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Abstract
This systematic review examined evidence on the effectiveness of Cognitive Behavioral Therapy (CBT) for adolescents with eating disorders, considering gender differences. Eating disorders, characterized by disturbances in eating behavior, weight, and body image, are serious psychopathological conditions that may result in severe physical, psychological, and social consequences, including mortality. CBT is among the leading therapeutic interventions, targeting the identification and modification of maladaptive cognitions and behaviors related to eating. Relevant studies were retrieved from Scopus, PubMed, and LILACS, screened using the Rayyan platform, and appraised for methodological quality with the CASPe guidelines. Findings suggest that gender-related cultural and cognitive factors shape treatment outcomes, as reflected in patients’ concerns and symptomatology. Nonetheless, research remains limited regarding males and other gender identities, underscoring a significant gap in the literature. This review was independently funded without external support.
References
Alosaimi, F. D., Al-Sultan, O. A., Alghamdi, Q. A., Almohaimeed, I. K., & Alqannas, S. I. (2014). Gender-specific differences in depression and anxiety symptoms and help-seeking behavior among gastroenterology patients in Riyadh, Saudi Arabia. Neurosciences Journal, 19(3), 203. http://nsj.org.sa/content/19/3/203.abstract
Arija-Val, V., Santi-Cano, M. J., Novalbos-Ruiz, J. P., Canals, J., & Rodríguez-Martín, A. (2022). Caracterización, epidemiología y tendencias de los trastornos de la conducta alimentaria. Nutrición Hospitalaria, 39, 8–15. https://doi.org/10.20960/nh.04173
Baker, J. H., Freestone, D., Cai, K., Silverstein, S., Urban, B., & Steinberg, F. D. (2024). Eating disorder clinical presentation and treatment outcomes by gender identity among children, adolescents, and young adults. Journal of Adolescent Health, 75(2), 254–260. https://doi.org/10.1016/j.jadohealth.2023.11.015
Beck, A. T., & Haigh, E. A. P. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1–24. https://doi.org/10.1146/annurev-clinpsy-032813-153734
Beckers, D., Burk, W. J., Larsen, J. K., & Cillessen, A. H. N. (2025). Friends’ influence on adolescents’ loss of control eating: The moderating role of self-esteem, fear of negative evaluation, and body dissatisfaction. Journal of Research on Adolescence, 35(1). https://doi.org/10.1111/jora.70005
Cabello, J. (2022). Lectura crítica de la evidencia clínica. Elsevier.
Calcaterra, V., Magenes, V. C., Basso, M., Conte, V., Maggioni, G., Russo, S., De Silvestri, A., Fabiano, V., Marrocco, E. A., Veggiotti, P., & Zuccotti, G. (2024). Eating disorder risks and psychopathological distress in Italian high school adolescents. Italian Journal of Pediatrics, 50(1). https://doi.org/10.1186/s13052-024-01717-7
Calugi, S., & Dalle Grave, R. (2019). Body image concern and treatment outcomes in adolescents with anorexia nervosa. International Journal of Eating Disorders, 52(5), 582–585. https://doi.org/10.1002/eat.23031
Calugi, S., Grave, A. D., Conti, M., Dametti, L., Chimini, M., & Grave, R. D. (2023). The role of weight suppression in intensive enhanced cognitive behavioral therapy for adolescents with anorexia nervosa: A longitudinal study. International Journal of Environmental Research and Public Health, 20(4). https://doi.org/10.3390/ijerph20043221
Chang, P. G. R. Y., Delgadillo, J., & Waller, G. (2021). Early response to psychological treatment for eating disorders: A systematic review and meta-analysis. Clinical Psychology Review, 86. https://doi.org/10.1016/j.cpr.2021.102032
Cibich, M., & Wade, T. D. (2019). Treating bulimia nervosa in the context of gender dysphoria using 10-session cognitive behavior therapy. International Journal of Eating Disorders, 52(5), 602–606. https://doi.org/10.1002/eat.23068
Cohn, L., Stuart, B. M., Andrew, W., & Wooldridge, T. (2016). Including the excluded: Males and gender minorities in eating disorder prevention. Eating Disorders, 24(1), 114–120. https://doi.org/10.1080/10640266.2015.1118958
Cowdrey, F. A., & Davis, J. (2016). Response to Enhanced Cognitive Behavioural Therapy in an Adolescent with Anorexia Nervosa. Behavioural and Cognitive Psychotherapy, 44(6), 717–722. https://doi.org/10.1017/S1352465815000740
Dahill, L. M., Morrison, N. M. V., Touyz, S., Mitchison, D., Bussey, K., Mannan, H., & Hay, P. (2023). An exploration of how adolescents experience and reason their parents’ comments on their weight, shape, and eating. Journal of Adolescence, 95(7), 1488–1504. https://doi.org/10.1002/jad.12221
Hernández, R., Fernández, C., & Baptista, P. (2014). Metodología de la investigación. McGraw-Hill.
Kambanis, P. E., Graver, H., Palmer, L. P., Stern, C. M., Tabri, N., Dunford, A., Burton-Murray, H., Breithaupt, L., Wang, S. B., Rossman, S. M., Mancuso, C. J., Andrea, A. M., Waller, G., Freid, C. M., Eddy, K. T., Thomas, J. J., & Becker, K. R. (2025). Patterns of symptom change in behaviors and cognitions during 10-session cognitive behavioral therapy (CBT-T) for non-underweight eating disorders. International Journal of Eating Disorders, 58(7), 1392-1398. https://doi.org/10.1002/eat.24429
Keegan, E., Waller, G., & Wade, T. D. (2022). A systematic review and meta-analysis of a 10-session cognitive behavioural therapy for non-underweight eating disorders. Clinical Psychologist, 26(3), 241–254. https://doi.org/10.1080/13284207.2022.2075257
Kolar, D. R., & Mebarak, M. (2022). An update on the epidemiology of eating disorders in Latin America: Current findings and future challenges. Current Opinion in Psychiatry, 35(6), 385–389. https://doi.org/10.1097/YCO.0000000000000813
Lucassen, M. F. G., Stasiak, K., Fleming, T., Frampton, C., Perry, Y., Shepherd, M., & Merry, S. N. (2020). Computerized cognitive behavioural therapy for gender minority adolescents: Analysis of the real-world implementation of SPARX in New Zealand. Australian & New Zealand Journal of Psychiatry, 55(9), 874–882. https://doi.org/10.1177/0004867420976846
Morán, C., Victoriano, M., Parra, J., Ibacache, X., Pérez, R., Sánchez, J., Sáez, K., & Mosso, C. (2024). Insatisfacción corporal, autoestima, sintomatología depresiva y estado nutricional en adolescentes. Andes Pediatrica, 95, 69–76.
Nagata, J. M., Ganson, K. T., & Murray, S. B. (2020). Eating disorders in adolescent boys and young men: An update. Current Opinion in Pediatrics, 32(4), 476–481. https://doi.org/10.1097/MOP.0000000000000910
Ohmann, S., Popow, C., Wurzer, M., Karwautz, A., Sackl-Pammer, P., & Schuch, B. (2013). Emotional aspects of anorexia nervosa: Results of prospective naturalistic cognitive behavioral group therapy. Neuropsychiatrie, 27(3), 119–128. https://doi.org/10.1007/s40211-013-0065-7
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 5(1). https://doi.org/10.1186/s13643-016-0384-4
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372(71). https://doi.org/10.1136/bmj.n71
Parker, L. L., & Harriger, J. A. (2020). Eating disorders and disordered eating behaviors in the LGBT population: A review of the literature. Journal of Eating Disorders, 8(1). https://doi.org/10.1186/s40337-020-00327-y
Pretorius, N., Arcelus, J., Beecham, J., Dawson, H., Doherty, F., Eisler, I., Gallagher, C., Gowers, S., Isaacs, G., Johnson-Sabine, E., Jones, A., Newell, C., Morris, J., Richards, L., Ringwood, S., Rowlands, L., Simic, M., Treasure, J., Waller, G., … & Schmidt, U. (2009). Cognitive-behavioural therapy for adolescents with bulimic symptomatology: The acceptability and effectiveness of internet-based delivery. Behaviour Research and Therapy, 47(9), 729–736. https://doi.org/10.1016/j.brat.2009.05.006
Rasmussen, S. M., Clausen, L., Pop, M. L., Højgaard, A. D., Kjeldsen, M. K., & Telléus, G. K. (2025). Eating disorder symptomatology among transgender and gender-diverse individuals: A cross-sectional study. Journal of Eating Disorders, 13(1). https://doi.org/10.1186/s40337-025-01212-2
Schapman-Williams, A. M., & Lock, J. (2007). Using cognitive-behavioral therapy to treat adolescent-onset bulimia nervosa: A case study. Clinical Case Studies, 6(6), 508–524. https://doi.org/10.1177/1534650107296822
Sepúlveda, M. I., Nadeau, J. M., Whelan, M. K., Oiler, C. M., Ramos, A., Riemann, B. C., & Storch, E. A. (2017). Intensive family exposure-based cognitive-behavioral treatment for adolescents with anorexia nervosa. Psicothema, 29(4), 433–439.
Strobel, C., Quadflieg, N., Naab, S., Voderholzer, U., & Fichter, M. M. (2019). Long-term outcomes in treated males with anorexia nervosa and bulimia nervosa—A prospective, gender-matched study. International Journal of Eating Disorders, 52(12), 1353–1364. https://doi.org/10.1002/eat.23151
Strobel, C., Quadflieg, N., Voderholzer, U., Naab, S., & Fichter, M. M. (2018). Short- and long-term outcome of males treated for anorexia nervosa: A review of the literature. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 23(5), 541–552. https://doi.org/10.1007/s40519-018-0538-6
Sysko, R., & Hildebrandt, T. (2011). Enhanced cognitive behavioural therapy for an adolescent with purging disorder: A case report. European Eating Disorders Review, 19(1), 37–45. https://doi.org/10.1002/erv.1044
Thornborrow, T., Evans, E. H., Tovee, M. J., & Boothroyd, L. G. (2022). Sociocultural drivers of body image and eating disorder risk in rural Nicaraguan women. Journal of Eating Disorders, 10(1). https://doi.org/10.1186/s40337-022-00656-0
UNESCO. (2021). Género, medios & TIC: Nuevos enfoques de investigación, educación & capacitación.
Unikel-Santoncini, C., Bojorquez-Chapela, I., Hernández-Serrato, M. I., & Villalobos-Hernández, A. (2022). Disordered eating behaviors and psychological correlates: Data from the Ensanut 2018-19. Salud Pública de México, 64(5), 471–477. http://dx.doi.org/10.21149/13464
Waller, G., & Beard, J. (2024). Recent advances in cognitive-behavioural therapy for eating disorders (CBT-ED). Current Psychiatry Reports, 26(7), 351–358. https://doi.org/10.1007/s11920-024-01509-0
Wergeland, G. J., Ghaderi, A., Fjermestad, K., Enebrink, P., Halsaa, L., Njardvik, U., Riise, E. N., Vorren, G., & Öst, L.-G. (2025). Family therapy and cognitive behavior therapy for eating disorders in children and adolescents in routine clinical care: A systematic review and meta-analysis. European Child & Adolescent Psychiatry, 34(3), 883–902. https://doi.org/10.1007/s00787-024-02544-1
Yildirim, A. B. E., Gündo?du, Ü., & Ero?lu, M. (2025). Myths regarding gender differences in eating disorders in adolescents. Turk Psikiyatri Dergisi, 36(1). https://doi.org/10.5080/u27259
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