What Is CBT-E? The Leading Treatment for Eating Disorders

So what is CBT-E? 

Cognitive Behavioral Therapy (CBT) is a thoroughly researched and proven treatment for many behavioral health conditions.  At Columbus Park, we use a form of CBT, designed specifically for eating disorders: “Enhanced CBT” (CBT-E).  CBT-E is the gold standard treatment for adult bulimia nervosa and binge eating disorder. CBT-E has also shown some success in treating adult anorexia.

CBT-E is a short-term, time limited, individual outpatient therapy

CBT-E is offered in two doses: 20-sessions over 20-weeks is the standard duration of treatment for bulimia and binge eating disorder. Since anorexia treatment requires weight restoration, 40-weeks duration is more typical. In all cases sessions are more frequent for the first month (twice weekly) and then gradually spread out over time.

Stage One: establish regular eating

– Typically 8 sessions over 4 weeks

Stage One of CBT-E focuses first on gaining a solid understanding of the factors that are keeping your eating problem going. Common “maintaining” factors include things like chronic dieting, rigid food rules, weight preoccupation, and negative mood states that impact eating – just to name a few.

With a clear understanding of the factors fueling the problem, we can work toward shaping a regular pattern of flexible eating. This may sound impossible at first, but typically within the first 8 sessions, we see great movement toward regular eating. Your therapist will give you strategies that will help you develop flexibility, manage urges and increase overall control of your food choices.

Stage Two: identify barriers to change

– Typically 2 sessions over 2 weeks

During this brief stage of treatment we review progress to date, identify obstacles or barriers to change and map out a plan for Stage 3. Here is where we get very specific about exactly what is fueling your remaining disordered behaviors or thoughts.

Stage Three: maintaining factors

– Typically 6 sessions over 6 weeks

Here is where we will explore things like over-concern with weight and shape, persistent restrictive or rigid eating styles, and event or mood-related eating behavior. These factors are explored and challenged systematically. In some cases, extreme perfectionism, low self-esteem and/or interpersonal difficulties may be areas that also need further exploration and treatment.

Stage Four: Ending Well

– 4 sessions over 8 weeks

In ending well, we shift to a focus to the future and how to reduce one’s vulnerability to relapse. At this point, you know yourself well and recognize the triggers to ED behaviors. You have developed strategies to ride out difficult times.