Maintenance Treatment for Anorexia Nervosa: A Comparison of Cognitive Behavior Therapy and Treatment as Usual

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. (C) 2008 by Wiley Periodicals, Inc.