Comparison of the Effectiveness of Cognitive Therapy and Schema Therapy in Weight Reduction among Women with Bulimia Nervosa

Reza Shakeri; Azra Ghaffari; Vakil Nazari

Authors

Reza Shakeri Department of Psychology, Ard.C., Islamic Azad University, Ardebil, Iran Author https://orcid.org/0009-0004-4800-3072
Azra Ghaffari Department of Psychology, Ard.C., Islamic Azad University, Ardebil, Iran Corresponding Author https://orcid.org/0000-0002-5927-1003
Vakil Nazari Department of Psychology, Ard.C., Islamic Azad University, Ardebil, Iran Author https://orcid.org/0009-0003-6832-0561

Keywords:

Cognitive Therapy, Schema Therapy, Weight Reduction, Bulimia Nervosa, Women

Abstract

Objective: This study aimed to compare the effectiveness of cognitive therapy and schema therapy in reducing weight among women with bulimia nervosa.

Methods and Materials: This experimental study employed a pretest–posttest design with a nonequivalent control group and follow-up assessment. The statistical population consisted of overweight women with bulimia nervosa who attended nutritional counseling and psychological centers in District 13 of Tehran during 2022–2024. Using convenience sampling and based on body mass index (BMI) and diagnostic criteria for bulimia nervosa, 51 eligible participants were selected according to Cochran’s formula. Participants were randomly assigned to two experimental groups and one control group. Weight was assessed at baseline as the pretest measure. Experimental Group A received cognitive therapy, whereas Experimental Group B received schema therapy; the control group was placed on a waiting list and received no intervention during the study period. Following completion of the interventions, posttest and follow-up assessments were conducted. Data were analyzed using repeated-measures analysis of variance and Bonferroni post hoc tests in SPSS version 22.

Findings: Repeated-measures analysis of variance demonstrated that both cognitive therapy and schema therapy produced statistically significant reductions in weight among women with bulimia nervosa compared with the control condition. The significant therapeutic effects were maintained at the follow-up assessment, indicating persistence of the treatment gains over time. However, the between-group comparison of the two active interventions revealed no statistically significant difference between cognitive therapy and schema therapy in their effectiveness for weight reduction. Thus, although both interventions were significantly more effective than the control condition, neither therapeutic approach demonstrated statistical superiority over the other.

Conclusion: Cognitive therapy and schema therapy appear to be effective psychological interventions for supporting weight reduction among overweight women with bulimia nervosa, with treatment effects remaining evident during follow-up. The absence of a significant difference between the two interventions suggests that both approaches may represent viable therapeutic options.

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