CBT-Enhanced for Eating Disorders(CBT-E)
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Overview
CBT-E is a specialised form of CBT designed by Christopher Fairburn to treat eating disorders across diagnoses. It targets the processes that maintain eating disorder symptoms, including over-evaluation of weight and shape, dietary restraint, and rigid rules.
What this therapy focuses on
Changing maintaining mechanisms rather than focusing on diagnostic labels, with structured behavioural change early in treatment.
What sessions are usually like
Session length: 50 minutes
Frequency: Weekly, sometimes twice weekly early on
Time-limited: Yes (20–40 sessions depending on severity)
Between-session work: Self-monitoring, meal plans, behavioural experiments
Session profile
Common uses and suitability
What problems it is commonly used for
Who this therapy may suit best
- Individuals able to engage with structured behavioural change
- Those motivated to tackle ED rules and routines
- Adults and older adolescents
When it may need adapting or may not be suitable
- High medical instability requires parallel medical management
- Severe comorbidity may need stabilisation first
Where this therapy may not be enough
CBT-E is not designed for severe medical instability without parallel medical management. Complex comorbidity may require additional approaches.
What happens in therapy
Real-Time Self-Monitoring
Writing down what you eat, when, and what you’re thinking and feeling — in real time, not from memory.
Regular Eating
Establishing a pattern of eating regularly throughout the day to break the restrict–binge cycle.
Exposure to Feared Foods
Gradually introducing foods you’ve been avoiding, reducing their power over you.
Evidence Base
Guideline support
Present in many ED pathways. NICE NG69 recommends CBT-ED as a treatment for bulimia nervosa and binge eating disorder.
Strength of evidence
Strong for bulimia nervosa and binge eating disorder; more variable for anorexia nervosa.
Limitations
Requires ED-specific competence and medical risk governance. Outcomes for anorexia are more variable.
Evidence claims by condition
CBT-E is one of the most recommended treatments for bulimia, helping break the restrict–binge–purge cycle.
Resources & Printables
For Adults
Regular Eating Plan
A template for establishing regular eating patterns.
Self-Monitoring Record
A real-time eating and thought monitoring sheet.
Food Fear Ladder
A graded exposure tool for feared foods.
ED Relapse Prevention Plan
A structured plan for maintaining recovery.
For Teenagers (12–17)
For Parents & Caregivers
Practitioner & Training Notes
Typical professional background
Specialist ED clinicians with CBT-E training.
Recognised training routes
CBT-E training through Fairburn’s programmes and specialist ED centres. Requires supervised practice.
Registration considerations
Core professional registration plus ED specialist competencies.
Source Registry
Link and cite; do not reproduce large sections verbatim.
Last evidence review: January 2026. All sources are verified and checked on a scheduled cadence.