The efficacy of compassion focused therapy in eating disorders: a systematic review of the literature

Journal article : Review

Background: Compassion Focused Therapy (CFT) is an evolution-informed intervention designed to address high levels of shame and self-criticism, which are common in eating disorders (EDs). Given the mixed findings of current ED treatments and the absence of prior systematic reviews on CFT in this context, this review aimed to critically evaluate its clinical outcomes. Method: A systematic search of databases was conducted, including PsychINFO, MEDLINE, PubMed, CINAHL, Cochrane Library, and Scopus. Grey literature databases were searched including CORE, PsyArVix Preprints, and BASE. The last search was conducted in February 2025. Studies were included where a quantitative outcome was reported following CFT in participants with any ED diagnosis, across the lifespan. A narrative approach was employed to synthesize the results and the Downs and Black (1998) checklist was used to assess the quality of included studies. Results: Twenty-three studies (8 randomized controlled trials, 2 uncontrolled trials, and 13 quasi-experimental) were included. Eighteen papers were English language, and most participants were adult females. Overall, CFT led to a reduction in ED core psychopathology, including across the EDE-Q subscales, as well as improvements in self-compassion and body image, and a decrease in shame. Evidence for change to body mass index was mixed. Results from trials varied in how effective this treatment was relative to other treatment modalities. Conclusion: There is preliminary evidence to support CFT as an effective treatment for adults with a range of ED diagnoses. However, the limited number of comparisons to evidence-based interventions and small sample sizes means there is limited evidence that CFT is as effective as current first-line treatments. Future research may benefit from larger sample sizes; direct comparisons of CFT to evidence-based interventions; standardizing outcomes; and exploring for whom CFT is most effective.

Authors: Stock, M; Beaman, L; Moreton, R; Holland-Borosh, C; Hartland, H

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BioMed Central
• Journal: Journal of Eating Disorders
• Volume: 13
• Issue: 1
• Article number: 235
• Publication date: 2025-10-23
• Acceptance date: 2025-09-23
• DOI: 10.1186/s40337-025-01418-4
• EISSN: 2050-2974
• ISSN: 2050-2974
• Language: English
• Keywords: Eating disorders; Anorexia nervosa; Bulimia nervosa; Self-compassion; Systematic review; Binge eating disorder; Compassion focused therapy
• Subtype: Review