Cognitive behavioural therapy for eating disorders: past, present and future

Cognitive behavioural therapy (CBT) is a first-line treatment for eating disorders, including anorexia nervosa, bulimia nervosa and binge-eating disorder, as approved by the National Institute for Health and Care Excellence (NICE). CBT addresses the cognitive and behavioural factors that maintain eating disorders. It offers patients tools to overcome difficulties. It is flexible to accommodate different presentations and complex comorbidities. CBT has a well-documented efficacy in treating eating disorders; research has shown that it significantly reduces symptoms and improves maintenance of long-term remission. The history and development of CBT for eating disorders began with Christopher Fairburn's interest in the application of CBT for eating disorders, followed by his development of evidence-based psychological treatments and the creation of enhanced CBT (CBT-E), which is appropriate for all types of eating disorders. CBT-E has four major goals: to engage patients in the treatment, to remove eating disorder psychopathology and behaviours, to correct the mechanisms maintaining eating disorder psychopathology and to ensure lasting change. CBT-E is a structured, patient-centred therapy suitable for a variety of settings, including outpatient and inpatient care, making it a flexible option for treating eating disorders in adults and adolescents. This paper summarises current applications of CBT for eating disorders and recent developments in the field.