Cognitive-Behavior Therapy with Eating Disorders: The Role of Medications in Treatment

By Bowers, Wayne A.; Andersen, Arnold E. | Journal of Cognitive Psychotherapy, April 1, 2007 | Go to article overview

Cognitive-Behavior Therapy with Eating Disorders: The Role of Medications in Treatment


Bowers, Wayne A., Andersen, Arnold E., Journal of Cognitive Psychotherapy


Cognitive-behavioral therapy has demonstrated efficacy in the treatment of bulimia nervosa, but there is less empirical data on its usefulness with anorexia nervosa or binge-eating disorder. The use of cognitive-behavioral therapy (CBT) is recommended as the first line of treatment for bulimia nervosa and strongly recommended in combination when medications alone have not been effective. Combined treatment also improves symptoms such as anxiety, depression, and dietary restriction. Empirical studies support the usefulness of CBT with binge-eating disorder and suggest higher remission rates with combined treatment. No single psychotherapy or medicine alone is effective in treating anorexia nervosa. CBT is typically used as part of a comprehensive treatment program with nutritional rehabilitation and prudent use of medication. Both CBT and medication may have benefits in maintaining gains for anorexia nervosa patients after inpatient treatment. More research on CBT alone and in combination with medication is needed to adequately understand the respective roles of these therapies in a comprehensive treatment of eating disorders.

Keywords: cognitive therapy; eating disorders; medications; combined treatment

Cognitive-behavioral therapy (CBT) has become one of the most prominent treatment models in mental health (Wonderlich, Mitchell, Swan-Kremier, Peterson, & Crow, 2004). Initially designed as an outpatient treatment, CBT has been adapted and used in a wide range of settings including crisis intervention, day treatment, partial hospital programs, and inpatient units (Bowers, Andersen, & Evans, 2004). CBT has been recommended as a primary approach in the treatment of eating disorders (American Psychiatric Association, 2000) and been called the "gold standard" in the treatment of bulimia nervosa (Mitchell, Peterson, Myers, & Wonderlich, 2001).

Like many psychiatric disorders, eating disorders have been treated using medications, psychotherapy, and at times a combination of medications and psychotherapy. Unlike other disorders, there is less uniformity and understanding of the role of medications when treating eating disorders, especially anorexia nervosa (Steinglass & Walsh, 2004). Crow and Brown (2003) suggest that a number of medications (primarily antidepressants) are of some benefit in the treatment of eating disorders but that there is considerable room for improvement. Peterson and Mitchell (1999) identify positive findings in the treatment of bulimia nervosa and binge- eating disorder with the use of antidepressant medications. Preliminary studies suggest that the use of fluoxetine and psychotherapy may be helpful in preventing relapse for individuals with anorexia nervosa after their weight has returned to normal (Kaye, Nataga, et al., 2001). Additionally, Brewerton (2004) has indicated that recent advances in the understanding of the neurobiological aspects of eating disorders offer encouraging possibilities for the use of atypical antipsychotics in the treatment of anorexia nervosa (Mitchell, de Zwaan, & Roerig, 2003).

BULIMIA NERVOSA

Among eating disorders, bulimia nervosa has the most empirical research regarding treatment outcome (Brewerton, 2004). A wide range of medicines has been studied in the treatment of bulimia nervosa with encouraging results (Steinglass & Walsh, 2004). The most widely explored medicines are the antidepressants (tricyclics, monoamine oxidase inhibitors, serotonin reuptake inhibitors), with the serotonin reuptake inhibitors (SSRIs) having found the most favor in treatment studies (Romano, Halmi, Sarkar, Koke, & Lee, 2002; Steinglass & Walsh, 2004; Walsh, Hadigan, Devlin, Gladis, & Roose, 1991). Antidepressant medications decrease depressive symptoms, improve mood, and may have a role in relapse prevention (Steinglass & Walsh, 2004). Additionally, SSRIs have demonstrated their usefulness in reducing binge frequency and ending binge-purge behavior (Bacaltchuk, Hay, & Mari, 2000). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Cognitive-Behavior Therapy with Eating Disorders: The Role of Medications in Treatment
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.