Trauma-Focused Cognitive-Behavioral Therapy for Adolescents Bullied Because of Weight: A Feasibility Study

The objective of this study was to test the feasibility and acceptability of a treatment for weight bullying.

Participants who had experienced weight-related bullying and were currently experiencing traumatic stress were recruited and enrolled in a feasibility trial of trauma-focused cognitive behavioral therapy combined with cognitive-behavioral therapy for eating disorders (TF-CBT-WB). Thirty adolescents (aged 11-17) were determined eligible and 28 began treatment (12 weeks).

This study demonstrated the treatment feasibility and acceptability of TF-CBT-WB for adolescents with traumatic stress following weight-bullying experiences. Overall retention and treatment satisfaction were good. Within-subjects improvements were observed for intrusion symptoms of traumatic stress, global eating-disorder severity, overvaluation of weight/shape, dissatisfaction with weight/shape, dietary restraint, and depression. Clinically-meaningful improvements were attained for several patient outcomes. Clinically-meaningful decreases in functional impairment were attained by more than half of the participants.

Overall, this clinical trial testing TF-CBT-WB for adolescents experiencing traumatic stress following weight-bulling experiences demonstrated therapy feasibility, acceptability, and initial evidence that clinically-meaningful improvements in patient outcomes were feasible. However, some patient outcomes thought to be more central to how the youth viewed the world failed to show improvements, suggesting that additional content related to these constructs might yield greater benefit.

This pilot study was registered on clinicaltrials.gov: NCT04587752, Cognitive-Behavioral Therapy for Weight-related Bullying.