Cognitive–behavioral therapy for eating disorders in primary care settings: does it work, and does a greater dose make it more effective?
Abstract
OBJECTIVE: This study aimed to determine whether cognitive-behavioral therapy (CBT) for eating disorders can be effective in a routine, primary care clinical setting, and to assess dose response. METHOD: The participants were 47 patients who commenced treatment with a publicly-funded primary care eating disorder service. They attended 7-33 sessions of individual CBT (mean = 17), using an evidence-based approach. Routine measures were collected pre- and post-therapy. RESULTS: Three-quarters of the patients completed treatment. Using intention to treat analysis (multiple imputation), the patients showed substantial improvements in eating attitudes, bulimic behaviors, and depression. However, there was no association between the level of improvement and the length of therapy past the 8th to 12th session. DISCUSSION: The level of effectiveness shown here is comparable to that previously demonstrated by more specialist services in secondary and tertiary care. The nonlinear association between number of sessions and recovery highlights the importance of early change, across the eating disorders.
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Emerging evidence in CBT-based programs for EDs suggests shorter duration programs may be as effective at reducing key ED psychopathology.
“This aligns with emerging evidence in CBT-based programs for EDs that suggest shorter duration programs may be as effective at reducing key ED psychopathology (35).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [35]
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- Authors
- Rose, C., & Waller, G.
- Affiliations
- AWP, First Step Primary Care Eating Disorder Service Bristol United Kingdom
- University of Sheffield (GB)
- Corresponding author
- Waller, Glenn
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2017-09-07
- Volume
- 50
- Issue
- 12
- Pages
- 1350-1355
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- OpenAlex
- W2752956817
- Cited by
- 29
- References
- 18
- Citations by year
- 2025: 4 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 10 · 2019: 2 · 2018: 3 · 2017: 2
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy, eating disorders, primary care, dose-response relationship, treatment duration, bulimic behavior, eating attitudes, depression, treatment effectiveness, early changes
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Female, Humans, Male, Primary Health Care, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
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