Eating Disorders

People with eating disorders experience significant alterations in their relationships with food. For example, individuals with anorexia nervosa restrict their food intake and individuals with bulimia nervosa experience episodes of binge eating followed by efforts to avoid gaining weight, including vomiting or excessive exercise. Cognitive behavioral therapy (CBT) and family-based therapy (FBT) are both evidence-based treatments for eating disorders. Read more

See recommended resources

Recent releases

Filter

Sort by

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

Eating Attitudes Test 26 (EAT-26) | Garner, Olmsted, Bohr, Garfinkel | 1982
- Test (PDF)
  Primary Link Archived Link
- Test (Word)
  Primary Link Archived Link
- Scoring and interpretation
  Primary Link Archived Link
- Website link
  Primary Link
- Reference Garner et al. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871-878
Eating Disorder Examination (EDE) | Fairburn, Cooper, O’Connor | 2014
- Interview
  Primary Link Archived Link
- Questionnaire (EDE-Q)
  Primary Link Archived Link
- Questionnaire for Adolescents (EDE-A)
  Primary Link Archived Link
- Reference Fairburn, C. G., Cooper, Z., & O’Connor, M. (1993). The eating disorder examination. International Journal of Eating Disorders, 6, 1-8.
ED15 | Tatham, Turner, Mountford, Tritt, Dyas, Waller | 2015
Primary Link Archived Link
- Scale
  Primary Link Archived Link
- Reference Tatham, M., Turner, H., Mountford, V. A., Tritt, A., Dyas, R., & Waller, G. (2015). Development, psychometric properties and preliminary clinical validation of a brief, session‐by‐session measure of eating disorder cognitions and behaviors: The ED‐15. International Journal of Eating Disorders, 48(7), 1005-1015.
Assessment Of Eating Disorders: Review And Recommendations For Clinical Use | Anderson, Lundgren, Shapiro, Paulosky | 2004
Primary Link Archived Link
- Journal article
  Primary Link Archived Link

Exercises

Binge Analysis | CREDO
Primary Link Archived Link

Guides and workbooks

Cognitive Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR): patient and family workbook | Thomas, J.J, Eddy, K.T | 2019
Primary Link Archived Link
Self-help manual for bulimia nervosa | Freeman, Downey | 2001
Archived Link
Taming the hungry bear: Your way to recover from chaotic overeating | Kate Williams
Archived Link

Information Handouts

Helpful tips after residential treatment
Primary Link Archived Link
Disordered Eating: Key Psychoeducation (Information Handouts) | Centre For Clinical Interventions
- What Are Eating Disorders?
  Primary Link Archived Link
- What Is Binge Eating?
  Primary Link Archived Link
- What Is Starvation Syndrome?
  Primary Link Archived Link
- Set Point Theory
  Primary Link Archived Link
- Eating Disorders and Neurobiology
  Primary Link Archived Link
- Eating Disorders: What Are The Risks?
  Primary Link Archived Link
- Eating Disorders in Men
  Primary Link Archived Link
- Atypical Anorexia Nervosa
  Primary Link Archived Link
- Binge Eating Disorder
  Primary Link Archived Link
Disordered Eating: Treatment (Information Handouts) | Centre For Clinical Interventions
- Orientation To Treatment
  Primary Link Archived Link
- Family Based Therapy: Information for Carers, Consumers, and Professionals
  Primary Link Archived Link
- A Guide to Self-Monitoring
  Primary Link Archived Link
- Weekly Weighing
  Primary Link Archived Link
- What Are Safety Behaviours?
  Primary Link Archived Link
- Eating Disorders Information For Carers
  Primary Link Archived Link
Disordered Eating: Information About Eating (Information Handouts) | Centre For Clinical Interventions
- Normal Eating vs. Disordered Eating
  Primary Link Archived Link
- Why Diets Do Not Work
  Primary Link Archived Link
- Regular Eating for Recovery
  Primary Link Archived Link
- Dietary Guidelines During Recovery
  Primary Link Archived Link
- Evaluating Dietary Advice
  Primary Link Archived Link
- Metabolism and Energy Requirements
  Primary Link Archived Link
- The REAL food pyramid
  Primary Link Archived Link
- Making Sense of Serving Sizes
  Primary Link Archived Link
- Carbohydrates – Myths and Facts
  Primary Link Archived Link
- Counting Calories
  Primary Link Archived Link
- Clean Eating
  Primary Link Archived Link
- All About Iron
  Primary Link Archived Link
- The Facts on Fat
  Primary Link Archived Link
- Vegetarian Diet and Eating Disorders
  Primary Link Archived Link
Disordered Eating: Your Physical Health (Information Handouts) | Centre For Clinical Interventions
- Unhealthy Exercise
  Primary Link Archived Link
- Vomiting and Your Health
  Primary Link Archived Link
- Laxative Misuse
  Primary Link Archived Link
- Gastrointestinal Changes
  Primary Link Archived Link
- Calcium and Bone Health
  Primary Link Archived Link
- Eating Disorders and Hormones
  Primary Link Archived Link
- Eating Disorders and Pregnancy
  Primary Link Archived Link
Disordered Eating: Body Image (Information Handouts) | Centre For Clinical Intervention
- Body Checking and Avoidance
  Primary Link Archived Link
- Body Image and Body Satisfaction
  Primary Link Archived Link
- Media and Body Image
  Primary Link Archived Link
- Unhelpful Thinking Styles
  Primary Link Archived Link
Transdiagnostic CBT-E formulation | CREDO
Primary Link Archived Link
Instructions for self monitoring (eating disorders) | CREDO
Primary Link Archived Link
Regular eating (patient handout) | CREDO
Primary Link Archived Link
Anorexia nervosa
Primary Link Archived Link
Binge eating disorder n
Primary Link Archived Link
Bulimia nervosa
Primary Link Archived Link
Compulsive exercise
Primary Link Archived Link

Information (Professional)

Topics to cover when assessing the eating problem | Fairburn | 2008
Primary Link
Topics to cover when educating patients about eating disorders | CREDO
Primary Link Archived Link
Short-term maintenance plan (Eating disorders) | CREDO
Primary Link Archived Link
Long-term maintenance plan (Eating disorders) | CREDO
Primary Link Archived Link

Presentations

Evidence-based cognitive behavioural therapy for eating disorders: principles and practice | Glenn Waller | 2017
Primary Link Archived Link
Putting the ‘B’ back into CBT for eating disorders | Glen Waller | 2011
Archived Link
Transdiagnostic CBT for eating disorders “CBT-E” | Chris Fairburn | 2016
Archived Link

Self-Help Programmes

Break Free From ED (Workbook) | Centre For Clinical Interventions | 2022
- Module 1: What Are Eating Disorders?
  Primary Link
- Module 2: What Keeps Eating Disorders Going?
  Primary Link Archived Link
- Module 3: Understanding The Number On The Scale
  Primary Link Archived Link
- Module 4: Self-Monitoring
  Primary Link Archived Link
- Module 5: Food And Energy
  Primary Link Archived Link
- Module 6: Eating For Recovery - Part 1
  Primary Link Archived Link
- Module 6: Eating For Recovery - Part 2
  Primary Link Archived Link
- Module 8: Binge Eating
  Primary Link Archived Link
- Module 9: Purging
  Primary Link Archived Link
- Module 10: Driven Exercise
  Primary Link Archived Link
- Module 11: Body Image 1 - Body Checking
  Primary Link Archived Link
- Module 12: Body Image 2 - Body Avoidance
  Primary Link Archived Link
- Module 13: Core Beliefs
  Primary Link
- Module 14: Maintaining Your Gains And Dealing With Setbacks
  Primary Link Archived Link
- Appendix: Getting Educated About Eating Disorders
  Primary Link Archived Link

Treatment Guide

Eating Disorders: Recognition And Treatment (NICE Guideline) | NICE | 2020
Primary Link
Maudsley Service Manual For Child And Adolescent Eating Disorders | Eisler, Simic, Blessitt, Dodge | 2016
Primary Link Archived Link
Eating disorders: recognition and treatment | National Institute for Health and Care Excellence (NICE) | 2020
Primary Link Archived Link
Group cognitive remediation therapy for adolescents with anorexia nervosa: The flexible thinking group | Maiden, Baker, Espie, Simic, Tchanturia | 2014
Primary Link Archived Link

Video

Eating disorders from the inside out | Dr Laura Hill | 2012
Primary Link

Worksheets

Disordered Eating (Worksheets) | Centre For Clinical Interventions
- Change Process Balance Sheet
  Primary Link Archived Link
- Tackling Avoided Foods
  Primary Link Archived Link
- Self-Monitoring Form
  Primary Link Archived Link
Blank Monitoring Record | CREDO
Primary Link Archived Link

What Are Eating Disorders?

Signs and Symptoms of Eating Disorders

Common to many of the eating disorders are a preoccupation with weight and body shape, significant anxiety about gaining weight, and behaviors intended to mitigate the anxiety.

Symptoms of anorexia nervosa may include:

restriction of energy intake leading to weight that is less than minimally normal or expected in the context of age, sex, developmental trajectory, and physical health;
an intense fear of gaining weight, an intrusive dread of fatness, or persistent behavior that interferes with weight gain;
disturbed perception of one’s body weight (e.g., a self-perception of being too fat);
self-evaluation is unduly influenced by body weight or shape;
a persistent lack of insight regarding the seriousness of low body weight;
endocrine disorder resulting in amenorrhea or loss of sexual interest or potency.

Symptoms of bulimia nervosa include:

recurrent episodes of binge eating (overeating) where excessively large amounts of food are consumed in a discrete period of time;
a feeling of lack of self-control over eating during a binge-eating episode;
recurrent behaviors to counteract weight gain such as self-induced vomiting, purging, fasting, use of drugs, diuretics, or excessive exercise;
self-evaluation is unduly influenced by body weight or shape;
a self-perception of being too fat and an intrusive dread of fatness.

Psychological Models and Theory of Eating Disorders

Fairburn, Cooper, and Shafran (2003) proposed a transdiagnostic cognitive behavioral model of eating disorders that describes the maintenance of both anorexia nervosa and bulimia nervosa. Central to the model is the individual’s judgment of their self-worth in terms of body weight or shape. Disordered eating behaviors are understood as a consequence of these self-beliefs.

Evidence-Based Psychological Approaches for Working with Eating Disorders

Enhanced Cognitive Behavior Therapy for Eating Disorder (CBT-E)

In 2003, Fairburn et al. argued for value in viewing eating disorders from a transdiagnostic perspective. They say that common mechanisms, such as a restricted assessment of self-worth, underpinned both anorexia and bulimia. CBT-E includes elements that focus on modification of eating habits, weight-control behavior, and concerns about eating, shape, and weight.

Family-Based Treatment (FBT) / Maudsley Family Therapy

FBT is an outpatient, intensive treatment in which the family is used as the primary resource to renourish the affected child or adolescent. It is described as a highly practical approach that attempts to modify problems in family structure that make refeeding more difficult (Lock and le Grange, 2005). Average length of treatment is 9–12 months. A 2013 meta-analysis indicated that individual therapy and FBT were equivalently effective at the end of treatment, but that FBT was superior at 6–12 month follow-up (Couturier, Kimber, & Szatmari, 2013).

Resources for Working with Eating Disorders

Psychology Tools resources available for working therapeutically with eating disorders may include:

psychological models of eating disorders including anorexia and bulimia
information handouts for eating disorders including anorexia and bulimia
exercises for eating disorders including anorexia and bulimia
CBT worksheets for eating disorders including anorexia and bulimia
self-help programs for eating disorders including anorexia and bulimia

References

Couturier, J., Kimber, M., & Szatmari, P. (2013). Efficacy of family‐based treatment for adolescents with eating disorders: A systematic review and meta‐analysis. International Journal of Eating Disorders, 46(1), 3–11.
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviourtherapy for eating disorders: A ‘transdiagnostic’ theory and treatment. BehaviourResearch and Therapy, 41(5), 509–528.
Lock, J., & le Grange, D. (2005). Family‐based treatment of eating disorders. International Journal of Eating Disorders, 37(S1), S64–S67.

Eating Disorders

.st0{fill:none;stroke:#000;stroke-width:2;stroke-linecap:round;stroke-linejoin:round;stroke-miterlimit:10} Filter

.st0{fill:none;stroke:#000;stroke-width:2;stroke-linecap:round;stroke-linejoin:round;stroke-miterlimit:10} Filter

Search

Language

Resource type

Problem

Therapy tool

Links to external resources

Assessment

Exercises

Guides and workbooks

Information Handouts

Information (Professional)

Presentations

Self-Help Programmes

Treatment Guide

Video

Worksheets

Recommended Reading

What Are Eating Disorders?

Signs and Symptoms of Eating Disorders

Psychological Models and Theory of Eating Disorders

Evidence-Based Psychological Approaches for Working with Eating Disorders

Enhanced Cognitive Behavior Therapy for Eating Disorder (CBT-E)

Family-Based Treatment (FBT) / Maudsley Family Therapy

Resources for Working with Eating Disorders

References

Filter

Filter