Treatment Outcome of Adults Receiving Virtual Cognitive Behavior Therapy for an Eating Disorder

ObjectiveThe aim of this paper is to evaluate the effectiveness of enhanced cognitive behavioral therapy (CBT-E) adapted to be delivered via telehealth in a real-world, clinic treatment setting by a multi-disciplinary team for adults with an eating disorder. MethodA retrospective analysis of treatment outcomes was conducted on adult patients (18+) who received adapted CBT-E, a transdiagnostic treatment approach specifically modified for the treatment of eating disorders. Outcome included weight and eating disorder, depression, and anxiety symptoms. Survival analyses were used to assess length of stay, weight restoration and alleviation of eating disorder, depression, and anxiety symptoms; multilevel models assessed outcome trajectories over treatment time. ResultsThe patient sample (n = 1,718) was predominantly white (73%), cisgender women (86%), with a mean age of 30 (SD = 12). Diagnoses included anorexia nervosa (AN, 56%), binge-eating disorder (BED, 24%), bulimia nervosa (BN, 7%), and other specified feeding and eating disorder (OSFED, 11%). Approximately 51% of patients with weight restoration targets achieved weight restoration (95% of their target weight) by week 40 of treatment. By week 40 in treatment, 49% of patients reached subclinical levels on the EDE-Q, 58% on the PHQ-8, and 56% on the GAD-7. DiscussionAdapted CBT-E delivered via telehealth by a multi-disciplinary team is effective in improving transdiagnostic eating disorder symptoms, depression, and anxiety in an outpatient setting. Outcomes were consistent across diagnoses, demonstrating the feasibility and effectiveness of virtual CBT-E. However, variability in treatment length makes direct comparison with clinical trial end-of-treatment outcomes challenging. Public Health SignificanceThis study shows that virtually-delivered CBT-E effectively treats eating disorders by improving symptoms and accessibility to treatment. Expanding virtual treatment can significantly reduce barriers to care, reaching more individuals and lessening the public health impact of these disorders.