Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base

Kaidesoja, Milla; Cooper, Zafra; Fordham, Beth

doi:10.1002/eat.23831

Cited by 17 publications

(8 citation statements)

References 64 publications

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“…Additionally, we had low response rates for our 1-month, 6-month, and 1-year follow-ups for ED symptom severity. However, we chose to present these data because the results were on our primary outcome, (a) the results were extremely promising and (b) due to the fact that many ED trials often do not include any follow-up data even if it exists and it has been recommended to include follow-up data if possible (Kaidesoja et al, 2022). However, in particular, our data on longer term outcomes should be interpreted with caution, given the high amount of missing data, specifically at 1-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Personalizing eating disorder treatment using idiographic models: An open series trial.

Levinson

Williams

Christian

et al. 2023

Journal of Consulting and Clinical Psychology

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Objective: Treatments for adults with eating disorders (EDs) only work in about 50% of individuals, and for some diagnoses (e.g., anorexia nervosa; atypical anorexia nervosa), there are no existing evidence-based treatments. Part of the reason that treatments may only work in a subset of individuals is because of the high heterogeneity present in the EDs, even within diagnoses. Manualized treatments delivered in a standard format may not always address the most relevant symptoms for a specific individual. Method: The current open series trial recruited participants with transdiagnostic ED diagnoses (N = 79) to investigate the feasibility, acceptability, and initial clinical efficacy of a 10-session network-informed personalized treatment for eating disorders. This treatment uses idiographic (i.e., one-person) network models of ecological momentary assessment symptom data to match participants to evidence-based modules of treatment. Results: We found that network-informed personalized treatment was highly feasible with low dropout rates, was rated as highly acceptable, and had strong initial clinical efficacy. ED severity decreased from pre- to posttreatment and at 1-year follow-up with a large effect size. ED cognitions, behaviors, clinical impairment, worry, and depression also decreased from pre- to posttreatment. Conclusions: These data suggest that network-informed personalized treatment has high acceptability and feasibility and can decrease ED and related pathology, possibly serving as a feasible alternative to existing treatments. Future randomized controlled trials comparing network-informed personalized treatment for ED to existing gold standard treatments are needed. Additionally, more research is needed on this type of personalized treatment both in the EDs, as well as in additional forms of psychopathology, such as depression.

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Section: Discussionmentioning

confidence: 99%

Personalizing eating disorder treatment using idiographic models: An open series trial.

Levinson

Williams

Christian

et al. 2023

Journal of Consulting and Clinical Psychology

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“…4,8,9 Without intervention, BED progresses to a chronic condition 10 and may lead to premature death. 8,9,11 While cognitive behavioral therapy (CBT) has demonstrated its effectiveness as an evidencebased BED intervention, 12,13 treatment rates for this disorder are reduced compared with other psychiatric conditions, including anorexia nervosa and bulimia nervosa. [14][15][16] Various barriers prevent individuals from seeking face-to-face psychotherapy, including limited access, clinician unawareness, sociocultural stigma, and treatment costs.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Web-Based Cognitive Behavioral Self-Help Intervention for Binge Eating Disorder

Pruessner,

Timm,

Barnow

et al. 2024

JAMA Netw Open

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ImportanceBinge eating disorder (BED) is one of the most frequent eating pathologies and imposes substantial emotional and physical distress, yet insufficient health care resources limit access to specialized treatment. Web-based self-help interventions emerge as a promising solution, offering more accessible care.ObjectiveTo examine the effectiveness of a web-based cognitive behavioral self-help intervention for individuals with BED.Design, Setting, and ParticipantsThis 2-arm, parallel-group randomized clinical trial conducted from January 15, 2021, to August 3, 2022, in Germany and other German-speaking countries enrolled patients aged 18 to 65 years who met the diagnostic criteria for BED (according to the Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]). Data analysis occurred between January 27 and September 4, 2023, following our statistical analysis plan.InterventionsParticipants were randomized to a web-based self-help intervention or a waiting-list control condition.Main Outcomes and MeasuresThe primary outcome was a change in objective binge eating episodes from baseline to after treatment. Secondary outcomes included global eating pathology, clinical impairment, work capacity, well-being, comorbid psychopathology, self-esteem, and emotion regulation.ResultsA total of 1602 patients were screened, of whom 154 (mean [SD] age, 35.93 [10.59] years; 148 female [96.10%]) fulfilled the criteria for BED and were randomized (77 each to the intervention and control groups). The web-based intervention led to significant improvements in binge eating episodes (Cohen d, −0.79 [95% CI, −1.17 to −0.42]; P &lt; .001), global eating psychopathology (Cohen d, −0.71 [95% CI, −1.07 to −0.35]; P &lt; .001), weekly binge eating (Cohen d, −0.49 [95% CI, −0.74 to −0.24]; P &lt; .001), clinical impairment (Cohen d, −0.75 [95% CI, −1.13 to −0.37]; P &lt; .001), well-being (Cohen d, 0.38 [95% CI, 0.01 to 0.75]; P = .047), depression (Cohen d, −0.49 [95% CI, −0.86 to −0.12]; P = .01), anxiety (Cohen d, −0.37 [95% CI, −0.67 to −0.07]; P = .02), self-esteem (Cohen d, 0.36 [95% CI, 0.13 to 0.59]; P = .003), and emotion regulation (difficulties: Cohen d, −0.36 [95% CI, −0.65 to −0.07]; P = .01 and repertoire: Cohen d, 0.52 [95% CI, 0.19 to 0.84]; P = .003).Conclusion and RelevanceIn this randomized clinical trial of a web-based self-help intervention for patients with BED, the findings confirmed its effectiveness in reducing binge eating episodes and improving various mental health outcomes, highlighting a scalable solution to bridge the treatment gap for this condition.Trial RegistrationClinicalTrials.gov Identifier: NCT04876183

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“…Eating disorders (EDs) are chronic and debilitating disorders with high relapse rates and low rates of full recovery (Keel & Brown, 2010; Strober et al, 1997). At present, no empirically supported treatments exist for adults with anorexia nervosa (AN) or other specified feeding and eating disorders (OSFED), and the empirically supported treatment for bulimia nervosa (BN) and binge eating disorder (BED), cognitive behavioral therapy for EDs (CBT‐E), only has a 50% success rate (Kaidesoja et al, 2022; Keel & Mitchell, 1997; Steinhausen, 2009; Steinhausen & Weber, 2009). This low response rate may be due to the heterogeneity of these disorders, even within the same diagnosis (Levinson et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

A pilot randomized controlled trial of transdiagnostic network‐informed personalized treatment for eating disorders versus enhanced cognitive behavioral therapy

Butler,

Ortiz,

Pennesi

et al. 2023

Intl J Eating Disorders

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ObjectiveEating disorders (EDs) are serious mental illnesses with high mortality and relapse rates and carry significant societal and personal costs. Nevertheless, there are few evidence‐based treatments available. One aspect that makes treatment difficult is the high heterogeneity in symptom presentation. This heterogeneity makes it challenging for clinicians to identify pertinent treatment targets. Personalized treatment based on idiographic models may be well‐suited to address this heterogeneity, and, in turn, presumably improve treatment outcomes.MethodsIn the current randomized controlled trial, participants will be randomly assigned to either 20 sessions of enhanced cognitive behavioral therapy (CBT‐E) or transdiagnostic network‐informed personalized treatment for EDs (T‐NIPT‐ED). Assessment of ED symptoms, clinical impairment, and quality of life will occur at pre‐, mid‐, posttreatment, and 1‐month follow‐up.ResultsWe will examine the acceptability and feasibility of T‐NIPT‐ED compared to CBT‐E. We also will test the initial clinical efficacy of T‐NIPT‐ED versus CBT‐E on clinical outcomes (i.e., ED symptoms and quality of life). Finally, we will test if the network‐identified precision targets are the mechanisms of change.DiscussionUltimately, this research may inform the development and dissemination of evidence‐based personalized treatments for EDs and serve as an exemplar for personalized treatment development across the broader field of psychiatry.Public SignificanceCurrent evidence‐based treatments for eating disorders result in low rates of recovery, especially for adults with AN. Our study aims to test the feasibility, acceptability, and clinical efficacy of a data‐driven, individualized approach to ED treatment, network‐informed personalized treatment, compared to the current evidence‐based treatment for EDs, Enhanced CBT. Findings have the potential to improve treatment outcomes for EDs by identifying and targeting core symptoms maintaining EDs.

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Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base

Cited by 17 publications

References 64 publications

Personalizing eating disorder treatment using idiographic models: An open series trial.

Personalizing eating disorder treatment using idiographic models: An open series trial.

Effectiveness of a Web-Based Cognitive Behavioral Self-Help Intervention for Binge Eating Disorder

A pilot randomized controlled trial of transdiagnostic network‐informed personalized treatment for eating disorders versus enhanced cognitive behavioral therapy

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