Types of therapy for eating disorders & how to decide

Key Takeaways

People with eating disorders generally focus intensely on food, weight, or body image, which can seriously affect their overall health and well-being.
The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.
Therapy can be effective in treating eating disorders. Treatment can include talking with a mental health professional, learning coping strategies, nutrition counseling, and, in some cases, medication.

People don’t choose to have low self-esteem or a negative body image, but these emotions often accompany eating disorders.

Approximately 28 million Americans will have an eating disorder in their lifetime. Although eating disorders are more common in women than in men, they can impact all genders, ethnicities, sexual orientations, ages, races, body shapes, and weights.

It’s important to understand the differences between eating disorders — especially when managing symptoms, finding the right treatment, and getting an accurate diagnosis.

The most common eating disorders are:

Anorexia nervosa: People with anorexia nervosa have a distorted body image and restrict their food intake. They may have an intense fear of gaining weight even if they’re underweight. Anorexia has the highest death rate of any mental health condition and can cause serious mental and physical health problems.
Binge eating disorder (BED): The most common eating disorder in the U.S., BED involves people eating large amounts of food in a short period of time and feeling as if they can’t stop. They often eat past the point of discomfort, and they often feel guilt or remorse after eating.
Bulimia nervosa: People with bulimia nervosa also consume large amounts of food in a short period of time, followed by periods of purging to avoid weight gain through vomiting, use of laxatives, or excessive exercise. Those with bulimia are often secretive about their eating habits and feel as if they have no control of how much they eat. Overeating may also cause feelings of guilt and shame.

What types of therapy may help treat eating disorders?

Treatment focuses on how you behave, think, and feel in relation to your eating disorder. Treatments for eating disorders generally address the following:

Restoring physical and mental health
Changing negative behaviors such as binging or restricting food
Developing coping strategies that support recovery
Challenging negative ways of thinking and learning how to make peace with your body
Addressing any ongoing or underlying mental health conditions
Creating a plan to prevent relapse

The current treatment options for eating disorders include:

Cognitive behavioral therapy (CBT): A form of talk therapy, CBT is considered the leading treatment for anorexia, and evidence shows it’s also effective in treating bulimia. In CBT, a therapist will help you learn how to manage eating disorders by changing your thoughts and behaviors. Some research suggests CBT isn’t recommended for trauma survivors.
Enhanced cognitive behavioral therapy (CBT-e): An enhanced form of CBT, CBT-e is designed to treat a variety of eating disorders, help you re-establish regular healthy eating habits, and address any emotions that contribute to your eating disorder. If someone isn’t ready to acknowledge they have an eating disorder or is struggling with depression or severe malnutrition, CBT-e might not be the right fit.
Family-based treatment (FBT): FBT, also known as the Maudsley approach, is considered the gold standard for treating teens with anorexia and involves the entire family as part of the treatment process. However, FBT may not be the best option for people with co-occurring conditions or families dealing with conflicts or their own mental health concerns.
Dialectical behavioral therapy (DBT): A type of talk therapy, DBT is proven to be effective in treating binge eating and symptoms of bulimia. The primary goals of DBT include helping you regulate your emotions and to be more mindful of your thoughts and feelings. DBT can be used as a supplement to FBT or a stand-alone treatment for complex eating disorders and substance use.
Nutrition therapy: With this treatment approach, a dietitian will work with you to improve your relationship with food, address your need for nutrients, and understand how food affects overall health. Lessons focus on mindful eating, meal planning, and addressing nutritional deficiencies.
Interpersonal psychotherapy (IPT): In treating bulimia and BED, IPT examines your relationships that may contribute to your eating disorder, such as unresolved grief, feelings of isolation, or conflicts with partners, co-workers, and family.
Acceptance and commitment therapy (ACT): This relatively new form of therapy focuses on changing your actions rather than your thoughts and feelings. ACT is also effective in addressing the root causes of eating disorders and preventing relapses.

What is the best therapy for eating disorders?

Professional support is key for fully recovering from an eating disorder. And getting help earlier than later improves your chances of recovery. Taking the first step toward recovery can be hard, but a variety of treatments are available to help you improve your relationship to your body and food.

The first step is acknowledging your eating disorder and reaching out to a mental health professional. With a therapist who specializes in eating disorders, you can create a plan that addresses your unique physical and mental health needs.

When deciding what treatment is best, consider factors such as the type and severity of the eating disorder, your unique therapy preferences (like if you prefer group or one-on-one settings), and whether you have a co-occurring condition like anxiety or depression.

A tailored combination of approaches, including talk therapy, nutritional counseling, and a strong support system often result in the best outcomes for eating disorders. Sometimes medication is prescribed to address eating disorders and any underlying mental health conditions. It’s important to work with your provider to decide if medication is the right option for you.

Find care with Rula

Living with an eating disorder can be challenging, but you don’t have to face it alone. Working with a mental health professional who specializes in eating disorders can help you learn coping strategies, practice self-care, and heal your relationship with food and your body.

At Rula, you can use our matching tool to connect you with a therapist who accepts your insurance and specializes in treating eating disorders. With our diverse network of providers, you can begin therapy as soon as tomorrow in a convenient online setting.

About the author

Linda Childers

Linda is an award-winning medical writer with experience writing for major media outlets, health companies, hospitals, and both consumer and trade print and digital outlets. Her articles have appeared in the Washington Post, USA Today, WebMD, AARP, Brain+Life, HealthyWomen.org, The Rheumatologist, California Health Report, Everyday Health, HealthCentral, and many other media outlets. While juggling the responsibilities of being part of the “sandwich generation” and caring for both her toddler son and terminally ill mother, a nurse friend encouraged her to seek therapy, which helped her to learn coping strategies and manage her depression. Linda hopes her work will help to destigmatize mental health conditions and encourage others to get the help they need.

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