Evidence-Based Eating Disorder Treatment

Thanks to a number of interlocking social, emotional, and biological factors that maintain and sustain them, eating disorders are often one of the most complex types of mental health conditions to diagnose and properly treat.

Still, over the years, there have been several schools of therapy and other treatment techniques developed to help people effectively manage their eating disorder symptoms.

Among these methods, several have been put through the paces of scientific testing, yielding promising results for anyone looking for help with their disordered eating behavior.

Cognitive Behavioral Therapy

As one of the most widely tested—and widely effective—types of psychotherapy, cognitive behavioral therapy (CBT) is often considered the gold standard in psychological treatment, including for the treatment of eating disorders. [1]

Capable of helping patients with a wide array of issues, CBT focuses on the recognition of distorted thinking, and how it leads to unhelpful behaviors. Patients are taught to identify these cycles, and given strategies for disrupting, redirecting, and, eventually, stopping these unhelpful thoughts. 

Enhanced Cognitive Behavioral Therapy (eCBT)

There are many versions of cognitive behavior therapy, including enhanced cognitive behavioral therapy (eCBT), which also helps bring patients’ attention to the behaviors and motivations of others.

eCBT can be especially helpful for those with bulimia or binge eating disorder.

By developing a better understanding of both themselves and those around them, eCBT can help a person become better at coping with difficult thoughts and feelings and develop a greater sense of confidence and self-worth.

The method is most notably connected to treatment for bulimia nervosa (BN) and binge eating disorder (BED). [2] But CBT, or different versions of it, is one of the most widely-recommended types of therapy for eating disorder treatment in general.

Interpersonal Psychotherapy

Interpersonal psychotherapy (IPT) is another evidence-based treatment frequently used to help people with bulimia nervosa and binge eating disorder. IPT focuses on relieving symptoms by improving interpersonal functioning, or the actions, events, and feelings that occur between two or more people. [3]

Rather than look to the past to root out potential issues, like other types of evidence-based treatments, IPT focuses on the relationships and complications a person is having in the present. There is a heavy emphasis on identifying ongoing conflicts that may be causing stress or difficulties, particularly when it comes to starting or maintaining relationships. 

Interpersonal psychotherapy generally lasts about 3-4 months.

This type of therapy tends to be more short-term than other programs, generally lasting between three to four months.

It is also broken up into distinct phases, with the focus shifting from learning more about the patient (and helping them learn about themselves) to focusing on improving their identified problem areas.

As it winds down, a course of IPT will shift away from more active therapy and focus on strategies for maintaining progress and using what was learned to keep making improvements in the long term.

Family-Based Therapy 

Family-based therapy (FBT), also called family-based treatment, is a popular method for treating eating disorders, particularly in adolescent-focused therapy.

This type of talk therapy involves as many members of someone’s immediate family as possible, and the group attends sessions together, where they’re taught about group dynamics and how it may impact an eating disorder.

For this treatment to be most effective, there are generally five central expectations that should be met: [4]

  1. The therapist makes no claims about what, or who, may have brought on the illness.
  2. The therapist is considered an expert consultant on the disorder, while parents are considered expert consultants on their child.
  3. Parents are enabled to help their child recover.
  4. The eating disorder is externalized, or, in other words, thought of as a separate entity from the patient.
  5. The approach to treatment is kept pragmatic, or as unemotional as possible.

This type of therapy is also typically broken up into phases.

In the early phases, parents are held responsible for much of a child’s eating-related decisions. But as treatment continues, more independence and autonomy is progressively given back to the child.


While medication isn’t used to “cure” eating disorders, it’s frequently used as a treatment for eating disorders like anorexia nervosa and bulimia nervosa.

Certain medications can help someone more effectively manage the symptoms of their eating disorder, maintain progress, or treat co-occurring mental health complications that contribute to their condition.

Of the medications used specifically to help with eating disorders, fluoxetine has been shown to reduce episodes of binge eating and vomiting for patients with BN. And topiramate is another medical treatment that has been effective for people with binge eating disorders. [5]

There is less evidence for medications that may help with anorexia nervosa, although antidepressants have been linked to helping maintain weight gain in patients who have already been successfully treated. [5]

Eating disorder recovery

Quality of Life, Retention, & Recovery

One of the most difficult aspects of treating an eating disorder is ensuring someone is prepared for the type of long-term, in-depth treatment they’ll most likely require. If a patient doesn’t feel ready to commit to recovery, they may be at risk of dropping out of a care program. 

Sometimes, the most helpful tactic isn’t focusing on long-term, sustainable recovery at first, but rather working to improve someone’s quality of life. This will hopefully help a patient feel mentally and physically better and can help them see that real results are possible, which may make them more open to long-term treatment.

In severe cases, a medical professional may even start by helping a patient utilize safer methods to express their eating disorder symptoms, rather than risk them dropping out of treatment.

For these types of patients, there is some evidence that cognitive remediation therapy (CRT) may be helpful.

Cognitive Remediation Therapy 

Cognitive remediation therapy is a therapeutic method that uses a series of mental activities, such as brain teasers, puzzles, and other mental exercises, to help a patient expand various aspects of their perspective.

These activities are designed to target and help develop a number of traits, including: [6]

  • Attention
  • Creativity
  • Introspection
  • Intuition and insight
  • Learning and memory
  • Planning
  • Problem-solving
  • Reasoning and judgment
  • Self-consciousness
  • Spontaneous thoughts
  • Understanding and representation

This type of evidence-based treatment is particularly known for its ability to improve cognitive impairment in patients with mental health disorders. This includes the rigid thinking that often upholds unhelpful behaviors.

Developing these cognitive abilities can also be useful for people who are otherwise unable or unwilling to try more intensive treatment. Actively building on traits like introspection, judgment, and self-consciousness can improve someone’s quality of life, and may help them see the benefit of longer-term treatment.

The Future of Eating Disorder Treatment

There are still many unknowns when it comes to eating disorder treatments.

Finding the ideal treatment method for anorexia nervosa has proven particularly difficult. While AN is most certainly treatable, no one method has been consistently reliable, with care teams instead trying multiple different approaches to find what works best for an individual patient.


Research into pharmacological (medication-based) treatments is also continuing to evolve. Very few drugs are currently approved specifically for eating disorder treatment, though it’s likely that more helpful medications will be named in the future, and treatments involving those that are already approved will continue to be refined.

Still, modern medicine can and does treat eating disorders every day. As is so often true, the future is likely to hold significant improvements in the way treatment is approached.

As we gain more insights into how the mixture of biology, genealogy, social environments, and mental and physical factors contribute to different eating disorders, we’ll hopefully continue to see noteworthy advancements in this field.

Finding the Best Eating Disorder Treatment for You

If you or a loved one are struggling with an eating disorder, it’s important to seek out help.

There are a number of treatments available, but figuring out which course or program would work best for you can feel overwhelming. You may want to start by reaching out to your physician or mental health therapist. These trained medical professionals will have relevant advice, experience, and recommendations on the best places to look for help.

A number of eating disorder hotlines can also assist you in finding resources and nearby treatment centers. And you can also contact a representative from your insurance company, for help looking in the right direction.

The most important step in the process is the first one. It may feel overwhelming to reckon with something of this magnitude, but seeking out treatment can help set you on the path to sustaining recovery.


  1. What is Cognitive Behavioral Therapy? (2017, July). American Psychological Association. Retrieved December 2, 2022. 
  2. Kass, A. E., Kolko, R. P., & Wilfley, D. E. (2013). Psychological treatments for eating disorders. Current opinion in psychiatry; 26(6):549–555.
  3. Interpersonal Psychotherapy (IPT)​. CAMH. Retrieved December 2, 2022.
  4. Rienecke, R.D., Le Grange, D. (2022). The five tenets of family-based treatment for adolescent eating disorders. Journal of Eating Disorders; 10(60). 
  5. Gorla, K., & Mathews, M. (2005). Pharmacological treatment of eating disorders. Psychiatry (Edgmont); 2(6):43–48.
  6. Fan, Q., Liao, L., & Pan, G. (2017). The Application of Cognitive Remediation Therapy in The Treatment of Mental Disorders. Shanghai archives of psychiatry; 29(6):373–375.

Last Update | 02 - 16 - 2023

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