The Meta-Analytic Evidence Is In-Time to Get on and Improve Our Treatments.

Abstract

The good news is that Bruns and colleagues' robust meta-analysis of randomized controlled trials (RCTs) of individual Cognitive-Behavioral Therapy (CBT) for eating disorders has provided us with evidence congruent with other recent meta-analyses in this area. The emerging message, however, holds up an unflattering mirror reflecting the following regarding the use of CBT with eating disorders; we do not know whether to use CBT with adults who have anorexia nervosa; CBT is better than doing nothing with the other eating disorder diagnostic groups; any form of therapist input will suffice as the length and intensity of the CBT make no difference to outcomes; all evidence-based therapeutic approaches seem to perform just as well as CBT. The field needs to rise to the challenge to offer something more informative for clinicians and consumers alike, and three research strategies to achieve this are described. Evidence-based approaches to improving overall outcomes of all our therapies for eating disorders are also described. The use of these approaches in our existing therapies can be evaluated to examine whether these achieve improved remission rates. The challenge for our research community is not in producing further meta-analyses but in improving CBT for people with eating disorders.