Eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder and avoidant restrictive food intake disorder (ARFID) are the four most common eating disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V). When it comes to deciding between DBT vs. CBT there are a couple of things to consider. Eating disorders, particularly anorexia nervosa is known to have the highest mortality rate of any mental health disorder. Eating disorders are often associated with other mental health disorders such as depression, bipolar disorder, anxiety, self-harm, and substance abuse disorder. In fact, studies have shown that approximately 30% of individuals who binge and purge, a classic maladaptive behavior in both anorexia and bulimia nervosa, also participate in self-harm behaviors such as cutting. At least 30 million individuals of all ages and genders in the United States are diagnosed with an eating disorder, which is approximately 8% of the population, which equals out to 20 million women and 10 million men. Psychotherapy is the mainstay treatment for eating disorders for individuals of all ages. The goal of psychotherapy is to help individuals learn healthy, adaptive ways to regulate emotions and analyze and restructure behaviors that are the result of emotional dysregulation while focusing on increasing mindfulness and tolerate distress.

Dialectal behavioral therapy (DBT)

Dialectical behavior therapy (DBT) provides clients with new skills to manage painful emotions and decrease conflict in relationships. Dialectical behavioral therapy encourages change but also promotes acceptance. The term dialectic means that two opposite ideas can be correct at the same time. This is helpful for individuals in eating disorder treatment as most of these clients adopt an “all or nothing view”. The dialectical view appeals to many as they navigate recovery; they can accept their difficulties and work towards changing them. Individuals learn to avoid either/or thinking (“I’m either recovered or I’m stuck with this eating disorder forever”) which can help them challenge other all-or-none thinking typical of an eating disorder. DBT specifically focuses on providing therapeutic skills in four key areas.

  • Mindfulness
  • Emotional regulation
  • Interpersonal effectiveness
  • Distress tolerance.

Mindfulness skills include learning how to make decisions based on both emotional and rational input and reducing judgmental thinking. Distress tolerance helps individuals gain skills for coping with crises, such as distraction and self-soothing. Emotion regulation teaches them to identify different feelings, as well as how to make themselves less vulnerable in the first place to extreme shifts in emotions. Interpersonal effectiveness involves the mastery of assertiveness techniques, including asking for help and challenging task of saying “no” to others.

Cognitive behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) specifically concentrates on patterns of abnormal thinking and distorted beliefs that are the underlying causes for irrational emotions and thought patterns that can lead to mental illness. This key concept for this type of therapy approach lies within the idea that thoughts and feelings are directly related to behavior and therefore gaining control of one’s thoughts and emotions can better dictate their behavior. Negative thoughts are often ingrained in us since early childhood and over time they become automatic. Automatic thoughts are emotion-driven thoughts that enter the mind without individuals being fully aware of them. These automatic thoughts can become relatively fixed over time and as a result, turn into dysfunctional behaviors. The components of cognitive-behavioral therapy include the following:

  • Functional Analysis: The stage of CBT where the individual is learning to identify problematic beliefs.
  • Actual Behaviors: The second stage of CBT where new skills are learned, practiced, and applied to real-world situations
  • Behavior Change: Final phase of CBT that encourage an individual to take steps towards implementing a developmental transformation.


We’re Here for You

If you are struggling or someone you know is struggling, we are here for you. Center for Discovery’s Treatment Centers specialize in treatment for eating disorders, mental health and dual diagnosis treatment with unique treatment programs for every individual to get them on their way to eating disorder recovery.

For more information, resources, or to consult with one of our specialists, call 855.495.3154.