of eating disorder diagnoses. Future research would benefit from directly comparing CBT‐E to CBT‐BN, expanding measured outcomes to include driven exercise and subjective binge eating, increasing consistency in the definition and measurement of outcomes, and exploring factors associated with treatment retention.