Cognitive Behaviour Therapy for Bulimia Nervosa and Eating Disorders Not Otherwise Specified: Translation from Randomized Controlled Trial to a Clinical Setting
Open accessAbstract
Background Enhanced Cognitive Behaviour Therapy (CBT-E) (Fairburn, Cooper and Shafran, 2003) was developed as a treatment approach for eating disorders focusing on both core psychopathology and additional maintenance mechanisms. Aims To evaluate treatment outcomes associated with CBT-E in a NHS Eating Disorders Service for adults with bulimia and atypical eating disorders and to make comparisons with a previously published randomized controlled trial (Fairburn et al., 2009) and "real world" evaluation (Byrne, Fursland, Allen and Watson, 2011). Method Participants were referred to the eating disorder service between 2002 and 2011. They were aged between 18-65 years, registered with a General Practitioner within the catchment area, and had experienced symptoms fulfilling criteria for BN or EDNOS for a minimum of 6 months. Results CBT-E was commenced by 272 patients, with 135 completing treatment. Overall, treatment was associated with significant improvements in eating disorder and associated psychopathology, for both treatment completers and the intention to treat sample. Conclusions Findings support dissemination of CBT-E in this context, with significant improvements in eating disorder psychopathology. Improvements to global EDE-Q scores were higher for treatment completers and lower for the intention to treat sample, compared to previous studies (Fairburn et al., 2009; Byrne et al., 2011). Level of attrition was found at 40.8% and non-completion of treatment was associated…
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Effectiveness studies serve a more heterogeneous patient population than RCTs.
“For instance, compared to RCTs, effectiveness studies tend to include more patients with comorbid disorders (Leichsenring, 2004), and therefore, serve a more heterogeneous patient population (Knott et al., 2015; Waller et al., 2014).”
From Effectiveness of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder: An implementation study (2024) · cites this paper as Knott et al., 2015
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- Authors
- Knott, S., Woodward, D., Hoefkens, A., & Limbert, C.
- Affiliations
- Cardiff Metropolitan University (GB)
- Cardiff and Vale University Health Board (GB)
- Corresponding author
- Limbert, Caroline
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-10-21
- Volume
- 43
- Issue
- 6
- Pages
- 641-654
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2163850218
- Cited by
- 57
- References
- 22
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 6 · 2022: 1 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 18 · 2017: 8 · 2016: 2 · 2015: 6
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Cardiff Metropolitan Research Repository (Cardiff Metropolitan University) (submittedVersion)
- Worcester Research and Publications (University of Worcester) (submittedVersion)
- 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
- bulimia nervosa, eating disorder not otherwise specified, treatment outcomes, real-world evaluation, treatment discontinuation, anxiety, Eating Disorder Examination Questionnaire, dissemination of psychotherapy
- MeSH terms
- Adolescent, Adult, Aged, Feeding and Eating Disorders, Female, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Bulimia Nervosa, Young Adult
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