Q: What is CBT?
A: CBT stands for Cognitive Behavior Therapy. This is a multidimensional form of treatment that is very effective for treating eating disorders, depression, and obsessive compulsive disorders. It is a brief therapy, usually lasting 20 weeks at the most, with a limited focus on the present issues related to the disorder.
Q: What do you mean by multidimensional?
A: CBT targets several different aspects of a disorder. In the case of eating disorders, CBT focuses on both eating-related behaviors and the thoughts that lead to and perpetuate the disorder.
Q: What exactly would a cognitive behavior therapist recommend?
A: Eating disorders frequently begin with dieting behaviors, including strict, self-imposed rules and restrictions. One of the behavioral goals of CBT is to reduce the restrictions and change rules into guidelines. To change the rules, you might be asked to include in your diet foods that you otherwise think of as “bad” or forbidden. You might also be asked to keep a record of your eating and eating disorder-related behaviors, such as purging. To change your thoughts, you might be asked to keep a log of any negative thoughts such as “I am a loser” and determine if there was a relationship between such thoughts and your eating or restricting behaviors. The therapist might suggest that you begin to challenge these thoughts and their connection to eating behaviors.
Q: How does CBT help to treat eating disorders?
A: By targeting the thoughts and behaviors that initiated and perpetuate the disorder, CBT begins to erode the disorder’s underlying framework. People who participate in CBT typically begin to question the purpose of some of their behaviors and challenge assumptions they have made. As a result, they start to change dysfunctional habits such as severe restriction to punish themselves. They may find that they do not need to binge once they stop following such harsh rules about food.
Q: Does CBT work better or worse than medications alone?
A: Each individual is different and has different preferences about the use of medications. Many people have found that the best treatment is a combination of CBT and medications. However, CBT has been shown in numerous cases to be just as effective as medication. The important thing to remember in making this comparison is that CBT can produce long-lasting results, with few symptoms recurring in the years to come.
Q: Is CBT better than other kinds of therapy?
A: Data from more than 20 research studies have shown that CBT is the most effective form of therapy for eating disorders. (For reviews, see Peterson & Mitchell, 1995; Wilson & Fairburn, 1998.) CBT can be adapted to all forms of eating disorders, including anorexia, bulimia, and binge eating disorder, although its effectiveness varies depending on the severity and type of disorder.
By Claire V. Wiseman, Ph.D.
Reprinted with permission from Eating Disorders Recovery Today
Spring 2004 Volume 2, Number 3
©2004 Gürze Books
About the Author
Claire Wiseman, Ph.D. is an assistant professor of psychology at Trinity College and an assistant clinical professor of psychiatry at the Yale School of Medicine.
Dr. Gnap website editor eatingdisordersrecoverytoday.com. Dr. Gnap is a family practice physician and behavioral medicine specialist in suburban Chicago. Dr. Gnap developed the Inner Control™ Program in 1970 and has worked with thousands of people to improve and correct medical, emotional, behavioral and learning problems including performance.