Therapy is central to the treatment of eating disorders, as it focuses on the behavioral, psychological, and social factors that contribute to these conditions. The type of therapy used depends on the type of disorder and individual preferences.

An eating disorder is a mental health condition that causes disturbances to your diet and the way you view food.

There are several types of eating disorders, including:

People who have an eating disorder may eat too much or too little food or become preoccupied with their body shape or weight. Without treatment, an eating disorder may become serious and potentially life threatening.

However, recovery from an eating disorder is possible with treatment. This often involves a team of health professionals who work together to help you on your way to recovery.

Therapy will be one part of your treatment plan.

This article explores the different types of therapy for eating disorders, how effective they are, and how you can seek help for yourself or a loved one.

Various types of therapy can be used in the treatment of eating disorders, including:

  • cognitive behavioral therapy (CBT) and enhanced cognitive behavioral therapy (CBT-E)
  • interpersonal psychotherapy (IPT)
  • family-based treatment (FBT)
  • dialectical behavior therapy (DBT)
  • acceptance and commitment therapy (ACT)
  • cognitive remediation therapy (CRT)
  • psychodynamic psychotherapy

The following sections explore each type of therapy in more detail.

CBT and CBT-E

CBT aims to identify the thought patterns and beliefs that contribute to your eating disorder.

These could be thoughts or beliefs associated with:

  • food
  • weight
  • body shape
  • appearance

Once you’ve identified these thoughts and beliefs, you’ll learn strategies to modify them and help manage them.

CBT is used for a variety of mental health conditions, and people who take part in CBT for eating disorders experience improvements in related symptoms such as depression and anxiety.

CBT-E is a type of CBT that’s intended for use in all types of eating disorders.

IPT

IPT is used to treat eating disorders such as binge eating disorder and bulimia. In IPT, you explore your eating disorder in the context of social and interpersonal relationships.

Four “problem areas” are used in IPT:

  • Interpersonal deficits: These often include feelings of isolation or a lack of close, fulfilling relationships. The relationships in question don’t have to be romantic — they can be your relationships with friends or family.
  • Role disputes: These disputes may involve a difference in expectations between you and one or more important people in your life, such as parents, friends, or employers.
  • Role transitions: These transitions may involve big life changes, such as being on your own for the first time, starting a new job, or being in a new relationship.
  • Grief: This can include feelings of loss due to the death of a loved one or the end of a relationship.

Your doctor will work with you to explore how issues in each of these problem areas contribute to your eating disorder. They’ll then help you develop strategies to improve your communication and interpersonal skills to help reduce your symptoms.

FBT

You may also see this type of therapy referred to as the Maudsley Method. It’s often used for children or adolescents who have an eating disorder.

In FBT, your family members are vital parts of your recovery process. They’re involved in helping you with goals such as:

  • maintaining healthy eating patterns
  • restoring and maintaining your weight at a level your doctor recommends
  • interrupting unhealthy behaviors such as binge eating or purging

DBT

DBT focuses on managing difficult emotions. You’ll learn skills to change the behaviors associated with your eating disorder.

DBT aims to build skills such as:

  • interpersonal skills
  • emotional expression
  • flexibility and openness
  • coping with feelings of distress
  • mindfulness

This form of therapy has been studied in the treatment of binge eating disorder, anorexia nervosa, and bulimia nervosa.

ACT

ACT asks you to focus on changing your actions rather than your thoughts or feelings.

One principle of ACT is that the behaviors associated with mental health conditions come from responses to unpleasant feelings such as anxiety and pain.

Your therapist will ask you to examine what your core values are and then to develop goals that help you better satisfy these values.

The aim is to accept all feelings — including the unpleasant ones — and to commit to changing your actions so they better align with your core values. It’s believed that by doing so, you can lead a better life and begin to feel better.

ACT is a viable treatment for eating disorders, but more research is needed to see whether it’s effective as a stand-alone therapy.

CRT

CRT focuses on promoting big-picture thinking and mental flexibility. It’s currently used in the treatment of anorexia nervosa.

In CRT, you’ll use a variety of exercises and tasks to help address the rigid thinking patterns that are often associated with anorexia nervosa. Examples of these tasks include:

  • drawing shapes or performing motions with your dominant and nondominant hand
  • repeatedly switching your attention between two topics
  • reading and summarizing increasingly difficult passages
  • finding different ways to navigate a map
  • coming up with alternative ways to use everyday objects

Psychodynamic psychotherapy

The overall goal of psychodynamic psychotherapy is to help you understand the underlying cause of your eating disorder. This involves diving deep into things such as your internal conflicts and motives.

Practitioners of this type of therapy believe that your symptoms are the result of unresolved wants and needs and, therefore, that understanding the root cause of your disorder can address your symptoms and reduce your risk of relapse.

The types of therapy that are the most effective in treating eating disorders depend on the individual, the type of eating disorder they have, and other personal factors.

  • CBT (and particularly CBT-E) is generally considered the gold standard for treating bulimia nervosa, anorexia nervosa, and binge eating disorder in adults.
  • FBT is often considered the most effective method for adolescents with anorexia nervosa.
  • DBT can be helpful for people with more significant emotional regulation difficulties or co-occurring mental health conditions (such as borderline personality disorder).

Research on the effectiveness of therapies for eating disorders

Researchers continue to investigate the effectiveness of therapies for eating disorders. Below is a snapshot of some of the results:

  • ACT: A 2020 study assessed 99 women with residual eating disorder symptoms and body image problems. At a 2-year follow-up, women who had received 12 sessions of ACT had fewer symptoms than those who had not received ACT.
  • CRT: A 2018 study looked at the use of CRT for 145 women with anorexia nervosa in an inpatient program. The results suggested that CRT may be beneficial as a supplemental treatment for anorexia nervosa, but further research is needed.
  • Psychodynamic psychotherapy: The authors of a 2016 paper reviewed 47 studies on psychodynamic psychotherapy for treating eating disorders. They noted that while studies are scarce, the available data supports the use of this therapy for eating disorders, particularly anorexia. But they stated that more studies are needed to test its effectiveness.
  • Shared decision making: The authors of a 2020 review noted that involving people and their families more actively in the decision making process around treatment options enhanced their motivation and improved outcomes.

Recovery versus cure

As we discuss the effectiveness of these therapies, it’s important to be cautious about using the word “cure” in the context of eating disorders. A more accurate term to use is “recovery.”

Therapy for eating disorders aims to equip you with skills and strategies you can use in your everyday life to address your condition. In this way, you can reach recovery, which means you experience few to no symptoms.

It is possible for someone who has recovered from an eating disorder to relapse. This is not uncommon with many eating disorders.

You can help manage a relapse by:

  • acknowledging that the relapse occurred and that this is normal with eating disorders
  • notifying your care team and support network of what you’re experiencing
  • being kind to yourself — you have not failed
  • identifying actionable steps in your treatment plan to help resume your recovery

A note about hope

If you believe that you or a loved one has an eating disorder, it’s important to remember that help is always available. Recovery from an eating disorder is possible by seeking treatment.

There are numerous resources available to help you find treatment. In the sections below, we’ll discuss where to find help and how to talk with a doctor.

You can use the resources below to find help that’s available in your area.

Your primary care doctor

Your primary care doctor can be an important first resource for getting help with an eating disorder. They can evaluate your symptoms and eating patterns and, if necessary, refer you to a treatment specialist in your area.

National Eating Disorders Association (NEDA)

NEDA is a nonprofit organization that works to support people who have eating disorders. NEDA’s website contains a wealth of information about eating disorders, treatment, and support.

Additional resources from NEDA that you may find helpful include:

  • Screening tool: This online tool may help you decide whether to seek treatment.
  • Treatment locator: This map tool can help you find treatment options close to you.

National Association of Anorexia Nervosa and Associated Disorders (ANAD)

ANAD is a nonprofit organization that aims to help people with eating disorders get care and support.

ANAD offers several resources, such as:

  • Treatment directory: The ANAD treatment directory can help you find treatment options in your area.
  • Helpline: The ANAD helpline (1-888-375-7767) provides information, offers support, and gives treatment referrals. It’s available Monday through Friday from 9 a.m. to 9 p.m. Central time. You can leave a message after hours.
  • Support groups: There are several virtual support groups that meet on a regular basis.

National Alliance on Mental Illness (NAMI)

NAMI aims to offer education, support, and public awareness of mental health issues.

Here are some NAMI resources you may find useful:

  • Helpline: The NAMI helpline (1-800-950-6264) provides information, support, and treatment referrals to those with mental health conditions. It’s available Monday through Friday from 10 a.m. to 10 p.m. Eastern time.
  • Support groups: NAMI offers support groups throughout the country for people with mental health conditions and their families.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA is a government agency that addresses mental health and substance use concerns throughout the country. SAMHSA’s website has a treatment locator that you can use to find a treatment facility in your area.

Additionally, the SAMHSA National Helpline (1-800-662-4357) is available 24 hours per day, 365 days per year. You can call this number to receive a referral for a treatment facility near you. All information is kept confidential.

Getting help for an eating disorder may seem challenging or scary at first. These feelings are normal — discussing concerns about your body or your mental health can require you to be more vulnerable than you’re used to.

But remember: Seeking help is a big first step on your recovery journey.

If you think you may have an eating disorder, make an appointment with a doctor to discuss your concerns. You can choose to see a primary care doctor or a mental health professional.

Try to be as open as possible with your doctor about your thought patterns, eating habits, and concerns. Also, don’t hesitate to ask questions if you have them.

If you’re nervous, it may be helpful to bring a family member or friend along with you for support.

If you’re concerned about a loved one

A friend or family member who has an eating disorder may not believe they need to seek treatment. They may also be defensive about topics like their diet and weight.

If you’re worried that someone close to you has an eating disorder, speak with them openly and compassionately about your concerns.

Encourage them to seek treatment. If they’re scared or unsure, offering to go with them may be helpful.

Treating an eating disorder often involves some form of therapy. The specific therapy method that’s used can depend on the eating disorder you have and which approach may be most effective for you.

Overall, therapy helps you learn strategies for changing the thought patterns or behaviors associated with your eating disorder. By using these in your daily life, you can recover.

If you have an eating disorder, it’s always important to know that help is available and that there are many resources you can use to find help.

Remember that seeking care is an important first step in your recovery journey.