Metacognitive Interpersonal Therapy-Eating Disorder (MIT-ED) in the Case of a Woman With Binge Eating Disorder and Avoidant and Obsessive-Compulsive Personality Disorders

Binge Eating Disorder (BED) needs more effective empirically supported treatments, given problems with attrition from and response to available options. One avenue to improve adherence and response is considering comorbid personality disorders, given their impact on the therapy relationship and on patients' capacities to comply with homework, for example, regularizing eating habits or abstaining from bingeing. We describe here the case of a woman in her thirties suffering from BED, and avoidant and obsessive-compulsive personality disorders, treated with Metacognitive Interpersonal Therapy for Eating Disorders (MIT-ED), a psychotherapy that has begun to gather empirical support. Silvia is a 34 year old married woman with two children. She begins psychotherapy to lose weight but she oscillates between restriction and daily binges, in the last 2 years she has gained 30 kg. During 20 sessions of MIT-ED Silvia realized that she tended to binge because she thought she was unworthy and unable to put boundaries to her mother's criticism and intrusions. The therapist helped her realize that following psychoeducation about eating made her feeling controlled, and that was the reason for initial noncompliance with behavioral tasks. During the therapy she formed more adaptive ideas of herself as worthy and autonomous and become able to put boundaries to her mother. At the end of the therapy, Silvia no longer suffered from BED as evident from Eating Disorder Examination Questionnaire (Fairburn and Beglin 2008) and from the Binge Eating Scale (Gormally et al. 1982). Implications for further application of MIT-ED across ED are discussed.