EMDR vs CBT in the treatment of anorexia nervosa: A preliminary study


In working with clients with anorexia nervosa for the past 18 months, it has become apparent that while many clinicians continue to utilise a variety of treatment means, CBT or systemic family therapy are often treatments most frequently offered to the sufferer. However, what does appear to be consistent is the general view (e.g., Waller; Treasure; Brewer) that ‘recovery’ will take an average between 1 to 2 years with many clients suffering from this disorder never making a full or complete recovery.

With this in mind, sixteen clients with a previous diagnosis of anorexia nervosa and under medical supervision with a BMI of 16.5 – 18 and still meeting the mental criteria of anorexia nervosa (DSM IV) were offered either EMDR (N.10) or CBT (N.6). Starting with the premise that most sufferers of anorexia nervosa argued that simply ‘eating’ is not the answer – but rather the mechanism by which control is maintained – it was agreed that regular weigh-ins and the use of food journals would form part of the study – however, no therapeutic emphasis would be placed directly on food in either the CBT or the EMDR group.

Those receiving EMDR recovered substantially quicker and with less food-related exposure, once the target memory precipitating the anorexic onset was identified. Interestingly, food intake and weight increased without needing to be targeted as a separate matter, once the ‘feeder’ memory had been adapted in 8 out of the 10 EMDR clients. In the remaining two clients, behavioural experiments targeting the “practice of behaving (and eating) normally’ one day a week in order to reduce the fear of ‘normality’ was used with good effect.

Whilst the CBT group did improve, they continued to fluctuate in terms of active anorexic patterns of behaviour and their weight or food intake did not appear to improve significantly.

Although the trial lasted for 6 months duration, on average, the EMDR group reached ‘recovery’ at around 3-4 month mark, compared to the CBT group of which five noticed ‘improvement,’ however, did not appear to have increased weight and still reported phobic reactions to both body-mage and food at the 4 month mark. One in the CBT group did make a significant improvement based on cognitive restructuring alone and this client did increase weight and intake significantly at the same ratio as the EMDR group.

At the initial 1-month follow-up post-study, the CBT group were still exhibiting symptoms of mental pre-occupation with diet/weight compared to the EMDR group who had reached normal BMI ranges (N.9) and all reported little to no pre-occupation with diet/eight.

Although this study is still pending follow-ups of all clients, there would appear, on the basis of this preliminary study that anorexia nervosa appears to respond better to EMDR in shorter treatment duration than CBT.

Furthermore, six of the EMDR group reposed using safe-space imagery to reduce their anxieties surrounding food and this may have been a contributory factor.






Susan Darker-Smith

Original Work Citation

Darker-Smith, S. (2007, June). EMDR vs CBT in the treatment of anorexia nervosa: A preliminary study. Presentation at the 8th EMDR Europe Association Conference, Paris, France



“EMDR vs CBT in the treatment of anorexia nervosa: A preliminary study,” Francine Shapiro Library, accessed October 24, 2020, https://emdria.omeka.net/items/show/19334.

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