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Eating disorders like anorexia nervosa (AN), binge eating disorder (BED), and bulimia nervosa (BN) can wreak havoc on the body. But at their core, these issues are mental health conditions residing in the mind.
That's why it's essential for people struggling with eating disorders to receive appropriate mental health treatment. Interpersonal psychotherapy is one of the tools people can use to help them confront the mental and behavioral issues that may be driving their eating disorder.
Interpersonal psychotherapy (IPT) is a method of treatment that focuses on improving someone's interpersonal relationships as a way to help them overcome mental illness.1
IPT is present-focused, meaning it addresses current, ongoing issues as opposed to childhood or earlier trauma. Specifically, the treatment is designed to help people better manage or mitigate:2
Complicated bereavement: Issues associated with grief and loss
Role disputes:Conflicts with one's significant other or other close relationships that cause distress
Role transitions:Changing life circumstances, including beginning or ending a marriage or relationship, having a child, or starting or losing a job
Sometimes, people may need help with something IPT refers to as "interpersonal deficits," or interpersonal struggles that occur outside of the above situations.2
Overall, the goal is to help someone resolve these issues to help them relieve the symptoms of their mental health condition.1
How does interpersonal psychotherapy work?
Like cognitive behavior therapy (CBT) and other popular forms of treatment, IPT is structured and time-limited, meaning treatment follows a predetermined course. This generally includes once-weekly sessions over 12-16 weeks but may vary by condition.1
In the initial phase of treatment, which lasts the first few weeks, therapists work with patients to clarify the situation(s) they want to focus on resolving. Patients will share some aspects of their past and current relationships to determine if they're experiencing a role transition, role dispute, complicated grief, or interpersonal deficits, with the rest of treatment dictated by this designation.2
The middle phase of treatment involves helping patients learn specific strategies for dealing with their situation, including:2
Healthier ways to mourn, whether the loss of a loved one or an old social role
Ideas for resolving interpersonal difficulties
Ways to reduce social isolation
Final sessions involve helping patients prepare for the end of therapy—a role transition in itself—by reviewing successes they may have experienced throughout treatment and the strategies that helped them achieve them.2
Interpersonal psychotherapy and eating disorders
IPT was initially developed to help people struggling with depression, but it's since been adapted to help with other mental health conditions, including various eating disorders.
From an interpersonal context, eating disorders may develop from or be maintained by complicated relationships. The social withdrawal and isolation that can come from poor interpersonal relationships can also help people hide their symptoms and struggle for longer periods.3
Interpersonal psychotherapy for eating disorders follows the same general format as IPT, with an overall goal of helping someone alleviate eating disorder symptoms through improving their interpersonal relationships.
IPT is commonly recommended in cases where binge eating is a symptom of the eating disorder, including cases of bulimia nervosa.3 This may be due to the emotional aspect of binge eating episodes, which can be triggered by negative moods.4
In the case of patients with BN, interpersonal psychotherapy has been found to be an effective tool for decreasing symptoms, albeit over time.
One study showed that patients following IPT treatment were not as initially successful at reducing symptoms after leaving therapy compared to those who did a course in cognitive behavioral therapy. However, by eight months after treatment, the IPT group had significantly improved, catching up to the CBT group.3
By six years after leaving treatment, up to 72% of the IPT patients no longer met the clinical criteria for bulimia nervosa.3
Binge eating disorder is another condition that can benefit from the psychological treatments of IPT.
Studies have shown that people with BED often struggle with assertiveness, the ability to express feelings, the capacity to deal with strangers, and the ability to understand others.4 All these issues can be addressed through the type of interpersonal skills taught in IPT.
In one analysis of how useful IPT can be for treating binge eating disorder, it was found that the treatment helped not only reduce eating disorder behaviors but concerns around weight and shape, as well.4
Along with being one of the most dangerous eating disorders, anorexia nervosa is, unfortunately, one of the most challenging conditions to successfully treat. No one type of therapy has yet shown to be consistently superior to others when treating the disorder.5
There have also been few studies examining the effectiveness of interpersonal psychotherapy for treating AN. In the most prominent one, the treatment method was found to be the least initially effective of the three therapies, which included CBT and non-specific supportive management.3,5
However, as with the bulimia nervosa patients, those with AN were found to get better over time after receiving IPT, with a 6-year follow-up showing modest improvement in symptom reduction for this group.3,5
Is interpersonal psychotherapy right for me?
Interpersonal psychotherapy is one of the leading tools for helping people overcome several mental health disorders, including eating disorders. But, like all forms of therapy, it's not suitable for everyone.
Benefits of interpersonal psychotherapy
When used for eating disorder treatment, IPT has repeatedly been found successful, helping reduce symptoms for those experiencing AN, BN, BED, and other common eating disorders.3,4,5
The therapy is also structured and time-limited, making it potentially easier for patients to prepare for and incorporate into their schedules.
In addition, as an evidence-based treatment, interpersonal psychotherapy may be more likely to be covered by health insurance companies.
Interpersonal psychotherapy disadvantages
Despite the long-term results regularly seen after IPT treatment, many eating disorder patients don't show as much improvement in the short term.3,5
Combined with the therapy's once-a-week schedule, this can potentially make it a poor choice for someone with a more severe eating disorder or someone who requires more therapeutic support.
If you or a loved one are struggling with an eating disorder, it's essential to seek out the appropriate care. Contact us today to see how we can help.
At Within Health, we understand the sensitive nature of eating disorders and how difficult—yet how important—it can be to reach out for help.
Our team of experts comes from a range of backgrounds, helping address the mental, physical, and emotional symptoms of eating disorders in people of all races, ages, genders, and sexual orientations. We offer several therapy programs, including interpersonal psychotherapy.
Our team will work with you to develop an individual treatment plan based on your specific history and needs. You can access your team and schedule from wherever you are through a specialized app, making treatment more accessible and easier to manage. You’ll also get your meals delivered and be able to submit your health vitals remotely.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Resources
Overview of IPT. (n.d.). International Society of Interpersonal Psychotherapy. Accessed November 2023.
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