Table 2 Overview of main psychological therapies for the management of low weight anorexia nervosa, bulimia nervosa and binge-eating disorder

Eating disorder indicated evidence base for use

Adults, Older adolescents Transdiagnostic/Adults with anorexia nervosa

Adults with anorexia nervosa

Adults with anorexia nervosa

Adults with anorexia nervosa

Adults with bulimia nervosa and BED

Children and adolescents with anorexia nervosa and bulimia nervosa

Adults with bulimia nervosa and BED

Theoretical model

CBT formulation & in CBT-E transdiagnostic maintaining factors

Cognitive/Interpersonal

Atheoretical

Psychodynamic formulation

Interpersonal function’s bidirectional relationship with bulimia nervosa/BED symptoms mediated by self-esteem & negative affect

Atheoretical ‘agnostic’

Understanding the dialectic of opposing views of eating disorder behaviours and their use in distress reduction

Targets

Dysfunctional eating, weight/shape (body dissatisfaction) beliefs, disordered eating

Intra- and interpersonal maintaining factors, e.g., inflexibility

Undernutrition, other ‘targets’ as personalised goals

Intra- and interpersonal maintaining factors, e.g., low self-esteem

Interpersonal (IP) problem areas: Grief, Role transitions, Role disputes, IP sensitivities

Food restriction and family eating; Other family/adolescent issues

Learning skills in:

mindfulness;

distress tolerance;

emotion regulation; & interpersonal effectiveness

Therapy tools

Behavioural monitoring, behavioural experiments, cognitive restructuring, chain analyses

Motivational interviewing, social integration, cognitive remediation

Psychoeducation, goal-directed and supportive therapy

Exploration of beliefs/schema, interpersonal therapy, goal setting, new behaviours

Exploration of interpersonal function and eating disorder, encouraging affect, clarification, communication analysis, therapeutic relationship

Psychoeducation, externalisation of the eating disorder, family meals with initial parental empowerment to progressing to age-appropriate independent eating

Training in emotion regulation skills; ‘meaning making’ as acceptance and change; validating the worth of the individual

Mood symptoms

Core mood intolerance module in CBT-E

Emotion skills training

Symptom management

Exploration/analysis of affective-emotional experiences

Encouraging affect: acceptance; effective communication of affect; experience suppressed affects

Symptom management

Addressed through emotion regulation skills and other training