The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis

Journal article


Linardon, Jake, Wade, Tracey, de la Piedad Garcia, Xochitl and Brennan, Leah. (2017) The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology. 85(11), pp. 1080 - 1094. https://doi.org/10.1037/ccp0000245
AuthorsLinardon, Jake, Wade, Tracey, de la Piedad Garcia, Xochitl and Brennan, Leah
Abstract

Objective: This meta-analysis examined the efficacy of cognitive- behavioral therapy (CBT) for eating disorders. Method: Randomized controlled trials of CBT were searched. Seventy-nine trials were included. Results: Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies. Conclusions: CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential.

Keywordsbinge eating; bulimia nervosa; cognitive-behavioral therapy; eating disorders
Year2017
JournalJournal of Consulting and Clinical Psychology
Journal citation85 (11), pp. 1080 - 1094
ISSN0022-006X
Digital Object Identifier (DOI)https://doi.org/10.1037/ccp0000245
Scopus EID2-s2.0-85032578720
Open accessOpen access
Page range1080 - 1094
Research GroupSchool of Philosophy
Author's accepted manuscript
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Bloom, Lisa, Shelton, Beth, Bengough, Melissa and Brennan, Leah. (2013) Psychosocial outcomes of a non-dieting based positive body image community program for overweight adults : A pilot study. Journal of Eating Disorders. https://doi.org/10.1186/2050-2974-1-44
Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial
O'Brien, Paul Edmond, Brennan, Leah, Laurie, Cheryl and Brown, Wendy. (2013) Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial. Obesity Surgery. https://doi.org/10.1007/s11695-013-0990-3
Pre-operative weight loss does not predict weight loss following laparoscopic adjustable gastric banding
Brown, Wendy, Moszkowicz, Julia, Brennan, Leah, Burton, Paul, Anderson, Margaret and O'Brien, Paul Edmond. (2013) Pre-operative weight loss does not predict weight loss following laparoscopic adjustable gastric banding. Obesity Surgery. https://doi.org/10.1007/s11695-013-0974-3
A systematic review of variables associated with the relationship between obesity and depression
Preiss, K, Brennan, Leah and Clarke, David. (2013) A systematic review of variables associated with the relationship between obesity and depression. Obesity Reviews. https://doi.org/10.1111/obr.12052
Progress and limitations in the measurement of cyber bullying
Dredge, Rebecca Katherine, Gleeson, John Francis Martin and de la Piedad Garcia, Xochitl. (2013) Progress and limitations in the measurement of cyber bullying. In In R. Hanewald (Ed.). From cyber bullying to cyber safety: Issues and approaches in educational contexts pp. 271 - 288 Nova Science Publishers.
Defining disordered eating trajectories across adolescence and assessing their impact on psychosocial outcomes using growth mixture modelling
Mitchell, Sarah A., Brennan, Leah, Krug, Isabel and Allen, Nicholas B.. (2013) Defining disordered eating trajectories across adolescence and assessing their impact on psychosocial outcomes using growth mixture modelling. https://doi.org/10.1186/2050-2974-1-S1-O65
Maternal controlling feeding behaviours and child eating in preschool-aged children
Moroshko, Irina and Brennan, Leah. (2013) Maternal controlling feeding behaviours and child eating in preschool-aged children. Nutrition and Dietetics. https://doi.org/10.1111/j.1747-0080.2012.01631.x
Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial
O'Brien, Paul Edmond, Brennan, Leah, Laurie, Cheryl and Brown, Wendy. (2013) Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity : long-term follow-up of a prospective randomised trial. Obesity Surgery. https://doi.org/10.1007/s11695-013-0990-3
Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents
Brennan, Leah, Walkley, Jeff, Wilks, Ray, Fraser, Steve and Greenway, Kate. (2013) Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Obesity Research and Clinical Practice. https://doi.org/10.1016/j.orcp.2012.02.010
A cluster randomised controlled trial of a telephone-based parent intervention to increase preschoolers' fruit and vegetable consumption
Wyse, Rebecca, Wolfenden, Luke, Campbell, Elizabeth, Campbell, Karen, Wiggers, John, Brennan, Leah, Fletcher, Amanda, Bowman, Jenny and Heard, Todd. (2012) A cluster randomised controlled trial of a telephone-based parent intervention to increase preschoolers' fruit and vegetable consumption. American Journal of Clinical Nutrition: A journal reporting the practical application of our world-wide knowledge of nutrition. 96(1), pp. 102 - 110. https://doi.org/10.3945/ajcn.111.030585
Prospective memory, emotional valence and multiple sclerosis
Rendell, Peter, Henry, Julie, Phillips, Louise, De la Piedad Garcia, Xochitl, Booth, Patricia, Phillips, Patricia and Kliegel, Matthias. (2012) Prospective memory, emotional valence and multiple sclerosis. Journal of Clinical and Experimental Neuropsychology. 34(7), pp. 734 - 749. https://doi.org/10.1080/13803395.2012.670388
Predictors of attrition in bariatric aftercare : a systematic review of the literature
Moroshko, Irina, Brennan, Leah and O'Brien, Paul. (2012) Predictors of attrition in bariatric aftercare : a systematic review of the literature. Obesity Surgery. 22(10), pp. 1640 - 1647. https://doi.org/10.1007/s11695-012-0691-3
Promoting protective factors for young adolescents : ABCD Parenting Young Adolescents Program randomised controlled trial
Burke, Kylie, Brennan, Leah and Cann, Warren. (2012) Promoting protective factors for young adolescents : ABCD Parenting Young Adolescents Program randomised controlled trial. Journal of Adolescence. 35(5), pp. 1315 - 1328. https://doi.org/10.1016/j.adolescence.2012.05.002
Parenting styles, communication and child/adolescent diets andweight status : let's talk about it
Parletta, Natalie, Peters, Jacqueline, Owen, Amber, Tsiros, Margarita and Brennan, Leah. (2012) Parenting styles, communication and child/adolescent diets andweight status : let's talk about it. Early Child Development and Care. 182(8), pp. 1089 - 1103. https://doi.org/10.1080/03004430.2012.678597
Does exercise improve weight loss after bariatric surgery? : A systematic review
Egberts, Kristine, Brown, Wendy, Brennan, Leah and O'Brien, Paul. (2012) Does exercise improve weight loss after bariatric surgery? : A systematic review. Obesity Surgery. 22(2), pp. 335 - 341. https://doi.org/10.1007/s11695-011-0544-5
Treatment acceptability and psychosocial outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents
Brennan, Leah, Wilks, Ray, Walkley, Jeff, Fraser, Steve and Greenway, Kate. (2012) Treatment acceptability and psychosocial outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Behaviour Change. 29(1), pp. 36 - 62. https://doi.org/10.1017/bec.2012.5
Parent- and adolescent-reported barriers to participation in an adolescent overweight and obesity intervention
Brennan, Leah, Walkley, Jeff and Wilks, Ray. (2012) Parent- and adolescent-reported barriers to participation in an adolescent overweight and obesity intervention. Obesity: a resourch journal. 20(6), pp. 1319 - 1324. https://doi.org/10.1038/oby.2011.358
Validity of the beck depression inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates
Hayden, Melissa J., Brown, Wendy A., Brennan, Leah and O'Brien, Paul Edmond. (2012) Validity of the beck depression inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates. Obesity Surgery. 22(11), pp. 1666 - 1675. https://doi.org/10.1007/s11695-012-0682-4
Prospective memory, emotional valence and ageing
Rendell, Peter, Phillips, L., Henry, J., Brumby-Rendell, Tristan, de la Piedad Garcia, Xochitl, Altgassen, M. and Kliegel, M.. (2011) Prospective memory, emotional valence and ageing. Cognition and Emotion (print version). 25(5), pp. 916 - 925. https://doi.org/10.1080/02699931.2010.508610
In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months
Brennan, Leah. (2011) In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months. Worldviews on Evidence-Based Nursing. 14(3), pp. 72 - 73. https://doi.org/10.1136/ebn1164
In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months
Brennan, Leah. (2011) In people with poorly controlled type 2 diabetes, cognitive behaviour therapy combined with motivational enhancement therapy reduces HbA1c after 12 months. Worldviews on Evidence-Based Nursing. 14(3), pp. 72 - 73. https://doi.org/10.1136/ebn1164
Predictors of dropout in weight loss interventions :a systematic review of the literature
Moroshko, Irina, Brennan, Leah and O'Brien, Paul Edmond. (2011) Predictors of dropout in weight loss interventions :a systematic review of the literature. Obesity Reviews. 12(11), pp. 912 - 934. https://doi.org/10.1111/j.1467-789X.2011.00915.x
Primary Goals for Weight Loss Questionnaire (PGWLQ) :Development and Psychometric Evaluation in Overweight and Obese Adults
Murphy, Kylie, Brennan, Leah, Walkley, Jeff, Reece, John and Little, Emma. (2011) Primary Goals for Weight Loss Questionnaire (PGWLQ) :Development and Psychometric Evaluation in Overweight and Obese Adults. Behaviour Change. 28(1), pp. 29 - 43. https://doi.org/10.1375/bech.28.1.29
Self-Monitoring in the Treatment of Overweight Adolescents
Sandilands, Mary, Brennan, Leah, Walkley, Jeff, Fraser, Steve and Greenway, Kate. (2011) Self-Monitoring in the Treatment of Overweight Adolescents. Behaviour Change. 28(2), pp. 97 - 109. https://doi.org/10.1375/bech.28.2.97
Predicting treatment initiation in a family-based adolescent overweight and obesity intervention
Dhingra, Akshay, Brennan, Leah and Walkley, Jeff. (2011) Predicting treatment initiation in a family-based adolescent overweight and obesity intervention. Obesity: a resourch journal. 19(6), pp. 1307 - 1310. https://doi.org/10.1038/oby.2010.289
Psychosocial predictors of eating disorder risk in overweight and obese treatment seeking adolescents
Russo, Jade, Brennan, Leah, Walkley, Jeff, Fraser, Steve and Greenway, Kate. (2011) Psychosocial predictors of eating disorder risk in overweight and obese treatment seeking adolescents. Behaviour Change. 28(3), pp. 111 - 127. https://doi.org/10.1375/bech.28.3.111
A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3 to 5 year old children
Wyse, Rebecca, Wolfenden, Luke, Campbell, Elizabeth, Campbell, Karen, Brennan, Leah, Fletcher, Amanda, Bowman, Jenny, Heard, Todd and Wiggers, John. (2011) A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3 to 5 year old children. Public Health Nutrition. 14(12), pp. 2245 - 2253. https://doi.org/10.1017/S1368980011001170
Reliability of the school food checklist for in-school audits and photograph analysis of children's school lunches
Mitchell, Sarah, Miles, Cara, Brennan, Leah and Matthews, Jan. (2010) Reliability of the school food checklist for in-school audits and photograph analysis of children's school lunches. Journal of Human Nutrition and Dietetics. 23(1), pp. 48 - 53. https://doi.org/10.1111/j.1365-277X.2009.00996.x
A randomised controlled trial of the efficacy of the ABCD Parenting Young Adolescents Program : rationale and methodology
Burke, Kylie, Brennan, Leah and Roney, Sarah. (2010) A randomised controlled trial of the efficacy of the ABCD Parenting Young Adolescents Program : rationale and methodology. Child and Adolescent Psychiatry and Mental Health. 4(22), pp. 1 - 14. https://doi.org/10.1186/1753-2000-4-22
Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study
Campbell, Karen, Andrianopoulos, Nick, Hesketh, Kylie, Ball, Kylie, Crawford, David, Brennan, Leah, Corsini, Nadia and Timperio, Anna. (2010) Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study. Appetite. 55(1), pp. 84 - 88. https://doi.org/10.1016/j.appet.2010.04.006
A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3- to 5-year-old children: Study protocol
Wyse, Rebecca, Wolfenden, Luke, Campbell, Elizabeth, Brennan, Leah, Campbell, Karen, Fletcher, Amanda, Bowman, Jenny, Heard, Todd and Wiggers, John. (2010) A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3- to 5-year-old children: Study protocol. BMC Public Health. 10(216), pp. 1 - 12. https://doi.org/10.1186/1471-2458-10-216
Adolescent and parent content preferences and predictors of intention to use an online healthy weight website for adolescents
Baulch, Jacqueline, Chester, Andrea and Brennan, Leah. (2010) Adolescent and parent content preferences and predictors of intention to use an online healthy weight website for adolescents. E - Journal of Applied Psychology. 6(1), pp. 19 - 26. https://doi.org/10.7790/ejap.v6i1.173
Changes in the content of children's school lunches across the school week
Brennan, Leah, Miles, Cara, Mitchell, Sarah and Matthews, Jan. (2010) Changes in the content of children's school lunches across the school week. Health Promotion Journal of Australia. 21(3), pp. 196 - 201.
Maternal psychosocial predictors of controlling parental feeding styles and practices
Mitchell, Sarah, Brennan, Leah, Hayes, Louise and Miles, Cara L.. (2009) Maternal psychosocial predictors of controlling parental feeding styles and practices. Appetite. 53(3), pp. 384 - 389. https://doi.org/10.1016/j.appet.2009.08.001
Health-related quality of life in obese children and adolescents
Tsiros, Margarita D., Olds, Timothy S., Buckley, Jonathan David, Grimshaw, Paul, Brennan, Leah, Walkley, Jeff, Hills, Andrew Peter, Howe, Peter and Coates, Alison M.. (2009) Health-related quality of life in obese children and adolescents. International Journal of Obesity. 33(4), pp. 387 - 400. https://doi.org/10.1038/ijo.2009.42
A cognitive behavioural intervention for overweight and obese adolescents illustrated by four case studies
Brennan, Leah, Walkley, Jeff, Lukeis, Sarah, Risteska, Anica, Archer, Lisa, Digre, Ellen, Fraser, Steve F. and Greenway, Kate. (2009) A cognitive behavioural intervention for overweight and obese adolescents illustrated by four case studies. Behaviour Change. 26(3), pp. 190 - 213. https://doi.org/10.1375/bech.26.3.190
Treatment alternatives for overweight and obesity: The role of online interventions
Baulch, Jacqueline, Chester, Andrea and Brennan, Leah. (2008) Treatment alternatives for overweight and obesity: The role of online interventions. Behaviour Change. 25(1), pp. 1 - 14. https://doi.org/10.1375/bech.25.1.1
Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: Study design and methodology
Brennan, Leah, Walkley, Jeff, Fraser, Steve F., Greenway, Kate and Wilks, Ray. (2008) Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: Study design and methodology. Contemporary Clinical Trials. 29(3), pp. 359 - 375. https://doi.org/10.1016/j.cct.2007.09.001
Cognitive behavioural therapy improves diet and body composition in overweight and obese adolescents
Tsiros, Margarita D., Parletta, Natalie, Brennan, Leah, Coates, Alison M., Walkley, Jeff, Petkov, John, Howe, Peter, David and Buckley, Jonathan David. (2008) Cognitive behavioural therapy improves diet and body composition in overweight and obese adolescents. American Journal of Clinical Nutrition. 87(5), pp. 1134 - 1140.
The influence of prior choices on current choice
De la Piedad Garcia, Xochitl, Field, Douglas and Rachlin, Howard. (2006) The influence of prior choices on current choice. Journal of the Experimental Analysis of Behavior. 85(1), pp. 3 - 22. https://doi.org/10.1901/jeab.2006.132-04
The combined effects of delay and probability in discounting
Yi, Richard, De la Piedad Garcia, Xochitl and Bickel, Warren. (2006) The combined effects of delay and probability in discounting. Behavioural Processes. 73(2), pp. 149 - 155. https://doi.org/10.1016/j.beproc.2006.05.001