Treehouse Counseling logo - therapy in Beaverton, OR
Young woman wearing yellow sweater talks to therapist in Beaverton office

Eating Disorder 101: Evidence-Based Treatments

Discover the therapeutic treatment modalities for eating disorders which are backed by statistical evidence for their efficacy.

Introduction

Welcome back to Treehouse Counseling’s blog series about eating disorders.

–>Eating Disorder 101: Eating Disorders vs Disordered Eating

–>Eating Disorder 101: Eating Disorder Subtypes

–>Eating Disorder 101: Gauging Level of Care Needs

This article will take a look at some (but not all!) of the first line therapeutic treatment modalities for eating disorders. Each modality included in this blog post is considered evidence-based, which generally means that its efficacy is backed by a statistically significant body of research. Though this article will not go in-depth into these studies themselves, the author will link references at the end for further reading.

Cognitive Behavioral Therapy (CBT)

  • Overview
    • Structured, goal-oriented therapy focusing on the relationship between thoughts, emotions, and behaviors
    • Addresses distorted beliefs about oneself in relation to food, body image, societal expectations, etc.
  • Principles and Techniques
    • Identifying and reframing negative thoughts/beliefs, sometimes called “self-talk”
    • Behavioral experiments, situational and imaginal exposures, homework practice
  • Strengths
    • Clear expectations, strong framework for practicing and improving cognitive skills
  • Weaknesses
    • Not as holistic as other frameworks
    • Focuses on the cognitive rather than the somatic (mind over body)

Family-Based Therapy/Maudsley Treatment

  • Overview
    • Highly structured therapy involving parents/caregivers as primary support in recovery
    • Primarily utilized with children and adolescents
  • Principles and Techniques
    • 3 phases of treatment
      • Phase One – Weight restoration
      • Phase Two – Returning control over eating back to the adolescent
      • Phase Three – Establishing healthy adolescent identity
  • Strengths
    • Externalizes the eating disorder to reduce shame and stigma
    • Promotes increased communication and collaboration within family structure
  • Weaknesses
    • Places main support role on parents/caregivers; limits autonomy of child/adolescent
    • Not suitable for all family dynamics

Dialectical Behavior Therapy (DBT)

  • Overview
    • Skills-based therapy to build emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness
    • Often used for clients with intense emotion dysregulation or co-occurring issues
  • Principles and Techniques
    • Conceptualizes eating disorder behaviors as a coping mechanisms in response to stress
    • Teaches alternate, sustainable coping skills to reduce reliance on eating disorder behaviors
  • Strengths
    • Hands-on and focused on concrete skill-building 
  • Weaknesses
    • Time and resource-intensive, limited trauma focus

Interpersonal Psychotherapy (IPT)

  • Overview
    • Brief, relational therapy that targets interpersonal issues and role changes that may contribute to eating disorder symptoms
  • Principles and Techniques
    • Role exploration, communication analysis, and enhancing social supports
  • Strengths
    • Takes into account micro-, meso-, and macro-system impacts on recovery
    • Promotes social connectedness and community, reduces isolation in the recovery process
  • Weaknesses
    • Limited scope, and inappropriate for certain co-occurring disorders

Acceptance and Commitment Therapy (ACT)

  • Overview
    • Mindfulness-based therapy that focuses on psychological flexibility and accepting uncomfortable thoughts/feelings rather than trying to change or eliminate them
  • Principles and Techniques
    • Utilizes somatic techniques to improve mindful awareness
    • Focuses on self-compassion to reduce shame and stigma
    •  Includes exposure-based interventions to increase distress tolerance
  • Strengths
    • Creates heightened emotional effectiveness and resilience
  • Weaknesses
    • Less focus on past history and trauma, more about present-focused regulation
    • Slower paced, skill-intensive

Conclusion

This article has offered a quick overview of some of the primary therapeutic modalities that you are likely to encounter in eating disorder treatment. There are many additional frameworks that can be helpful as primary or secondary approaches, especially if you or a loved one are experiencing a co-occurring concern, such as trauma (e.g. EMDR, IFS, ketamine-assisted therapy, etc.). It’s also important to keep in mind that many therapists are trained in multiple modalities, and are often able to integrate different frameworks into an approach that works for each client. 

Additional publications have been included below under the reference section to provide experimental and comparative data on the efficacy of the aforementioned modalities. 

Future articles will discuss weight-inclusive recovery approaches.

Thank you for reading, and take care.

References

Agras, W. Stewart; Bohon, Cara (7 May 2021). “Cognitive Behavioral Therapy for the Eating Disorders”. Annual Review of Clinical Psychology. 17 (1): 417–438.doi:10.1146/annurev-clinpsy-081219-110907

Dalle Grave , R., Dametti, L., Conti, M., Bersan, C., Dalle Grave , A., & Calugi, S. (2021). Day-hospital enhanced cognitive behavior therapy for adults: immediate and follow-up effects. International Journal of Eating Disorders, 1-6. https://doi.org/10.1002/eat.23632

Lock, J.; Le Grange, D.; Agras, W. S.; Moye, A.; Bryson, S. W.; Jo, B. (2010). “Randomized Clinical Trial Comparing Family-Based Treatment with Adolescent-Focused Individual Therapy for Adolescents with Anorexia Nervosa”. Archives of General Psychiatry. 67(10): 1025–32. doi:10.1001/archgenpsychiatry.2010.128

Lopes, R. M., Silva, A. F., Rodrigues, A. C., Matias-Martins, A. C., Santos, F. M. A., Coelho, P.F., … Melo, V. S. (2025). Beyond the Plate: Evidence-Based Psychotherapies for Eating Disorders – A Transdiagnostic Comparison. European Psychiatry, 68(S1), S688–S689. doi:10.1192/j.eurpsy.2025.1401

Peterson, C.B., Becker, C.B., Treasure, J. et al. The three-legged stool of evidence-based practice in eating disorder treatment: research, clinical, and patient perspectives. BMC Med 14, 69 (2016). https://doi.org/10.1186/s12916-016-0615-5

Russell, H., Aouad, P., Le, A. et al. Psychotherapies for eating disorders: findings from a rapid review. J Eat Disord 11, 175 (2023). https://doi.org/10.1186/s40337-023-00886-w

Treatment Modalities – Eating Disorders Center for Treatment and Research. (2026). UC San Diego Health. https://eatingdisorders.ucsd.edu/treatment/treatment-modalities

Stock, M., Beaman, L., Moreton, R. et al. The efficacy of compassion focused therapy in eating disorders: a systematic review of the literature. J Eat Disord 13, 235 (2025). https://doi.org/10.1186/s40337-025-01418-4

More from Treehouse Counseling's blog