Enhanced cognitive behavioral therapy (CBT-E) is CBT to treat eating disorders.
- A form of CBT called enhanced cognitive behavioral therapy (CBT-E) is an adaptation of CBT designed to treat eating disorders.
- CBT-E moves through four distinct stages of treatment over the course of 20 to 40 weeks via regular outpatient therapy sessions.
- Enhanced CBT is different from CBT. It’s important to ask providers about their training and ensure their training is in CBT-E.
Cognitive behavioral therapy (CBT) is a popular therapy modality with adaptations to treat a wide range of mental health conditions, including depression, anxiety, OCD, and more. Broadly, CBT focuses on identifying patterns of thoughts, emotions, and/or behaviors that negatively influence our lives. A form of CBT called enhanced cognitive behavioral therapy (“CBT-E”) is an adaptation of CBT designed to treat eating disorders.
An Overview of Enhanced Cognitive Behavioral Therapy
CBT-E is considered the first-line, evidence-based treatment for people with eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED). Even though these conditions present different problematic behaviors, they share many of the same foundational features at their core. For example, people with AN, BN, and BED often experience extreme concern with weight and shape and/or difficulty coping with negative emotions.
These factors–“overvaluation” of shape and weight and mood intolerance–are common triggers to problematic eating behaviors like food restriction, binge eating, or purging.
While CBT-E is a manualized and structured treatment, it’s intended to fit the client “like a glove” with a focus on creating a personalized “formulation” or map of the client’s eating disorder and a customized plan for addressing their unique patterns and challenges.
The Four Stages of CBT-E
CBT-E moves through four distinct stages of treatment over the course of 20 to 40 weeks via regular outpatient therapy sessions. The longer treatment length is generally for those who need to restore weight (as with anorexia nervosa). CBT-E highlights the importance of “starting well” and building momentum at the start, so sessions are generally twice weekly for the first four to eight weeks, then once weekly for roughly eight weeks, and bi-weekly thereafter.