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Holistic Therapy Approach

Cognitive Behavioural Therapy

Beating Eating Disorders

Understanding & managing the risks of sports & eating disorders

Allie Outram

MBACP (Accred) . PG Dip . BSc (Hons) . Dip PT


To print the information about about Eating Disorders and Cognitive Behavioural Therapy click the downlload PDF below.  Filename: outram_eating_disorders.pdf outram_eating_disorders.pdf

What are Eating Disorders?

My area of special interest and expertise is eating disorders. I am a Beat Ambassador, sharing their vision that eating disorders can and will be beaten (visit: I have had personal experience of overcoming an eating disorder and now aim to inspire other sufferers and give insight into the complexities of this tenacious and notoriously difficult to treat illness. I have made many media appearances, given presentations, published a book, and written several newspaper and magazine articles about this subject. My aim has been to challenge the stereotypes and stigma that people with eating disorders face, campaign for better services and treatment, and provide information, support and encouragement to those seeking treatment and recovery.

Obesity, anorexia nervosa and bulimia nervosa are medical diagnoses. They are the extreme results of disordered eating, and the latter two need appropriate multidisciplinary team working if your physical health is significantly affected. I am able to provide counselling to those who are aware that their eating habits are not appropriate, and would like to understand how to eat a more varied and socially accepted diet.

Our bodies and minds are connected, if not completely joined. It is understandable therefore that sometimes our feelings and internal turmoil may be expressed physically. You may be aware that you treat your body badly, but it seems to be the only way to cope with the way you feel. You may have a relationship with food that is the most important relationship in your life. As an integrative counsellor and CBT-E practitioner (see below) I will use a model that suits you and your current understanding of your eating concerns. I also will incorporate into our counselling ideas about how you feel you fit into the world and your roles and expectations. I am a qualified nutritionist and can answer or correct any misunderstandings you might have about food, if you want me to. I will not be doing this automatically as my role for you is that of a counsellor.

So what is CBT-E (Enhanced Cognitive Behaviour Therapy or Transdiagnostic CBT for Eating Disorders) and how might it benefit me?

CBT-E is the cutting edge development in CBT treatment especially designed for eating problems and disorders. It differs from standard CBT because it is based on a specific theoretical model of the psychological and behavioural mechanisms that underlie and maintain the eating problems. It is a structured, tailored form of one-to-one talking therapy in which you and your therapist work together as a team. It focuses on helping you change your eating behaviours now and in the future (it does refer to the past but does not centre on it). Generally the twenty sessions version of the treatment is recommended for most people (around five months).

What does it involve?

Initially it has predominantly a behavioural emphasis, the first eight sessions being undertaken twice weekly to give you the best opportunity to break into the eating behaviours. This concentrates on establishing a more regular eating pattern, reducing binge eating and loss of control. This can have the additional effect of reducing preoccupation, anxiety and improving mood. Progress is measured throughout treatment and is anticipated after only four weeks.

The stage two review is an opportunity to assess change and collaboratively design stage three, targeting the maintaining processes that have been identified so far. At this point the frequency reduces to weekly. Section three itself (consisting of eight sessions), addresses concerns about shape and weight, thinking about and developing the life you want to live, rules about food and dealing with event-changes and mood-changes effectively. It may also include more intense work on low self-esteem, clinical perfectionism or interpersonal problems if appropriate.


This is a highly comprehensive treatment but the components are uniquely tailored to your needs. The last few sessions are undertaken on a fortnightly basis addressing how to get back on track when lapses occur and awareness of potential triggers for setbacks in the future. A review session 20 weeks after the end of treatment is an opportunity to discuss how setbacks have been managed and to make recommendations for continued progress.

The standing of CBT-E

Encouragingly with patients who are not significantly underweight (the great majority of adult cases), about 80% complete treatment and of them about three quarters make a full recovery that appears to be well-maintained.

Watch Allie’s recent BACP presentation titled: “Understanding eating disorders” Eating Disorders