Eating disorders are serious mental and physical illnesses that affect a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no recommended treatments for EDNOS.
Enhanced Cognitive Behaviour Therapy (CBT-E) is a cutting edge treatment for all eating disorders, including EDNOS. This treatment has been shown to be efficacious in a randomised control trial (Fairburn et al., 2009) and effective when conducted in a community clinic (Byrne, Fursland, Allen, & Watson, 2011). CBT-E is designed to be structured and time-limited, as well as flexible and individualised. By focussing on the present, not the past, CBT-E targets current factors that maintain the eating disorder, such as strict dieting, binge eating and vomiting. Clients are active participants in their treatment and are required to engage in between-session tasks. Treatment for those with a body mass index ≥ 17.5 lasts 20 sessions while those in the anorexic range receive 40 sessions and may need referral to a higher level of care. The initial phase of CBT-E focuses on teaching clients to self-monitor their behaviours, thoughts and feelings in realtime. Significant others are also seen by the therapist, with the client’s consent. In the latter phase of CBT-E clients identify areas of over-evaluation and its consequences. Clients are urged to find other areas of their life that may have been pushed aside by their eating disorder, and to address bodychecking, food avoidance and “feeling fat”, Interpersonal problems, low self- esteem, and clinically significant perfectionism are all targeted in this stage.
Byrne, S. M., Fursland, A., Allen, K. L., & Watson, H. (2011). The effectiveness of enhanced cognitive behavioural therapy for eating disorders: An open trial. Behaviour Research and Therapy, 49, 219-226.