The Matrix - Cognitive Behavioural Therapy for Eating Disorders (CBT-ED)

Programme Summary

Cognitive Behavioural Therapy for Eating Disorders (CBT-ED) is an umbrella term for a range of tailored interventions that can be used for the treatment of eating disorders (including anorexia nervosa, bulimia nervosa, binge eating disorder) in children, young people, and adults. CBT for eating disorders includes enhanced CBT (CBT-E), a transdiagnostic approach that aims to help patients understand and disrupt the processes that maintain their eating disorder psychopathology. CBT is a term describing therapies which focus on altering negative cognitions and addressing unhelpful behaviours, as a route to changing the core negative emotions associated with a disorder. CBT has been shown to lead to significant improvements across several ED outcomes.

Usability - Rating: 5

Core components

Cognitive Behavioural Therapy (CBT) is an encompassing term that includes a range of psychological therapies that apply the standard principles of CBT and are used in the treatment of mental health disorders. This therapy recognises the inter-relationship between thoughts, emotions and behaviours, and how alterations in one domain can impact other domains. CBT therefore identifies, challenges, and modifies unhelpful cognitive structures, facilitating emotional and behavioural changes. Various CBT interventions have been developed to target eating disorders. These include specific manualised CBT approaches for anorexia nervosa, bulimia nervosa, and for binge eating (1-3).

In the context of Anorexia Nervosa (AN), CBT aims to reduce the symptoms of AN, its risks to physical health, and help individuals achieve and maintain a healthy weight. Treatment includes psychoeducation to identify the risks of malnutrition and being underweight, cognitive restructuring to address the cognitive aspects of the disorder, and behavioural strategies that can help promote normal eating patterns. CBT simultaneously addresses emotional regulation, body image issues, self-efficacy and relapse prevention. As part of the treatment process, a tailored treatment plan is established to address the processes suspected to sustain the eating disorder. CBT in children and young people (CYP) should take into consideration specific developmental needs of CYP.

In the context of Bulimia Nervosa (BN), CBT addresses the core features of this disorder, which have been identified as binge eating, use of inappropriate compensatory behaviours, and excessive body image concerns. Treatment therefore includes psychoeducation as it relates to weight and the negative effects of binge eating, purging, and extreme dieting. It also includes establishing a healthy eating pattern, addressing the eating disorder psychopathology, maintaining positive body image, and preventing relapse.

In the context of Binge Eating Disorder (BED), CBT aims to reduce dietary restraints and its influence on binge eating pathology via the use of cognitive and behavioural strategies. The treatment therefore involves the formulation of the person's psychological issues to identify the dietary and emotional factors that contribute to the eating disorder. Subsequently, cognitive restructuring, behavioural experiments and exposure are used to address the underlying triggers identified in the psychological formulation. Treatment also includes psychoeducation, monitoring of binge eating behaviours, addressing body image concerns (if any), and relapse prevention.

One widely used CBT intervention for eating disorders is Enhanced CBT (CBT-E) (4), which is a manualised transdiagnostic intervention for the treatment of all forms of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. CBT-E aims to help patients understand and disrupt the processes that maintain their eating disorder psychopathology. This helps to highlight the focus of treatment and facilitates a tailored approach to treatment. Hence, its exact form as an intervention is dependent on the individualised formulation of the processes that have been identified as maintaining the disorder. Patients are subsequently introduced to cognitive and behavioural strategies to address their individual eating disorder psychopathology and its maintaining processes. Family involvement is an essential part of CBT-E when the intervention is delivered to young people including young adults.

CBT-E has four stages:

Stage 1: Focuses on gaining understanding about the patient’s difficulties/ challenges with food and eating. The stage also aims to establish and stabilise regular, healthy eating patterns
Stage 2: Focuses on reviewing progress made, and developing a therapy plan
Stage 3: Focuses on addressing the processes that maintain the eating disorder, e.g. concerns about shape and weight, extreme dietary restraints, low self-esteem or interpersonal problems
Stage 4: Focuses on the future, including dealing with setbacks, maintaining the changes that have been achieved, and minimising the likelihood of relapse.

The Scottish Intercollegiate Guidelines Network recommends CBT for eating disorder (CBT-ED) programmes for people with eating disorders.

Fidelity

CBT for eating disorders should be delivered by competent practitioner(s) with ongoing supervision from accredited psychological therapists. The intervention should be delivered as per the validated manual and should be formulation-driven, to select the most appropriate techniques for the eating disorder presentation. Practitioner competence and fidelity to treatment can be monitored and evaluated using appropriate measures, e.g., via recording of treatment sessions and use of fidelity checklists to determine practitioner adherence against a CBT competency assessment tool, such as the Cognitive Therapy Scale-Revised (5). There are also CBT-ED specific rating measures under development, such as the CBT-E Components Checklist (6) and the Cognitive Behavioural Therapy Scale for Eating Disorders (CBTS-ED) developed by Beard et al. (7).

Modifiable Components

CBT can be delivered in several formats for the different types of eating disorders.

In the treatment of Anorexia Nervosa (AN), CBT can be delivered in an individualised format, offered in up to 40 sessions over 40 weeks. Up to 3 sessions per week should be offered in the first 2-3 weeks of therapy, if using Fairburn’s CBT-E model.

In the treatment of bulimia nervosa (BN), it can be delivered as a bulimia-nervosa-focused guided self-help intervention based on cognitive behavioural approaches. Brief practitioner support should supplement the self-help programme, with four to nine 20-minute therapist sessions provided over 16 weeks. CBT for the treatment of BN can also be delivered as an individualised format, offered in 20 sessions over 20 weeks. For CBT-E, Fairburn (4) recommends that 2 sessions per week should be offered in the first phase of therapy.

In the treatment of Binge Eating Disorder (BED), CBT can be offered as binge-eating-disorder-focused guided self-help interventions that are based on cognitive behavioural approaches. Brief practitioner support should supplement the self-help programme, with four to nine 20-minute therapist sessions provided over 16 weeks. CBT for the treatment of BED is available in group format, delivered in 16 weekly 90-minute group sessions over 4 months, and in an individualised format, offered in 16-20 sessions.

In addition to the enhanced version of CBT (CBT-E) which provides a transdiagnostic approach to treatment, CBT manuals are available to address the specific eating disorder (AN, BN and BED). A brief 10-session manualised CBT intervention (CBT-T) (8) is also available for all forms of eating disorders in patients who are not underweight.

Supports - Rating: 5

Support for Organisation / Practice

Implementation Support

Implementation support is mainly provided by trained accredited supervisors who support the application of CBT within each therapist’s practice. Support for implementing CBT is also available through the NES Adult Mental Health and CAMHS workstreams. Regular CPD events can be accessed through the Turas Learn site: https://learn.nes.nhs.scot/46686/cognitive-behavioural-therapy/cpd-for-cbt-therapists. Implementation support is also provided by the British Association of Behavioural and Cognitive Psychotherapies (BABCP), the UK based accredited body for therapists practicing Cognitive Behavioural Therapy. BABCP also accredits training programmes and provides CPD, and resources related to CBT practice.

Start-up Costs

There are no start-up costs associated with training provided within university training programmes (if training through an NHS place organised by NES). Costs apply when training is provided by private organisations.

Building Staff Competency

Qualifications Required

Staff will usually hold an undergraduate degree in a relevant area (e.g. nursing, psychology, medicine) and will have completed postgraduate training in CBT (PG Diploma, MSc or Doctoral level).

Training Requirements

Cognitive Behavioural Therapy (CBT) training is included in the adult and child focused MSc CBT/PTPC programmes and the Doctorate in Clinical psychology training programmes in Scotland. Additional training in adapting CBT for eating disorders is available through the NES psychology workstreams and also available through professional organisations such as the British Association of Behavioural and Cognitive Psychotherapies (BABCP).

Supervision Requirements

Regular (minimum 1 hour a month) supervision by a supervisor who is a CBT therapist and has completed the following pathway of supervision training:

NES Generic supervision competences training (GSC) (or equivalent)
NES Specialist Supervision Training: CBT (adult or child focus)

It is recommended practice in Scotland that this psychological intervention is conducted under regular supervision with a practitioner who has expertise in a) the intervention b) the clinical area and c) has completed training in supervision of psychological therapies and interventions (Further information: https://www.nes.scot.nhs.uk/our-work/supervision-of-psychological-therapies-and-intervention/).

Evidence - Rating: 5

Theory of Change

Broadly, CBT theories would assume that eating disorders develop via early experiences, leading to negative core beliefs and subsequently ways of thinking and coping to manage distress arising from these beliefs. The assumption would be within CBT that EDs are maintained by the continued use of unhelpful cognitive and behavioural strategies, which then become the targets of treatment. The transdiagnostic CBT-E model (4) assumes that maintaining processes are likely similar across different eating disorders, hence disrupting the process in one disorder is likely to cause a disruption across other ED symptoms. CBT interventions therefore focus on addressing the psychological and behavioural processes underlying and sustaining the eating disorder psychopathology.

Children and Young People - Rating: 5

Children and Young People (CYP) evidence overview for CBT for eating disorders

Existing evidence for CBT demonstrating its effectiveness in eating disorders in CYP is limited and the RCT level studies mostly focus on Bulimia Nervosa. Some of the available evidence is described below.

One RCT that compared CBT and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (9). Participants were 81 female adolescents, aged 14-20 years, with BN or partial BN. Participants received up to 60 sessions of either CBT or PDT over 12-months. The study was conducted in Germany.

Another trial compared CBT for adolescents with family-based therapy for Adolescent Bulimia Nervosa (FBT-BN) in 109 adolescents (mean 16 years) with BN (10). The study was conducted in the USA. The majority of participants were female (94%) and 46% identified as belonging to an ethnic minority. Participants received an average of 14 sessions and outcomes were measured at end of treatment, 6 month, and 12 month follow up. FBT-BN was more achieved higher abstinence rates from binging and purging than CBT at the end of treatment and 6 month follow up, but by 12 months there was no difference seen between treatments.

Dalle Grave et al. (11) systematically reviewed a number of case series and cohort trials that have been conducted on CBT-E for adolescents and generally found it to be acceptable, completed by about two thirds of adolescent patients, and associated with significant improvements in eating disorder and general psychopathology scores. One study (12) explored CBT-E and FBT in adolescents who were assigned to treatment on the basis of preference. FBT was more effective than CBT-E in terms of weight gain at end of treatment, but there was no difference at 6 and 12 month follow up and no difference in ED pathology at end of treatment or follow up.

CYP outcomes achieved for CBT

In pre-post analysis or compared to wait-list or active controls, the following outcomes were reported;

Significant remission rate of BN at post-treatment (9). No significant between group differences for CBT and PDT in remission (9).
Significantly reduced frequency of binge and purge behaviours at post-treatment (9,10). Lower reduction in abstinence from binging and purging behaviours following CBT compared to FBT at end of treatment and at 6 month follow up, reducing to non-significant differences at 12 month follow up (10).
Significantly decreased psychopathology at post-treatment (9,13), at 60 weeks follow-up (13).
Significantly increased weight /BMI for adolescents with AN at post-treatment (13), at 60 weeks follow-up (13), and at 2-years follow-up.

Adults - Rating: 5

Adult evidence overview for CBT for eating disorders

A number of studies have reported the effectiveness of CBT in eating disorders. The studies mentioned below include those that have evaluated the effectiveness of CBT in any eating disorder, including AN, BN, and BED and studies that have looked at CBT in relation to specific eating disorders. Overall, CBT appears to lead to significant improvements across several ED outcomes.

CBT for Eating Disorders (mixed presentations) Rating 5

The evidence base largely consists of studies of subjects with mixed eating disorder presentation, usually BN, Eating Disorder Not Otherwise Specified (EDNOS), OSFED and a small number of AN. The Enhanced CBT model (CBT-E;) (4) for eating disorders is a widely evaluated CBT intervention which is a manualised transdiagnostic intervention for the treatment of all forms of eating disorders. A brief 10-session manualised CBT intervention (CBT-T) (8) has also been evaluated for all forms of eating disorders in patients who are not severely underweight. The literature for CBT for mixed presentation of eating disorders is presented here.

This evidence includes three meta-analyses, a systematic review and 2 RCTs.

The first was a review and meta-analytic synthesis by Dahlenburg in 2019 examining treatment outcomes for CBT-E. This included 10 pre-post design studies and 5 RCTs with participants with AN, BN, BED or EDNOS diagnoses. There were 948 participants in all, all of whom were female.

The second was a review involving 10 RCTs and 10 uncontrolled trials (n- 981 adults) which included AN, BN, BED, EDNOS and OFSED (14). The Fairburn model of CBT-E was included and compared to active and inactive controls.

The third was an RCT conducted in the Netherlands evaluating the effectiveness of CBT-E in 143 adults with eating disorders, including AN, BN, BED, and otherwise specified feeding and eating disorder (OSFED) (15). CBT-E was delivered over 20 sessions, preceded by one preparatory session and followed by one review session 20 weeks after treatment. Sessions were held twice a week for the first 4 weeks, weekly for the next 10 weeks, and then biweekly in the last 6 weeks.

The fourth was a meta-analysis that evaluated the efficacy of CBT for eating disorders (16). 79 RCTs conducted in adults and adolescents with AN, BN, and BED were included. CBT was delivered in several formats including therapist-led CBT (in group and individual) and self-help formats.

The fifth was a meta-analytic study that evaluated the effectiveness of CBT in adults with eating disorders including BN, BN, BED, and Eating Disorder Not Otherwise Specified (EDNOS) (17) on quality of life. The study included 33 RCTs and non-RCTs, and CBT was delivered in individual, group, and self-help formats.

Another study was an RCT comparing a web-based CBT intervention to a waiting list control condition, carried out among 214 female patients with BN, BED and EDNOS (18).

Adult outcomes achieved for CBT for eating disorders

Compared to waitlist or active control, the following outcomes were observed;

Significantly improved eating disorder symptoms (reduced binge and purge frequencies and BMI change) at post-treatment (16,18).
Significant remission from eating disorder at post-treatment (15,17).
Significantly improved eating disorder symptoms in the first 6-weeks of therapy (15) and at post-treatment(4,19) but not maintained at long-term follow up (15).
CBT-E facilitated greater speed of weight restoration and faster changes in core psychopathology than some other structured therapies (14).
Significantly reduced cognitive symptoms of eating disorder at post-treatment (16).
Significantly improved mental health (including improved symptoms of depression, self-esteem, and social functioning) at post-treatment following web-based CBT (19).
Significantly improved quality of life at post-treatment (17).

Adults - bulimia nervosa - Rating: 5

The majority of research on psychological interventions for BN have been centred around CBT tailored to eating disorders. Evidence specifically focusing on Bulimia Nervosa is outlined below. This includes meta-analyses and RCTs.

A network meta-analysis compared the effectiveness of psychological and pharmacological interventions for bulimia nervosa (20). The study included 21 RCTs which evaluated 12 treatments, and recruited adults (aged at least 18 years) who fulfilled diagnostic criteria for BN. Participants who were assigned to CBT received the intervention in several formats including individual, guided self-help, pure self-help, and group formats. Montelone (21) conducted a systematic meta-review of meta-analysis and network meta-analysis. Fifty-nine studies were included and included adults and adolescents with AN, BN, BED. The outcomes for psychological therapies for BN were summarised within this review.

Two RCTs evaluated remote interventions for BN. Mitchell et al. (22) compared remote with face-to-face CBT (N=128) and Ruwaard et al. (23) compared online CBT with bibliotherapy or waiting list/delayed intervention (N=105).

Another RCT (24) focused on binge eating symptoms and compared traditional CBT with two other forms of CBT adapted for eating disorders (schema therapy and appetite-focused CBT; N=112).

Adult outcomes achieved for CBT for BN

Individual cognitive behavioural therapy focusing on eating disorders was most effective in achieving remission at the end of treatment (20,21).
Improvements in frequency of binging and purging compared to control were observed and maintained at 1 year follow up following remote or online CBT (22,23).
Large effect sizes observed for binge eating, other eating disorder symptoms and overall functioning across CBT and augmented CBT (24).

Adults - Binge Eating Disorder - Rating: 5

Adult evidence overview for CBT for Binge Eating Disorder

The outcomes of the literature focusing specifically on BED is described here. It includes three meta-analyses investigating the impact of different forms of CBT (guided self-help, group and individual therapy).

A meta-analytic review evaluating the effectiveness of treatment options for binge eating disorder in adults (25) summarised the evidence for the effectiveness of CBT for BED in 2016. It included 34 trials, of which 9 were waitlist-controlled psychological trials and 25 were placebo-controlled trials. Four studies for therapist-led CBT (n=295) contributed to meta-analysis for the binge eating abstinence outcome. The study noted methodological limitations of many included studies and highlighted the need for high quality research.

A second meta-analysis (26) investigated the efficacy of psychological and medical treatments for BED. The review included 81 RCTs (7515 participants) and included an analysis of CBt with other psychological treatments and individual CBT with guided self-help CBT interventions.

Third meta-analysis investigated rates of abstinence following psychological therapy for BED (27). The analysis included 39 RCTs that included 65 treatment conditions. Most conditions comprised CBT (n=40).

A fourth meta-analysis (28) investigated internet-based guided CBT and included 3 RCTs (298 participants with BED or subthreshold BED). effective in reducing binge episodes, ED psychopathology, and shape and weight concerns.

Adult evidence outcomes for CBT for binge eating disorder

Compared to inactive controls, therapist-led CBT decreased binge-eating frequency and increased binge-eating abstinence (25), with large effects (26).
Other types of CBT delivery such as guided self-help have similar, but smaller effects (medium-large) when compared to waitlist controls (25,26).
Internet-based guided self-help CBT was associated with significant reductions in binge episodes, ED psychopathology, and shape and weight concerns (28).
Around half of treatment completers achieved abstinence post-treatment and rates were maintained at follow up (27).

Adults - anorexia nervosa - Rating: 5

The evidence base for CBT for AN is the sparsest. The reviews of ED interventions which include a mixture of eating disorders usually only have a very small number of anorexia cases and therefore cannot be cited as robust evidence for its efficacy. Evidence includes a meta-analysis and RCTs.

One non-randomized clinical study conducted in Canada (29) included 88 participants with AN who had achieved a body mass index (BMI) of at least 19.5 kg/m2 and had control of their binge eating and purging symptoms following completion of a specialised hospital-based programme. CBT was delivered over a period of 1-year, in 50 individual therapy sessions.

One multi-centre RCT compared CBT-E with MANTRA and Specialist Supportive Clinical Management (SSCM) for 120 adults in total with 39 in the CBT-E group aged 17 years and older with AN with BMI between 14.0 to 18.5 kg/m² in Australia. Participants were offered 25-40 fifty-minute sessions of CBT-E over a 10-month period. Outcomes were assessed at end of treatment and at 6 and 12 month follow up (30).

Another multi-centre RCT compared CBT-E with focal psychodynamic therapy with 242 adults in total and 80 in the CBT-ED group with adults with AN with BMI between 15-18.5kg/ m². The study was conducted in Germany, and participants were offered 10 months of treatment. Outcomes were assessed at end of treatment and at 3 and 12 month follow up (31).

A meta-analytic study in 2021 examined the efficacy and acceptability of psychological interventions for outpatients with AN and included 13 RCTs (with 1047 patients) (32).

Adult outcomes achieved for anorexia nervosa

Modest improvement in clinical course and quality of life, with no superiority of any therapies. No overall differences in BMI and eating disorder symptoms in therapies (including CBT) and treatment as usual (32).
Significantly increased BMI at up to 12-month follow-up for CBT-ED and comparison treatments, with no significant differences between treatments with regard to achievement of healthy weight (30,31).
Significantly reduced eating disorders symptomatology, distress levels, and clinical/psychosocial impairment at up to 12-month follow-up for CBT-ED and comparison treatments, with no significant differences between treatments in the reductions in symptoms (30).
Superior effectiveness of CBT compared to TAU as a maintenance treatment for weight restored AN (29).

Significantly longer time to relapse in 1-year assessments (29).

Fit

Values

Cognitive Behavioural Therapy (CBT) is a psychological intervention that can be used in for the treatment of eating disorders (including anorexia nervosa, bulimia nervosa, binge eating disorder) in children, young people, and adults. CBT can also be delivered as enhanced CBT (CBT-E), a transdiagnostic intervention that aims to help patients understand and disrupt the processes that maintain their eating disorder psychopathology. Family involvement is an essential component of CBT-E when it is delivered to young people.

Does the eating disorder focus for this intervention align with the requirements of your organisation?

Priorities

CBT for eating disorders, such as CBT-E, adopts a tailored approach to treatment as the exact form of the intervention is dependent on the individualised formulation of the processes that have been identified as maintaining the disorder. CBT-E aims to equip patients with cognitive and behavioural strategies to address their individual eating disorder psychopathology and its maintaining processes.

Is your organisation looking to deliver an intervention that prioritises addressing the processes underlying and sustaining the eating disorder psychopathology?

Existing Initiatives

Does your service currently deliver interventions to treat eating disorders?
Are existing initiatives practicable and effective?
Do existing initiatives fit current and anticipated requirements?

Capacity

Workforce

CBT can be delivered by healthcare professionals (e.g. psychologists, psychiatrists, or mental health nurses) who have undergone training to support its delivery. CBT can be delivered to patients weekly.

Does your service have qualified practitioners who are available and interested in learning and delivering CBT?
Can your service support the time commitment required for practitioner training, supervision, and intervention delivery?
Will your practitioners deliver CBT face-to-face or remotely (including guided self-help CBT)?
If delivered face-to-face, is there capacity to support its delivery?

Technology Support

Cognitive Behavioural Therapy can be delivered without access to technology but access to video platforms for remote delivery can be useful as is access to methods of recording sessions for supervision.

Will CBT be delivered in-person or remotely?
Does your service have the technology to support CBT remote delivery?
Can your practitioners access technology to record sessions for supervision?

Administrative Support

CBT for eating disorders can be delivered in self-help, group or individual formats. Group and individual delivery can be held in several settings including community mental health centres, outpatient clinic settings, and hospitals. Administrative support is needed to manage appointments, collate and input outcome measures and process written reports.

In what setting will CBT be delivered?
Does your service have a venue to deliver CBT sessions?
Can administrative supports be provided to deliver CBT in the chosen format?

Financial Support

Scottish Government/NES Psychology routinely funds training programmes in CBT and supervisor training. Training is available from other organisations at a cost.

Can your service financially support practitioner training costs if accessed outside NES?

Need

Comparable Population

Research studies have included adolescents and adults with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified.

Is this comparable to the population your organisation would like to serve?

Desired Outcome

CBT is associated with significant improvements across several eating disorder outcomes, including eating disorder psychopathology, remission, binging and purging behaviours, weight/ BMI, and mental health.

Is delivering an intervention for the treatment of eating disorders a priority for your organisation?
Does your organisation have other initiatives in place that effectively and efficiency achieve the above outcomes?

Key References

1.Freeman C. Overcoming anorexia nervosa: a self-help guide using cognitive behavioral techniques. : Robinson; 2009.

2.Myra Cooper, Gillian Todd & Adrian Wells. Treating Bulimia Nervosa and Binge Eating: An Integrated Metacognitive and Cognitive Therapy Manual. Myra Cooper, Gillian Todd & Adrian Wells, Routledge, 2008, £22.99 pb, 264 pp. ISBN 9781583919453. 2009; . Accessed Jun 8, 2026.

3.Fairburn CG editor. Cognitive behavior therapy and eating disorders. : (2008). Cognitive behavior therapy and eating disorders. xii, 324 pp. New York, NY, US: The Guilford Press; US; 2008.

4.Fairburn CG, Cooper Z, Doll HA, O'Connor ME, Palmer RL, Dalle Grave R. Enhanced cognitive behaviour therapy for adults with anorexia nervosa: a UK-Italy study. Behaviour Research & Therapy 2013 Jan;51(1):2.

5.Blackburn I, James IA, Milne DL, Baker C, Standart S, Garland A, et al. THE REVISED COGNITIVE THERAPY SCALE (CTS-R): PSYCHOMETRIC PROPERTIES. 2001; . Accessed Jun 8, 2026.

6.Bailey-Straebler S, Cooper Z, Dalle Grave R, Calugi S, Murphy R. Development of the CBT-E Components Checklist: A tool for measuring therapist self-rated adherence to CBT-E. 2022; . Accessed May 22, 2026.

7.Beard J, Cooper Z, Masson P, Mountford VA, Murphy R, Raykos B, et al. Assessing clinician competence in the delivery of cognitive-behavioural therapy for eating disorders: development of the Cognitive-Behavioural Therapy Scale for Eating Disorders (CBTS-ED). Cognitive Behaviour Therapy 2024;53(1):29–47.

8.Waller G, Tatham M, Turner H, Mountford VA, Bennetts A, Bramwell K, et al. A 10-session cognitive-behavioral therapy (CBT-T) for eating disorders: Outcomes from a case series of nonunderweight adult patients. 2018; . Accessed Jun 8, 2026.

9.Stefini A, Salzer S, Reich G, Horn H, Winkelmann K, Bents H, et al. Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry 2017 Apr;56(4):329–335.

10.Le Grange D, Lock J, Agras WS, Bryson SW, Jo B. Randomized Clinical Trial of Family-Based Treatment and Cognitive-Behavioral Therapy for Adolescent Bulimia Nervosa. 2015; . Accessed Jun 8, 2026.

11.Dalle Grave R, Conti M, Sartirana M, Sermattei S, Calugi S. Enhanced cognitive behaviour therapy for adolescents with eating disorders: A systematic review of current status and future perspectives. 2021; . Accessed Jun 8, 2026.

12.Le Grange D, Gorrell S, Hughes EK, Accurso EC, Yeo M, Pradel M, et al. Delivery of Family-Based Treatment for Adolescent Anorexia Nervosa in a Public Health Care Setting: Research Versus Non-Research Specialty Care. Frontiers in psychiatry Frontiers Research Foundation 2019;10:1001.

13.Dalle Grave R, Calugi S, Doll HA, Fairburn CG. Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: an alternative to family therapy?. Behaviour Research & Therapy 2013 Jan;51(1):R9–R12.

14.Atwood ME, Friedman A. A systematic review of enhanced cognitive behavioral therapy (CBT-E) for eating disorders. Int J Eat Disord 2020;53(3):311–330.

15.de Jong M, Spinhoven P, Korrelboom K, Deen M, van der Meer I, Danner UN, et al. Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial. Int J Eat Disord 2020;53(5):447–457.

16.Linardon J, Wade TD, de la Piedad Garcia X, Brennan L. The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. 2017; . Accessed Jun 5, 2026.

17.Linardon J, Brennan L. The effects of cognitive-behavioral therapy for eating disorders on quality of life: A meta-analysis. Int J Eat Disord 2017;50(7):715–730.

18.ter Huurne ED, de Haan HA, Postel MG, van der Palen J, VanDerNagel JEL, DeJong CAJ. Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial. 2015; . Accessed Jun 8, 2026.

19.Dahlenburg SC, Gleaves DH, Hutchinson AD. Treatment outcome research of enhanced cognitive behaviour therapy for eating disorders: a systematic review with narrative and meta-analytic synthesis. Brunner-Mazel Eating Disorders Monograph Series 2019;27(5):482–502.

20.Slade E, Keeney E, Mavranezouli I, Dias S, Fou L, Stockton S, et al. Treatments for bulimia nervosa: a network meta-analysis. Psychol Med 2018;48(16):2629–2636.

21.Monteleone AM, Pellegrino F, Croatto G, Carfagno M, Hilbert A, Treasure J, et al. Treatment of eating disorders: A systematic meta-review of meta-analyses and network meta-analyses. Neuroscience & Biobehavioral Reviews 2022;142:104857.

22.Mitchell JE, Crosby RD, Wonderlich SA, Crow S, Lancaster K, Simonich H, et al. A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behaviour Research & Therapy 2008 May;46(5):581–592.

23.Ruwaard J, Lange A, Broeksteeg J, Renteria-Agirre A, Schrieken B, Dolan CV, et al. Online cognitive-behavioural treatment of bulimic symptoms: a randomized controlled trial. Clinical Psychology & Psychotherapy 2013;20(4):308–318.

24.McIntosh VVW, Jordan J, Carter JD, Frampton CMA, McKenzie JM, Latner JD, et al. Psychotherapy for transdiagnostic binge eating: A randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy. Psychiatry Res 2016;240:412–420.

25.Brownley KA, Berkman ND, Peat CM, Lohr KN, Cullen KE, Bann CM, et al. Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis. Ann Intern Med 2016 Sep 20;165(6):409–420.

26.Hilbert A, Petroff D, Herpertz S, Pietrowsky R, Tuschen-Caffier B, Vocks S, et al. Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder. Journal of Consulting & Clinical Psychology 2019 Jan;87(1):91–105.

27.Linardon J. Rates of abstinence following psychological or behavioral treatments for binge-eating disorder: Meta-analysis. Int J Eat Disord 2018;51(8):785–797.

28.Moghimi E, Davis C, Rotondi M. The Efficacy of eHealth Interventions for the Treatment of Adults Diagnosed With Full or Subthreshold Binge Eating Disorder: Systematic Review and Meta-analysis. Journal of Medical Internet Research 2021;23(7):e17874.

29.Carter JC, McFarlane TL, Bewell C, Olmsted MP, Woodside DB, Kaplan AS, et al. Maintenance treatment for anorexia nervosa: a comparison of cognitive behavior therapy and treatment as usual. Int J Eat Disord 2009 Apr;42(3):202–207.

30.Byrne S, Wade T, Hay P, Touyz S, Fairburn CG, Treasure J, et al. A randomised controlled trial of three psychological treatments for anorexia nervosa. Psychol Med 2017;47(16):2823–2833.

31.Zipfel S, Wild B, Gros G, Friederich H, Teufel M, Schellberg D, et al. Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial. Lancet 2014 Jan 11;383(9912):127–137.

32.Solmi M, Wade TD, Byrne S, Del Giovane C, Fairburn CG, Ostinelli EG, et al. Comparative efficacy and acceptability of psychological interventions for the treatment of adult outpatients with anorexia nervosa: a systematic review and network meta-analysis. The Lancet.Psychiatry 2021;8(3):215–224.

Programme Developer Details

Website: https://babcp.com/

Cognitive Behavioural Therapy for Eating Disorders (CBT-ED)

Compare

Key overview details

Evidence

Fit

Capacity

Supports

Usability

Need

Programme Summary

Usability - Rating: 5

Supports - Rating: 5

Evidence - Rating: 5

Children and Young People - Rating: 5

Adults - Rating: 5

Adults - bulimia nervosa - Rating: 5

Adults - Binge Eating Disorder - Rating: 5

Adults - anorexia nervosa - Rating: 5

Fit

Capacity

Need

Key References

Programme Developer Details