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

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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