Panel Discussion 9 - When Cognitive Behavioral Therapy Is Insufficient for Eating or Body Image Concerns: Considerations for Minoritized Patients and Those with Comorbidities

Eating disorders are lethal psychiatric illnesses with high rates of impairment and comorbidities. Eating disorders and body image concerns are extremely difficult to treat, with low rates of treatment response and high rates of relapse for those that do respond to treatment. For instance, only about 50% of individuals respond to enhanced cognitive behavioral therapy (CBT-E), the first-line treatment for eating disorders. However, as most individuals presenting for such issues present with comorbid conditions (e.g., anxiety, depression: rates estimated up to 95%), CBT and other evidence-based treatments are often unable to address the complexity of such cases. Furthermore, individuals of various minoritized identities (e.g., race, ethnicity, gender, sexual orientation, weight status) are at an increased risk of developing eating and body image issues, and existing evidence-based treatments have not been developed with these populations in mind. As such, CBT often needs to be modified to meet the demands of patients with comorbidities and holding minority identities. Panelists were chosen to discuss existing gaps in the use of CBT for eating and body image concerns and present on their ongoing efforts and projects to modify CBT to better serve a broader range of populations. First, discussions will focus on why existing first-line treatments do not work for a wide range of individuals. Next, panelists will present on recent projects and case studies focused on modifying treatments to better target comorbid conditions and concerns related to minoritized identities. Additionally, we will discuss future considerations in addressing treatment gaps for diverse populations and provide suggestions for maximizing treatment effectiveness. Finally, the panel will conclude with discussion and questions from the audience.