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Maintenance treatment for anorexia nervosa: A comparison of cognitive behavior therapy and treatment as usual

  1. Jacqueline C. Carter PhD1,2,*,
  2. Traci L. McFarlane PhD1,2,
  3. Carmen Bewell MA1,3,
  4. Marion P. Olmsted PhD1,2,
  5. D. Blake Woodside MD1,2,
  6. Allan S. Kaplan MD1,2,4,
  7. Ross D. Crosby PhD5

Article first published online: 23 OCT 2008

DOI: 10.1002/eat.20591

Issue

International Journal of Eating Disorders

International Journal of Eating Disorders

Volume 42, Issue 3, pages 202–207, April 2009

Additional Information

How to Cite

Carter, J. C., McFarlane, T. L., Bewell, C., Olmsted, M. P., Woodside, D. B., Kaplan, A. S. and Crosby, R. D. (2009), Maintenance treatment for anorexia nervosa: A comparison of cognitive behavior therapy and treatment as usual. International Journal of Eating Disorders, 42: 202–207. doi: 10.1002/eat.20591

Author Information

  1. 1

    Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, Canada

  2. 2

    Department of Psychiatry, University of Toronto, Toronto, Canada

  3. 3

    Department of Clinical Psychology, York University, Toronto, Canada

  4. 4

    Center for Addiction and Mental Health, Toronto, Canada

  5. 5

    Neuropsychiatric Research Institute, Fargo, North Dakota

*Toronto General Hospital, 200 Elizabeth Street EN8-241, Toronto, Ontario, M5G 2C4, Canada

Publication History

  1. Issue published online: 4 MAR 2009
  2. Article first published online: 23 OCT 2008
  3. Manuscript Accepted: 13 AUG 2008

Funded by

  • The Canadian Institutes of Health Research. Grant Numbers: MOP-44041, MH060271
  • The National Institutes of Health
  • The Ontario Mental Health Foundation

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Keywords:

  • anorexia nervosa;
  • cognitive behavior therapy;
  • relapse prevention

Abstract

Objective

The aim of this study was to compare two maintenance treatment conditions for weight-restored anorexia nervosa (AN): individual cognitive behavior therapy (CBT) and maintenance treatment as usual (MTAU).

Method

This study was a nonrandomized clinical trial. The participants were 88 patients with AN who had achieved a minimum body mass index (BMI) of 19.5 and control of binge eating and purging symptoms after completing a specialized hospital-based program. Forty-six patients received 1 year of manualized individual CBT and 42 were in an assessment-only control condition (i.e., MTAU) for 1 year. This condition was intended to mirror follow-up care as usual. Participants in both the conditions were assessed at 3-month intervals during the 1-year study. The main outcome variable was time to relapse.

Results

When relapse was defined as a BMI ≤ 17.5 for 3 months or the resumption of regular binge eating and/or purging behavior for 3 months, time to relapse was significantly longer in the CBT condition when compared with MTAU. At 1 year, 65% of the CBT group and 34% of the MTAU group had not relapsed.

Discussion

The current findings provide preliminary evidence that CBT may be helpful in improving outcome and preventing relapse in weight-restored AN. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009

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