Treating eating disorders

Eating disorders (anorexia nervosa, bulimia nervosa and related conditions) are common, often chronic and disabling, and sometimes fatal. Professor Chris Fairburn from the Department of Psychiatry, University of Oxford and his colleagues have made considerable advances into the understanding and treatment of these conditions.

The success of Cognitive Behavioural Therapy

In a ground-breaking study of the treatment, based in Oxford, and published in 1993, Chris and his colleagues compared CBT-BN to two alternative psychological therapies. They found that CBT-BN produced a complete and lasting cure in almost half the cases, quite unlike the other two treatments. These results were replicated in 2000, together with an American team. As a result of these successes, and further replications elsewhere, the National Institute of Clinical Excellence (NICE) recommended that ‘All patients with bulimia nervosa should receive cognitive behavioural therapy’. This was the first time NICE had endorsed a psychological treatment for any disorder.

In the late 1990s Chris, together with Zafra Cooper and Roz Shafran, set about developing an ‘enhanced’ form of CBT-BN suitable for all eating disorders (CBT-E) including anorexia nervosa. They published their results in 2009 and 2013 showing that 80% of patients completed the treatment and three-quarters of these made a full recovery. There is no other treatment with this clinical range or level of effectiveness.

Training in delivering CBT-E

There is worldwide interest from clinicians in being trained to deliver CBT-E. This has led Chris and his team to shift their research onto how best to disseminate psychological treatments. The result has been the development of ‘web-centred training’, a means of training large numbers of therapists simultaneously. It is currently being tested in a pilot study involving all eligible therapists across a country in Europe.