Exposure therapy for eating disorders: A systematic review
The current paper reviews the literature on exposure interventions for eating disorders, including studies on exposure and response prevention, in vivo feared food exposure, mirror exposure, family-based treatment with exposure, and virtual reality exposure therapy.
Abstract
Exposure therapy is a potential method for the treatment of eating disorders. The current paper reviews the literature on exposure interventions for eating disorders, including studies (N = 60) on exposure and response prevention (ERP), in vivo feared food exposure, mirror exposure, family-based treatment with exposure, and virtual reality exposure therapy. Mirror exposure alone or in the context of cognitive-behavioral therapy (CBT) can decrease body dissatisfaction. The few controlled trials on ERP for binge and purge cues show only marginal benefit of ERP for binge or purge cues over and above other treatment methods such as CBT. In vivo exposure to feared foods may decrease state anxiety and increase caloric intake and body mass index, but research is limited. Virtual reality exposure could improve accessibility and feasibility of exposures in the clinical setting. A significant portion of the trials incorporated exposures into an overarching treatment such as CBT, body image therapy, or inpatient treatment, so the effects of exposure itself are difficult to parse apart. We discuss the state of the current literature in the context of learning theory and offer insights into new approaches to the application of exposure therapy in an eating disordered population.