Brief Cognitive-Behavioral Therapy for Non-Underweight Eating Disorders (CBT-T): Psychological and Weight-Related Outcomes, and Predictors of Improvement.

OBJECTIVE

Brief Cognitive Behavioral Therapy (CBT-T) has been developed as an accessible treatment for eating disorders in non-underweight individuals. It is important to understand the factors that predict response to this treatment in this population. This study examined predictors of outcomes from CBT-T using a large naturalistic sample. The aims were to determine outcomes of CBT-T and to identify the role of pre-therapy characteristics and early change in predicting outcomes.

METHOD: The sample consisted of 371 adults who entered CBT-T (10 sessions). All completed measures at sessions 1, 4, and 10, including eating pathology (EDE-Q); anxiety (GAD-7); and depression (PHQ-9). Body Mass Index was calculated from clinician-measured weight and height. Intent-to-treat (GLMM) and completer analyses were used.

RESULTS

Of the 371 participants, 53.1% completed therapy. There were no factors that predicted attrition. In ITT analyses, patients showed significant changes in EDE-Q scores overall and between sessions 1-4 and 4-10, with large effect sizes and ending substantially below clinical cut-off. In ITT analyses, BMI did not change over treatment, regardless of baseline BMI. Completer analyses indicated a small increase in BMI, although the magnitude of change was small. Baseline scores (EDE-Q, BMI, PHQ-9, GAD-7) offered minimal prediction of outcome at end of therapy, whereas early change (session 1-4) in restraint and weight concerns were strong predictors of overall outcome.

CONCLUSIONS

CBT-T replicated its strong effects for non-underweight patients, while BMI remained broadly stable, with only small increases observed in completer analyses.