Q & A: DBT and Eating Disorders

Q: I’ve heard a lot about Dialectical Behavior Therapy (DBT). Does it have any application to eating disorders? (L.S., Boston)

A: Dialectical behavior therapy, a psychotherapeutic treatment that teaches adaptive skills to enhance emotional regulation capabilities, was designed by Marsha Linehan at the University of Washington and has been shown to be effective for treating patients with borderline personality disorders who exhibit parasuicidal behaviors (see the article on p. 1). Because it’s been empirically proven, others have been interested to see whether this therapy might help for other clinical conditions, especially where patients have chaotic temperaments and problems. Several treatment programs have experimented with this approach for eating disorders patients. Wonderlich and associates at the University of North Dakota are incorporating features of DBT in a research program for patients with multi-impulsive bulimia nervosa and on the basis of preliminary observations suggest that it’s quite helpful. Recently, a modified form of DBT, 2-hour group sessions for 20 weeks, was found to be effective for treating women with binge eating disorder, 89% of whom stopped binge eating by the end of treatment (J Consulting and Clin Psychology 2002; 69: 1061). Although at six-month follow-up abstinence rates were down to 56%, this is still a promising approach. Those interested in learning more are advised to read Linehan’s work and treatment manuals.

— JY