A survey of attitudes towards computerized self-help for eating disorders within a community-based sample
Abstract
BACKGROUND: Bulimia nervosa (BN) is an eating disorder with many physical, psychological and social consequences. Guided self-help (GSH) is recommended in the treatment of BN (NICE, 2004). One of the ways in which to provide GSH is via the internet using evidence-based packages with regular support from a clinician or trained support worker. AIMS: The aim of this community-based survey was to investigate attitudes towards online self-help for eating disorders and the support required whilst using such an approach. METHOD: Two-hundred and fifty-three participants with bulimic symptoms completed the survey. The sample was recruited primarily online. The mean age was 29.11 years (SD = 8.67; min = 16, max = 64). RESULTS: Attitudes towards online self-help (SH) for eating disorders were very positive. The inclusion of some form of support to accompany such an intervention was important to the majority of participants. Remote mediums of support such as e-mail, a forum and text messaging were most often selected as helpful. Most participants expressed a preference for weekly support contacts and for flexible support lengths that could respond to support needs as required. CONCLUSIONS: Online self-help for eating disorders is a desirable treatment option for many individuals. The information gathered regarding preferences in the type, medium, duration and frequency of support could be used in the development of future self-help strategies in order to maximize uptake, retention and outcomes.
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Those with BED commonly experience treatment-seeking hesitancy due to self-stigma, waiting lists, and previous negative treatment experiences.
“or commonly experience treatment-seeking hesitancy due to self-stigma, waiting lists, and previous negative treatment experiences (16, 17).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [17]
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · see citing works
Mental health literacy: Public knowledge and beliefs about mental disorders
Jorm, A. F. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.5.396 · Cited by 2,114 · see citing works
Binge eating: nature, assessment, and treatment
(1994) · Choice Reviews Online · doi:10.5860/choice.31-4640 · Cited by 1,801 · see citing works
(2008) · Cited by 1,397 · see citing works
Binge Eating: Nature, Assessment and Treatment
Hanson, K., & Pasulka, P. S. (1994) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/014860719401800419 · Cited by 1,166 · see citing works
Adherence in Internet Interventions for Anxiety and Depression
Christensen, H., Griffiths, K. M., & Farrer, L. (2009) · Journal of Medical Internet Research · doi:10.2196/jmir.1194 · Cited by 1,133 · see citing works
Bower, P., & Gilbody, S. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.186.1.11 · Cited by 1,084 · see citing works
Cognitive Behavior Therapy and Eating Disorders
Mitchell, J. E. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09bk05121 · Cited by 886 · see citing works
Cognitive behavioural therapy for anxiety disorders in children and adolescents
James, A. C., James, G., Cowdrey, F. A., Soler, A., & Choke, A. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004690.pub4 · Cited by 876 · see citing works
The Eating Disorder Examination (12th edition).
Fairburn, C. G., & Cooper, Z. (1993) · Cited by 638 · see citing works
Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. A., Goldberg, D., Mann, A., Tylee, A., Marks, I., & Gray, J. A. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.1.46 · Cited by 516 · see citing works
Peterson, C. B., Crosby, R. D., Wonderlich, S. A., Joiner, T., Crow, S. J., Mitchell, J. E., Bardone‐Cone, A. M., Klein, M., & le Grange, D. (2007) · International Journal of Eating Disorders · doi:10.1002/eat.20373 · Cited by 425 · see citing works
GELLATLY, J., BOWER, P., HENNESSY, S., RICHARDS, D., GILBODY, S., & LOVELL, K. (2007) · Psychological Medicine · doi:10.1017/s0033291707000062 · Cited by 419 · cited 1× · see citing works
“…guidelines (2004) and has also been highlighted in many studies that focus on computerized cognitive behavioural therapy (cCBT) for low mood (Gellatly et al., 2007) and bulimia nervosa (BN) (Pretorius, Rowlands, Ringwood and Schmidt, 2010; Sanchez-Ortiz, Munro, Startup, Treasure and…”
BackgroundBhattacharya, D., Aldus, C. F., Barton, G., Bond, C. M., Boonyaprapa, S., Charles, I. S., Fleetcroft, R., Holland, R., Jerosch‐Herold, C., Salter, C., et al. (2016) · Cited by 339 · see citing works
Internet-based mental health programs: A powerful tool in the rural medical kit
Griffiths, K. M., & Christensen, H. (2007) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2007.00859.x · Cited by 270 · cited 1× · see citing works
“Studies of help-seeking behaviour for mental health problems have indicated that self-help strategies are a popular option for many individuals with mental health problems, including those with BN (Mond et al., 2007; Griffiths and Christensen, 2007; Jorm, 2000).”
BackgroundEating Disorder Examination Questionnaire
Fairburn, C. G., & Beglin, S. J. (2011) · PsycTESTS Dataset · doi:10.1037/t03974-000 · Cited by 205 · see citing works
Pao, M., & Kazak, A. E. (2014) · Oxford University Press eBooks · doi:10.1093/med/9780199335114.003.0012 · Cited by 198 · see citing works
Cognitive behavioural therapy for anxiety disorders in children and adolescents
James, A. C., Soler, A., & Weatherall, R. R. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004690.pub2 · Cited by 198 · see citing works
Pathways to help‐seeking in bulimia nervosa and binge eating problems: A concept mapping approach
Hepworth, N. S., & Paxton, S. J. (2007) · International Journal of Eating Disorders · doi:10.1002/eat.20402 · Cited by 196 · see citing works
Randomized trial of internet-delivered self-help with telephone support for pathological gamblers.
Carlbring, P., & Smit, F. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0013603 · Cited by 187 · see citing works
Wiant, A. A., Wiclaman, K. F., l, E. B. R., & White, M. (2011) · Cited by 171 · see citing works
The Law of Attrition Revisited
Christensen, H., & Mackinnon, A. (2006) · Journal of Medical Internet Research · doi:10.2196/jmir.8.3.e20 · Cited by 161 · see citing works
Sánchez-Ortiz, V. C., Munro, C., Stahl, D., House, J., Startup, H., Treasure, J., Williams, C., & Schmidt, U. (2011) · Psychological Medicine · doi:10.1017/s0033291710000711 · Cited by 154 · see citing works
Self-citationEvans, E. J., Hay, P., Mond, J., Paxton, S. J., Quirk, F. H., Rodgers, B., Jhajj, A. K., & Sawoniewska, M. A. (2011) · Eating Disorders · doi:10.1080/10640266.2011.566152 · Cited by 110 · see citing works
Perceived helpfulness of websites for mental health information
Oh, E., Jorm, A. F., & Wright, A. (2008) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-008-0443-9 · Cited by 103 · see citing works
Pretorius, N., Arcelus, J., Beecham, J., Dawson, H., Doherty, F., Eisler, I., Gallagher, C., Gowers, S., Isaacs, G., Johnson-Sabine, E., et al. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.05.006 · Cited by 97 · see citing works
Carrard, I., Rouget, P., Fernández-Aranda, F., Volkart, A.-C., Damoiseau, M., & Lam, T. (2006) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2005.07.031 · Cited by 88 · cited 1× · see citing works
“A number of studies have also shown the efficacy of online CBT self-help for BN (Sanchez-Ortiz, Munro, Stahl et al., 2011; Pretorius et al., 2009; Carrard et al., 2006, 2010).”
BackgroundCarrard, I., Fernández‐Aranda, F., Lam, T., Nevonen, L., Liwowsky, I., Volkart, A.-C., Rouget, P., Golay, A., der Linden, M. V., & Norring, C. E. A. (2010) · European Eating Disorders Review · doi:10.1002/erv.1043 · Cited by 77 · see citing works
Eating Disorder Examination-Questionnaire as a measure of change in patients with bulimia nervosa
Sysko, R., Walsh, B. T., & Fairburn, C. G. (2005) · International Journal of Eating Disorders · doi:10.1002/eat.20078 · Cited by 67 · see citing works
Sánchez-Ortiz, V. C., House, J., Munro, C., Treasure, J. L., Startup, H. M., Williams, C. J., & Schmidt, U. H. (2011) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/bf03325314 · Cited by 54 · see citing works
Mond, J., Marks, P., Hay, P., Rodgers, B., Kelly, C., Owen, C., & Paxton, S. J. (2006) · Journal of Youth and Adolescence · doi:10.1007/s10964-006-9087-9 · Cited by 45 · see citing works
Sánchez-Ortiz, V. C., Munro, C., Startup, H. M., Treasure, J. L., & Schmidt, U. H. (2011) · European Eating Disorders Review · doi:10.1002/erv.1074 · Cited by 39 · see citing works
McClay, C.-A., Waters, L., McHale, C., Schmidt, U. H., & Williams, C. J. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2083 · Cited by 37 · see citing works
Murray, K. A., Schmidt, U. H., Pombo‐Carril, M. G., Grover, M., Alenya, J., Treasure, J. L., & Williams, C. M. (2004) · Computers in Human Behavior · doi:10.1016/j.chb.2004.11.014 · Cited by 29 · see citing works
Pretorius, N., Rowlands, L., Ringwood, S., & Schmidt, U. H. (2010) · European Eating Disorders Review · doi:10.1002/erv.985 · Cited by 26 · see citing works
Kenicer, D., McClay, C.-A., & Williams, C. (2012) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-12-102 · Cited by 12 · see citing works
Self-citationAndrewes, H. E., Kenicer, D., McClay, C.-A., & Williams, C. M. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002277 · Cited by 8 · see citing works
Sánchez-Ortiz, V. C., Munro, C., Stahl, D. R., House, J., Startup, H. M., Treasure, J. L., Williams, C., & Schmidt, U. H. (2011) · ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) · Cited by 3 · see citing works
Somers, J., Querée, M., Broderick, J., Leung, B., Bilsker, D., & Cohen, K. (2019) · CBT for Depression: An Integrated Approach · doi:10.4135/9781526452351.n2
Flagged first, then by citations
Cited by
Sorted by citations
Batterham, P. J., & Calear, A. L. (2017) · JMIR Mental Health · doi:10.2196/mental.7722 · Cited by 161 · see citing works
E-Health Interventions for Eating Disorders: Emerging Findings, Issues, and Opportunities
Aardoom, J. J., Dingemans, A. E., & van Furth, E. F. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0673-6 · Cited by 78 · see citing works
Linardon, J., Messer, M., Lee, S., & Rosato, J. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-01005-3 · Cited by 76 · see citing works
Linardon, J., Shatte, A., Tepper, H., & Fuller‐Tyszkiewicz, M. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23268 · Cited by 61 · see citing works
Psychotherapies for eating disorders: findings from a rapid review
Russell, H., Aouad, P., Lê, Â. H., Marks, P., Maloney, D., Barakat, S., Boakes, R., Brennan, L., Bryant, E., Byrne, S. M., et al. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00886-w · Cited by 48 · see citing works
Daugelat, M., Pruccoli, J., Schag, K., & Giel, K. E. (2023) · European Eating Disorders Review · doi:10.1002/erv.2999 · Cited by 48 · see citing works
Slade, M., Rennick-Egglestone, S., Llewellyn-Beardsley, J., Yeo, C., Roe, J., Bailey, S., Smith, R. A., Booth, S., Harrison, J., Bhogal, A., et al. (2021) · JMIR Formative Research · doi:10.2196/24417 · Cited by 39 · see citing works
“Digital health technologies [46] are increasingly being used in global mental health practice, motivated by challenges such as lengthy waiting lists for treatment [47], limited access to in-person mental health treatment in rural and remote communities [48-50], and the distress inherent in accessing in-person treatmen…”
BackgroundRennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Trials · doi:10.1186/s13063-020-04428-6 · Cited by 38 · see citing works
Views on online self-help programmes from people with eating disorders and their carers in UK
Yim, S. H., Spencer, L., Gordon, G., Allen, K. L., Musiat, P., & Schmidt, U. H. (2021) · European Journal of Public Health · doi:10.1093/eurpub/ckab046 · Cited by 35 · see citing works
Cheung, L., Thomas, P. C., Brvar, E., & Rowe, S. L. (2024) · JMIR Mental Health · doi:10.2196/57795 · Cited by 19 · see citing works
Plateau, C. R., Brookes, F. A., & Pugh, M. (2017) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.08.004 · Cited by 17 · see citing works
Yim, S. H., Bailey, E., Gordon, G., Grant, N., Musiat, P., & Schmidt, U. H. (2020) · Journal of Medical Internet Research · doi:10.2196/17880 · Cited by 14 · see citing works
Barakat, S., & Maguire, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010119 · Cited by 13 · see citing works
Nissling, L., Fahlke, C., Lilja, J. L., Skoglund, I., & Weineland, S. (2020) · JMIR Formative Research · doi:10.2196/19226 · Cited by 12 · see citing works
Rom, S., Miskovic‐Wheatley, J., Barakat, S., Aouad, P., Fuller‐Tyszkiewicz, M., & Maguire, S. (2022) · International Journal of Eating Disorders · doi:10.1002/eat.23803 · Cited by 8 · see citing works
Rogers, C., Webb, J. B., Bauert, L., & Carelock, J. (2022) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2022.849836 · Cited by 8 · see citing works
Rom, S., Miskovic-Wheatley, J., Barakat, S., Aouad, P., Kim, M., Fuller-Tyszkiewicz, M., & Maguire, S. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1229261 · Cited by 7 · see citing works
Teles, S., Ferreira, A., & Paúl, C. (2022) · Behavior and Information Technology · doi:10.1080/0144929x.2021.2021285 · Cited by 7 · see citing works
Alan, H. (2024) · Behaviour and Information Technology · doi:10.1080/0144929x.2024.2303626 · Cited by 8 · see citing works
eHealth treatments for compulsive overeating: A narrative review
Moghimi, E., Davis, C. A., & Rotondi, M. (2020) · Current Addiction Reports · doi:10.1007/s40429-020-00312-0 · Cited by 3 · see citing works
Atorkey, P., Paul, C. L., Wiggers, J. H., Bonevski, B., Mitchell, A., & Tzelepis, F. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179336 · Cited by 4 · see citing works
Patient experiences of internet-based enhanced cognitive behavior therapy for eating disorders
Wiberg, A.-C., Ghaderi, A., Parling, T., Jansson, M., & Welch, E. (2025) · Internet Interventions · doi:10.1016/j.invent.2025.100801 · Cited by 2 · see citing works
Barakat, S., Rom, S., Kim, M., Aouad, P., & Maguire, S. (2025) · European Eating Disorders Review · doi:10.1002/erv.3176 · Cited by 1 · see citing works
Davey, E., Micali, N., Bryant‐Waugh, R., Bennett, S. D., Lau, C., & Shafran, R. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01113-w · Cited by 1 · see citing works
Email-assisted guided self-help for binge eating: an illustrative case study
Jenkins, P. E., & Cardy, J. (2025) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x25100226
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679929
Davey, E., Micali, N., Bryant‐Waugh, R., Bennett, S. D., Lau, C., & Shafran, R. (2024) · Figshare · doi:10.6084/m9.figshare.27140677
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679935
Davey, E., Micali, N., Bryant‐Waugh, R., Bennett, S. D., Lau, C., & Shafran, R. (2024) · Figshare · doi:10.6084/m9.figshare.27140683
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679938
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679944
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679941
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679911
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679917
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679932
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679908
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679923
Davey, E., Micali, N., Bryant‐Waugh, R., Bennett, S. D., Lau, C., & Shafran, R. (2024) · Figshare · doi:10.6084/m9.figshare.27140686
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679926
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679914
Rennick‐Egglestone, S., Elliott, R. A., Smuk, M., Robinson, C., Bailey, S., Smith, R., Keppens, J., Hussain, H., Pollock, K., Cuijpers, P. J., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12679920
- Authors
- McClay, C.-A., Waters, L., Schmidt, U., & Williams, C.
- Affiliations
- University of Glasgow (GB)
- Corresponding author
- Williams, Christopher
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-11-28
- Volume
- 44
- Issue
- 1
- Pages
- 65-78
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2142955320
- Cited by
- 41
- References
- 40
- Citations by year
- 2025: 3 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 19 · 2017: 2 · 2016: 1
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- bulimia nervosa, eating disorders, online self-help, clinician support, remote support, email, online forums, text messaging
- MeSH terms
- Adolescent, Adult, Attitude, Female, Humans, Male, Middle Aged, Motivation, Patient Acceptance of Health Care, Surveys and Questionnaires, Self-Help Groups, Cognitive Behavioral Therapy, Internet, Electronic Mail, Bulimia Nervosa, Community-Based Participatory Research, Text Messaging
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