Is Art Therapy an Effective Treatment for Eating Disorders?

Emily Weekes

There has been a sharp rise in the prevalence of eating disorders (Hay et al., 2023). A particularly high rate of eating disorder patients (up to 70%) choose to drop out of traditional talking therapies (e.g., cognitive behavioural therapy) (Fassino et al., 2009; Heywood et al., 2022), and eating disorders have a high relapse rate, with published estimates ranging from 22% to 63% (McFarlane et al., 2008). This suggests that research into alternative treatment options would be beneficial for those struggling with eating disorders.

​

Feelings of shame are closely associated with the formation and maintenance of eating disorders (Troop & Redshaw, 2012). Talking therapies alone are often not enough to express and work through the complexity of feelings of shame (Greenberg & Iwakabe, 2011). Griffin et al. (2023) hypothesised that art therapy could address eating disorder patients' feelings of shame by allowing them to visually represent their feelings and feel empowered through movement, sensory and symbolic activities.

​

Summary of Griffin et al. (2023) - Art therapy and eating disorders: A mixed methods feasibility study

Griffin et al. (2023) conducted a feasibility study to explore whether a large-scale randomised controlled trial that investigates the impacts of art therapy on eating disorders would be feasible. Besides gaining an understanding of the feasibility, they also gained insights into the impacts of art therapy on those with anorexia nervosa.

​

Researchers obtained a sample of nine 18–43-year-old women diagnosed with anorexia nervosa (AN) that were part of a Day Patient Program at the Royal Melbourne Hospital. The participants took part in twice-weekly 1.5-hour group art therapy sessions for 8 weeks. They were interviewed by the researchers on week 4 and week 8 of the art therapy programme. They were also asked to complete questionnaires using the Experience of Shame Scale (Andrews et al., 2002) before the study began and at weeks 2, 4, 6 and 8.

​

A thematic analysis of the interviews demonstrated that participants responded very well to the art therapy sessions. General themes suggested that art therapy promotes self-regulation, flexible attitudes and self-expression while allowing for the exploration of unfamiliar areas of the self and challenging the perfectionistic ideals that are very often seen in patients with eating disorders. Many participants also reported feeling empowered and accomplished. They explained that the non-verbal element of art therapy was helpful when they struggled to vocalise what they were feeling but felt that they needed a release. Participants also responded well to the group environment and seeing others’ points of view. Results showed no adverse effects of the art therapy sessions on the participants.

​

Despite this, researchers found that there was a large amount (over 40%) of missing data due to very high attrition rates (5 participants left the study as they withdrew from the Day Patient Program), meaning that hypothesis testing of questionnaire results was not conducted, and trends in data were instead discussed descriptively. Trends in the Experience of Shame Scale questionnaire showed that participants’ levels of shame were lower after they started the art therapy sessions.

Overall, it was concluded that while art therapy sessions were practical to run and could facilitate self-expression, accomplishment and flexibility in participants, conducting large-scale studies on the effectiveness of art therapy for adults with eating disorders would be feasible only if high rates of attrition and missing data could be resolved.

​

It seems that art therapy may be an effective way of allowing those with eating disorders to non-verbally express themselves and challenge perfectionistic ideals. However, the study discussed had an extremely small sample size and focused only on the impacts of art therapy on those with anorexia nervosa. Therefore, further research into the impacts of art therapy on those with other eating disorders, and on larger sample sizes should be conducted.

​

References 
 

Andrews, B., Qian, M., & Valentine, J. D. (2002). Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale. British Journal of Clinical Psychology, 41(1), 29-42.

​

Fassino, S., Pierò, A., Tomba, E., & Abbate-Daga, G. (2009). Factors associated with dropout from treatment for eating disorders: a comprehensive literature review. BMC Psychiatry, 9, 1-9.

​

Greenberg, L. S., & Iwakabe, S. (2011). Emotion-focused therapy and shame.

​

Griffin, C., Fenner, P., Landorf, K. B., & Cotchett, M. (2023). Art therapy and eating disorders: A mixed methods feasibility study. The Arts in Psychotherapy, 82, 101994.

​

Hay, P., Aouad, P., Le, A., Marks, P., Maloney, D., Touyz, S., & Maguire, S. (2023). Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia—a rapid review. Journal of Eating Disorders, 11(1), 23.

​

Heywood, L., Conti, J., & Hay, P. (2022). Paper 1: a systematic synthesis of narrative therapy treatment components for the treatment of eating disorders. Journal of Eating Disorders, 10(1), 137.

​

McFarlane, T., Olmsted, M. P., & Trottier, K. (2008). Timing and prediction of relapse in a transdiagnostic eating disorder sample. International Journal of Eating Disorders, 41(7), 587-593.

​

Troop, N. A., & Redshaw, C. (2012). General shame and bodily shame in eating disorders: A 2.5‐year longitudinal study. European Eating Disorders Review, 20(5), 373-378.