Cognitive Behavioural Therapy - Enhanced for Eating Disorders (CBT-E)

The National Institute of Health and Care Excellence (NICE, 2017) guidelines recommend Cognitive Behavioural Therapy - Enhanced for eating disorders (CBT-E) as the leading treatment for eating disorders.

What is CBT-E?

CBT-E is a specialised type of CBT tailored for eating disorders. It is based upon the premise that an individual’s thoughts, behaviours, and feelings are all connected and influence one another. Eating disorders are typically characterised by over-valued beliefs about shape and weight and self-critical thoughts. This often results in unhealthy behaviours around food (including food restriction, bingeing and/or purging). In turn, this influences an individual’s emotions, and can lead to feelings of anxiety, shame, and/or low mood. The aim of CBT-E is to identify and address any unhelpful thought patterns/beliefs and behaviours around food and body image, in order to increase feelings of content, self-worth, and happiness. 

What does CBT-E involve?

  • Developing an understanding of what may have led to eating or body image difficulties and what may be keeping these difficulties going.

  • Recording food intake to observe any patterns or triggers to disordered eating behaviours.

  • Psychoeducation and nutritional advice regarding the effects of food restriction on the body and the importance of eating enough and a variety of foods.

  • Adopting regular eating habits.

  • Reintroducing avoided or feared foods.

  • Learning healthy ways to manage difficult emotions.

  • Learning tools to improve body image and increase self-esteem.

  • When a regular pattern of eating has been established, working towards a sustainable healthy relationship with food by listening to internal hunger fullness signals (also known as "intuitive eating").