Dialectical behavior therapy in eating disorders

Abstract

Dialectical Behavior Therapy (DBT) has been adapted for a variety of mental disorders characterized by emotional dysregulation and, in recent decades, also for eating disorders (EDs).

Objective: To update the evidence on the efficacy of DBT in EDs.

Method: A search was conducted in PubMed, ScienceDirect, WoS, and Scopus databases using keywords: (eating disorders OR anorexia nervosa OR bulimia nervosa OR binge eating disorder) AND (dialectical behavior therap* OR DBT), covering from 2011 to 2025, following the PRISMA guideline.

Results: A total of 833 studies were found, and 20 of them were selected for review. DBT appears to be most effective in Binge Eating Disorder, reducing the binge frequency. In Bulimia, improvements were observed in subscales related to ineffectiveness, interoceptive awareness, and a decrease in vomiting frequency. In Anorexia Nervosa, the results were not statistically significant when compared to an active control group.

Conclusions: Empirical evidence suggests positive outcomes from DBT, especially in Binge Eating Disorder, as measured by a reduction and, in some cases, abstinence from binge episodes in the past 28 days.