Internet-based interventions for eating disorders in adults: a systematic review
Open accessAbstract
BACKGROUND: This systematic review evaluates the efficacy of internet-based interventions for the treatment of different eating disorders in adults. METHOD: A search for peer reviewed journal articles detailing Randomised Control Trials (RCT) and Controlled Trials (CT) addressing participants with eating disorders aged at least 16 was completed in the electronic databases Web of Science, PsycInfo and PubMed. The quality of the included articles was assessed, results were reviewed and effect sizes and corresponding confidence intervals were calculated. RESULTS: Eight studies, including a total of N = 609 participants, fulfilled the selection criteria and were included. The majority of treatments applied in these studies were based on CBT principles. Six studies described guided self-help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates. These studies produced significant medium to high effect sizes both within and between the groups after utilisation of guided self-help programs or a self-help book backed up with supportive e-mails. The two remaining studies utilised a specific writing task or e-mail therapy that did not follow a structured treatment program. Here, no significant effects could be found. Treatment dropout rates ranged from 9% to 47.2%. Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies. CONCLUSIONS: Overall, the results support the value of internet-based interventions that use guided self-help to tackle eating disorders, but further research is needed due to the heterogeneity of the studies.
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eTherapies' efficacy in reducing ED and binge-eating symptomatology in transdiagnostic ED samples has growing evidence across multiple meta-analyses, with small to medium average effect sizes.
“Moreover, their efficacy in reducing ED and binge-eating symptomatology in transdiagnostic ED samples has growing evidence across multiple meta-analyses, with small to medium average effect sizes reported (22, 25–27).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [25]
The Results (Outcomes; page unavailable) report reductions in binge-eating and eating-disorder symptoms in some studies of internet-based interventions. But this paper is one systematic review, not multiple meta-analyses, and it does not report a pooled small-to-medium average effect size; its reported effects vary and are often moderate to high. The cited passages also do not establish that the effects apply specifically to transdiagnostic samples. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe efficacy of online CBT interventions as alternatives to face-to-face treatment for patients with eating disorders is controversial.
“Although the efficacy of online CBT interventions as alternatives to face-to-face treatment for patients with EDs is rather controversial [13, 23], such interventions may have a lot of advantages when used as therapeutic tools.”
From Cost-effectiveness of the mobile application TCApp combined with face-to-face CBT treatment compared to face-to-face CBT treatment alone for patients with an eating disorder: Study protocol of a multi-centre randomised controlled trial (2018) · cites this paper as [23]
The Conclusions describe internet-based CBT interventions as a promising alternative to face-to-face therapy, while cautioning that the evidence is not definitive. The Discussion’s Limitations section also says direct comparisons are difficult. These qualifications support uncertainty, but the review does not characterize the interventions’ efficacy as controversial. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSupported online self-help programs (eTherapies) are effective in transdiagnostic eating disorder samples and may improve access to treatment.
“Studies in transdiagnostic eating disorder (ED) samples suggest supported online self-help programs (eTherapies) are effective and may improve access to treatment”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [25]
A variety of Internet-based programs for eating disorders have been developed with overall evidence suggesting that they offer a promising approach to preventing and treating eating disorders.
“A variety of Internet-based programs for eating disorders have been developed with overall evidence suggesting that they offer a promising approach to preventing and treating eating disorders [19–24].”
High dropout rates are commonly reported in trials of Internet-based programs for eating disorders, with one systematic review reporting dropouts ranging from 9 to 47.2%.
“High dropout rates (i.e., not starting or finishing the intervention or not completing assessments) are commonly reported in trials of these programs with one systematic review of Internet-based interventions for eating disorders reporting dropouts ranging from 9 to 47.2% [21].”
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- Authors
- Dölemeyer, R., Tietjen, A., Kersting, A., & Wagner, B.
- Affiliations
- Leipzig University (DE)
- IFB Adiposity Diseases (DE)
- Corresponding author
- Dölemeyer, Ruth
- Venue
- BMC Psychiatry
- Published
- 2013-08-06
- Volume
- 13
- Issue
- 1
- Pages
- 207-207
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3750530
- OpenAlex
- W1974836041
- Cited by
- 99
- References
- 71
- Citations by year
- 2025: 8 · 2024: 4 · 2023: 9 · 2022: 17 · 2021: 7 · 2020: 2 · 2019: 8 · 2018: 7 · 2017: 7 · 2016: 14 · 2015: 9 · 2014: 6 · 2013: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung (FKZ:01EO1001, 01EO1001)
- 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
- online intervention, eating disorders, adults, guided self-help, cognitive behavioral therapy, treatment discontinuation, depression, anxiety, quality of life, eating behaviour, abstinence
- MeSH terms
- Adult, Feeding and Eating Disorders, Humans, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Internet
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