Effects of cognitive-behavioral and psychodynamic-interpersonal treatments for eating disorders: a meta-analytic inquiry into the role of patient characteristics and change in eating disorder-specific and general psychopathology in remission

Abstract

Plain English summary To help people with eating disorders (EDs) recover it is important to know what makes therapies effective or not. Therefore, we summarized the effects of two common therapies for eating disorders, cognitive behavior therapy (CBT) and psychodynamic-interpersonal therapy (PIT) and examined how ED diagnosis, comorbid personality disorder and changes in psychopathology could influence ED remission. We found that CBT was most consistently effective, with about 1/3 of patients in remission for anorexia, bulimia, and mixed samples, and 50% for patients with binge eating disorder. The effects of PIT were uncertain due to a lack of studies and could be only marginally effective. In CBT, changing the patients’ eating disordered thoughts or their depression or anxiety was not associated with ED remission. We discuss why this may be and suggest that CBT may be more effective because it manages to engage a subgroup of patients who are motivated to change and less depressed or anxious. Thus, patients with more severe symptoms may benefit less. We conclude that CBT may be necessary to help people recover from eating disorders, but that some patients may still require interventions aimed at strengthening self-functions to substitute eating disordered behavior in the long-term.

Keywords

• Eating disorders
• Cognitive-behavioral therapy
• Psychodynamic therapy
• Interpersonal therapy
• Treatment effect
• Psychopathology