An internet-based program to enhance motivation to change in females with symptoms of an eating disorder: a randomized controlled trial
Abstract
Background: Previous research has demonstrated an association between low motivation to change and an unfavorable treatment outcome in patients with an eating disorder. Consequently, various studies have examined the effects of motivational enhancement therapy (MET) on motivation to change and treatment outcome in eating disorders. In each of these studies, MET was administered in a face-to-face setting. However, because of its anonymity and ease of access, the internet provides several advantages as the format for such an intervention. Therefore, the current study investigated the effects of an internet-based program (‘ESS-KIMO’) to enhance motivation to change in eating disorders. Method: In total, 212 females were accepted for participation and assigned randomly to the intervention condition (n = 103) or waiting-list control condition (n = 109). The intervention consisted of six online MET sessions. Before and after the intervention or waiting period respectively, participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the Stages of Change Questionnaire for Eating Disorders (SOCQ-ED), the Pros and Cons of Eating Disorders Scale (P-CED), the Self-Efficacy Scale (SES), and the Rosenberg Self-Esteem Scale (RSES). A total of 125 participants completed the assessment post-treatment. Completer analyses and intent-to-treat analyses were performed. Results: Significant time × group interactions were found, indicating a stronger increase in motivational aspects and self-esteem, in addition to a stronger symptom reduction on some measures from pre- to post-treatment in the intervention group compared to the control group. Conclusions: Internet-based approaches can be considered as useful for enhancing motivation to change in eating disorders and for yielding initial symptomatic improvement.
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Internet-based interventions have proved efficacy in reducing eating-disorder-related symptoms in a number of randomised controlled trials.
“Internet-based interventions have proved their efficacy in reducing ED-related symptoms in a number of Randomised Controlled Trials (RCTs) [17–19].”
A small between-group effect size (Cohen's d = 0.40) is expected.
“A small between-group effect size (Cohen’ s d = 0.40) is expected.”
The a priori sample size calculation was based on results from previous studies that implemented Internet-based programs in the treatment of eating disorders.
“The a priori sample size calculation was based on results from previous studies that implemented Internet-based programs in the treatment of EDs [58–60].”
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Enhancing Motivation to Reduce Restrictive Eating: A Novel Approach
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Self-citation
- Authors
- Hötzel, K., von Brachel, R., Schmidt, U., Rieger, E., Kosfelder, J., Hechler, T., Schulte, D., & Vocks, S.
- Affiliations
- Osnabrück University (DE)
- King's College London (GB)
- Australian National University (AU)
- Hochschule Düsseldorf University of Applied Sciences (DE)
- Witten/Herdecke University (DE)
- Ruhr University Bochum (DE)
- Corresponding author
- Hötzel, K.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-10-16
- Volume
- 44
- Issue
- 9
- Pages
- 1947-1963
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2123318133
- Cited by
- 55
- References
- 85
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 7 · 2017: 7 · 2016: 4 · 2015: 6 · 2014: 4
- FWCI
- 5.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- eating disorders, motivation for change, motivational enhancement therapy, online intervention, online therapy, self-esteem, self-efficacy, stages of change, symptom relief, women
- MeSH terms
- Adolescent, Adult, Anorexia Nervosa, Female, Humans, Middle Aged, Motivation, Self Concept, Treatment Outcome, Internet, Bulimia Nervosa, Young Adult, Motivational Interviewing
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