IntroductionEnhanced cognitive behaviour therapy (CBT-E) is a recommended treatment for different eating disorders (ED) with a strong evidence base from randomized controlled trials (RCT) and meta-analyses for especially Bulimia nervosa (BN) and Binge eating disorder (BED). Less is known about theeffectiveness of CBT-E in patients with various ED-diagnoses and in real-world settings.

AimThe aim of this present study was to investigate if CBT-E is an effective treatment of EDs in a real-worldsetting.

MethodsPsycINFOand PubMedwere searched for studies from 2008 until February 2024, where adults or adolescents diagnosed with an ED, were treated with CBT-E in a real-worldsetting. From the studies data of remission and assessment of symptoms were extracted. The within group effect size (Cohens d) was calculated based on symptoms and ED-behaviours.

Results31 studies with a total of 4,042 adult and adolescent participants were included. The remission rate was 57.0% for treatment completers and 32.7% for the intention to treat (ITT) population. Both treatment completers and the ITT obtained a large within group effect size post treatment, 1.58 and 1.30. In total 65.4% of the participants completed the CBT-E treatment.

ConclusionCBT-E delivered as a treatment of EDs in real-world settings led to symptom reduction with large effect sizes. The remission rates were comparable with rates in previous meta-analysesof both effectiveness and efficacy studies.