Effects of Emotion-Focused Therapy on Weight Restoration and Emotion Regulation in Adolescents With Anorexia Nervosa

To investigate the effects of emotion-focused therapy (EFT) on weight restoration and emotion regulation in adolescents with anorexia nervosa (AN).

This retrospective study included 188 adolescents with AN treated at Chongqing Mental Health Center between January 2023 and December 2025. According to treatment methods, patients were divided into a control group and an EFT group. After screening based on inclusion and exclusion criteria, 60 patients in each group were included in the final analysis. The control group received routine nutritional support, cognitive behavioral therapy, and medication when necessary, while the EFT group additionally received EFT. Both groups were treated for 12 weeks. Body mass index (BMI), nutritional indicators, Eating Attitudes Test-26 (EAT-26), Trait Meta-Mood Scale (TMMS), Generalized Anxiety Disorder-7 (GAD-7), and Children's Depression Inventory-2 (CDI-2) scores were compared between the two groups. Safety outcomes were retrospectively collected from electronic medical records. Multiple linear regression analysis was performed to evaluate the independent association between EFT and BMI improvement.

After 12 weeks of treatment, BMI and nutritional indicators in the EFT group were higher than those in the control group, while the EAT-26 scores were significantly lower (all p < 0.05). At weeks 4, 8, and 12, TMMS scores in the EFT group were significantly higher, while GAD-7 and CDI-2 scores were significantly lower than those in the control group (all p < 0.05). No significant between-group differences were observed in refeeding syndrome or readmission rates (all p > 0.05). Multiple linear regression analysis showed that EFT remained independently associated with higher BMI at week 12 after adjustment for baseline BMI, age, sex, and olanzapine use (β = 0.382, p < 0.05). Moderate-to-large effect sizes were observed for major outcome measures (Cohen's d = 0.77-1.23).

EFT combined with routine nutritional support and psychotherapy may be associated with improved weight restoration, emotional regulation, nutritional status, and reduced anxiety and depressive symptoms in adolescents with AN. However, due to the retrospective single-center design and limited sample size, further prospective studies are warranted to confirm these findings.