Cognitive behavioral therapy for anorexia nervosa

Cognitive behavioral therapy (CBT) represents one of the most influential theories and therapies in the treatment of eating disorders. Over the course of the past twenty-five years, several adaptations of CBT for bulimia nervosa (BN), anorexia nervosa (AN), and binge eating disorder (BED) have been developed and evaluated. The empirical foundation for CBT in the treatment of eating disorders is especially strong for BN. In the case of AN, limited data indicate that CBT has the potential to be an effective psychotherapy, with evidence supporting its clinical utility and superiority over other treatments in relapse prevention for adults with weight-restored AN. In the case of individuals with low-weight AN, and individuals with severe and enduring AN, CBT is effective but largely not distinct from the other therapies to which it has been compared. Moreover, attrition presents a significant problem at all stages of care. This chapter provides an overview of the empirical research, core theoretical principles, and a discussion of the essential features of CBT for AN in clinical practice. In an effort to advance an evidence-based practice that will be more helpful to those whose lives are burdened with AN, we need to continue to close the knowledge gaps and develop more efficacious treatments.