Emotion acceptance behavior therapy for anorexia nervosa: a pilot study

Objective: This study aimed to evaluate the preliminary effectiveness of Emotion Acceptance Behavior Therapy (EABT), an outpatient psychotherapeutic intervention for anorexia nervosa (AN) based on a disorder-specific model of symptom maintenance that emphasizes emotion avoidance. EABT combines standard behavioral interventions that are central to the clinical management of AN with evidence-supported strategies to increase emotion awareness, decrease emotion avoidance, and encourage resumption of valued activities and relationships outside the eating disorder.

Method: Twenty-four individuals aged ≥17 years with AN were treated using the EABT manual. EABT was delivered in 33-58 individual sessions provided over 38-53 weeks. Assessments were conducted before and after treatment, and at 3- and 6-month follow-ups.

Results: Thirteen patients (54.2%) completed EABT; 11 (45.8%) dropped out or were withdrawn. EABT was associated with significant improvements in weight, disordered eating symptoms, and emotion avoidance that were maintained over 6-month follow-up. The majority of EABT completers achieved a body mass index >18.5 (n = 9/13) or had a normal Eating Disorder Examination Global score (n = 10/13) at post-treatment.

Discussion: Preliminary data suggest that EABT may have utility for a subset of adults with AN. Future research will focus on improving outcomes in EABT nonresponders and identifying of mechanisms that drive treatment response.