Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial

Martie Jong, Philip Spinhoven, Kees Korrelboom, Mathijs Deen, Iris Meer, Unna N. Danner, Selma Schuur, Maartje Schoorl, Hans W. Hoek*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
Enhanced cognitive behavior therapy (CBT‐E) is a transdiagnostic treatment suitable for the full range of eating disorders (EDs). Although the effectiveness of CBT(‐E) is clear, it is not being used as widely in clinical practice as guidelines recommend. The aim of the present study was to compare the effectiveness of CBT‐E with treatment as usual (TAU), which was largely based on CBT principles.

Method
We conducted a randomized controlled trial on a total of 143 adult patients with an ED who received either CBT‐E or TAU. The primary outcome was recovery from the ED. Secondary outcome measures were levels of ED psychopathology, anxiety, and depressive symptoms. Self‐esteem, perfectionism, and interpersonal problems were repeatedly measured to examine possible moderating effects. We explored differences in duration and intensity between conditions.

Results
After 80 weeks, there were no differences between conditions in decrease in ED psychopathology, or symptoms of anxiety and depression. However, in the first six weeks of treatment there was a larger decrease in ED psychopathology in the CBT‐E condition. Moreover, when the internationally most widely used definition of recovery was applied, the recovery rate at 20 weeks of CBT‐E was significantly higher (57.7%) than of TAU (36.0%). At 80 weeks, this difference was no longer significant (CBT‐E 60.9%; TAU 43.6%). Furthermore, CBT‐E was more effective in improving self‐esteem and was also the less intensive and shorter treatment.

Discussion
With broader use of CBT‐E, the efficiency, accessibility and effectivity (on self‐esteem) of treatment for EDs could be improved.
Original languageEnglish
Pages (from-to)717-727
JournalInternational Journal of Eating Disorders
Volume53
Issue number5
DOIs
Publication statusPublished - 2020

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