The Efficacy of Cognitive-Behavioral Therapy for Eating Disorders: A Systematic Review and Meta-Analysis

The Efficacy of Cognitive-Behavioral Therapy for Eating Disorders: A Systematic Review and Meta-Analysis
Journal of Consulting and Clinical Psychology, 2017

Eating disorders, such as anorexia nervosa (AN), binge eating disorder (BED), bulimia nervosa (BN), and other specified feeding and eating disorders (OSFED), affect over 20 million people in the United States. Eating disorders have also been on the rise since the beginning of the COVID-19 pandemic (Steinberg et al., 2023). Although Cognitive Behavioral Therapy (CBT) is widely used in the treatment of eating disorders, comparison effect sizes on treatment type and impact on residual thinking patterns and cognitive symptoms (which are predictive of relapse) have been absent in the literature (Linardon et al., 2017).

A meta-analysis by Linardon et al. (2017) suggests that CBT for binge eating disorders and bulimia nervosa, when compared to pharmacological intervention (antidepressants), yielded similar effect sizes at post treatment. That said, CBT for binge eating disorders showed a longer lasting impact than pharmacotherapy at follow-up. In studies comparing CBT and interpersonal psychotherapy effects on remission rate, CBT was consistently more efficacious than interpersonal psychotherapy in post treatment and had a lasting effect on cognitive symptoms during follow-up as well. 

Studies comparing randomized controlled trials of CBT, interpersonal psychotherapy, and pharmacological intervention at post treatment and follow-up demonstrate that CBT has a lasting and significant effect on behavioral and cognitive eating disorder symptoms (Linardon et al., 2017). Effect sizes were particularly significant in the treatment of binge eating disorder and bulimia nervosa, evidencing the profound effectiveness of CBT in guiding patients to overcome challenging eating disorders.    


Highlights from the Meta-Analysis

“Therapist-led CBT was shown to be more efficacious than active comparisons at reducing behavioral and cognitive symptoms in individuals with BN and BED.”

“Critically, improvements in core behavioral symptoms were sustained at follow-up periods, suggesting that CBT has an enduring effect beyond the end of treatment.”

“...unlike the durable effects of CBT, where improvements seem to be sustained after treatment ends, BED symptoms do not seem to be sustained following the discontinuation of medication…The data suggest that the use of pharmacotherapy alone is not recommended in terms of producing long-term change.”


At Feeling Good Institute, our therapists are highly specialized in CBT methods that reduce harmful residual thinking patterns and cognitive symptoms. This evidence-based approach, as indicated in the research, helps clients sustain their recovery and improve their overall quality of life. 

Research Brief Author: Rose Elia Chahla, MA, APCC

Citation: Linardon, J., Wade, T. D., De la Piedad Garcia, X., & Brennan, L. (2017). The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. Journal of consulting and clinical psychology, 85(11), 1080.

Citation: Steinberg, D., Perry, T., Freestone, D., Bohon, C., Baker, J. H., & Parks, E. (2023). Effectiveness of delivering evidence-based eating disorder treatment via telemedicine for children, adolescents, and youth. Eating Disorders, 31(1), 85-101.

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