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Cited by 51Eating Disorders and BehaviorsDigital Mental Health InterventionsNutrition, Health and Food Behavior

Acceptance and efficacy of a guided internet self-help treatment program for obese patients with binge eating disorder

Open access
Isabelle, Carrard, Christelle, Crépin, Patrick, Rouget, Tony, Lam, Martial, Van der Linden, Alain, Golay·2011·Clinical Practice & Epidemiology in Mental Health
DOI 10.2174/1745017901107010008PMC PMC3087972
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Abstract

Introduction: A significant percentage of obese patients suffer from binge eating disorder (BED), with negative consequences on psychological health, quality of life, weight loss treatment and maintenance. Cognitive behavioral therapy (CBT), delivered in traditional or self-help format, is effective in reducing BED symptoms. To improve dissemination, a self-help treatment program composed of eleven CBT based modules was implemented on the Internet and evaluated in a population of adult obese patients with BED. Method: Forty-two obese BED patients wait-listed for a multi-disciplinary obesity treatment took part in the study. Twenty-two patients completing the six-month online guided self-help treatment program were compared to a control group of twenty patients without intervention. Both groups were evaluated before and after six months of Internet self-help treatment or waiting list. A follow-up evaluation was carried out six months later. Results: Participants in the online self-help treatment program showed higher binge eating abstinence rates, lower EDE-Q shape and weight concerns, and improved TFEQ disinhibition of eating and hunger scores compared to the control group. They also scored better on psychological health and quality of life measures after intervention, and gains were maintained at follow-up. No effect was found regarding BMI. The number of modules completed was correlated with a better quality of life improvement at post evaluation. Participants rated the program as useful and easy to use. Conclusion: The Internet seems to be a valuable tool for disseminating CBT for BED obese patients. Acceptance of new technology was good in this population. Further research is needed with a larger sample to corroborate these results.

AI snapshot

Written from the paper’s full text.

TL;DR

In a non-randomized controlled trial, a 6-month guided Internet CBT self-help program for obese women with binge eating disorder was well accepted and produced higher post-treatment binge abstinence and improvements in eating-disorder, depression, and quality-of-life measures than a wait-list control, with no BMI effect. Some gains were maintained at 6-month follow-up after all patients began weight-loss treatment, but the small sample limited significance.

Key findings

  • Acceptance and satisfaction were high: 23 of 42 patients (55%) offered the program were interested, 22 began it, and only 2 (9%) dropped out; participants rated it easy to use (M=8.6, SD=1.9) and useful (M=8.1, SD=1.9) on 0–10 scales.
  • Binge eating abstinence at post-evaluation was 45% (n=9) in the Internet program group versus 15% (n=3) in the control group (Pearson’s chi-square=4.3, p<.05); at follow-up, both groups reached 55% abstinence (chi-square=0.001, ns).
  • The Internet group showed significant post-treatment improvements in EDE-Q shape concern (F(2,37)=4.5, p=.042) and TFEQ hunger (F(2,37)=5.2, p=.028), plus BDI-II depression (F(2,37)=6.3, p=.017) and IWQOL-Lite total quality of life (F(2,37)=14.2, p=.001), sustained at follow-up for IWQOL-Lite total (F(2,35)=8.0, p=.008); no BMI effect was found.
  • Compliance regression explained 49% of variance in quality-of-life improvement: more modules completed predicted better improvement (Beta=0.874, t=3.9, p=.001), while more e-mails sent predicted less improvement (Beta=-0.710, t=-3.2, p=.005).

Methods

  • Controlled study without randomization: 42 obese BED patients wait-listed for a multidisciplinary weight-loss treatment were recruited; 22 began the Internet program (20 evaluated post), and 20 wait-list controls were assessed at baseline and 6 months (18 completed follow-up).
  • Intervention: a 6-month guided Internet CBT-based self-help program with 11 modules, a self-monitoring diary, and a psychologist coach who exchanged at least weekly e-mails; controls waited 6 months without intervention.
  • Assessments at baseline, post, and 6-month follow-up after weight-loss treatment began; measures included EDO, EDE-Q, TFEQ, BDI-II, SCL-90R, and IWQOL-Lite; analyses used ANCOVAs with baseline covariates, chi-squares, and multiple regression.

Limitations

  • Stated by the authors: small sample size and likely underpowered analyses; many effects failed to reach significance; no longer follow-up, so long-term effects remain hypothetical; the trial was controlled but not randomized; a larger randomized controlled trial is needed.
  • Evident from the text: all participants were women, limiting generalizability to men; dropouts were excluded from longitudinal analyses; the control condition was a wait-list rather than an active comparator.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2174/1745017901107010008

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

11 tests recomputed · 4 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 34 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    After six months of the Internet program, participants' EDE-Q shape concern significantly improved compared to the control group (F(2,37)=4.5, p=.042).

    “participants’ shape concern (F(2,37)=4.5, p=.042) measured by EDE-Q”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.
  • Findingown data

    After six months of the Internet program, participants' TFEQ perception of hunger significantly improved compared to the control group (F(2,37)=5.2, p=.028).

    “perception of hunger (F(2,37)=5.2, p=.028) measured by TFEQ, significantly improved compared to the control group”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.
  • Findingown data

    There was no difference in change in BMI between the Internet program group and the control group.

    “There was no difference in change in BMI between groups.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.
  • Findingown data

    The difference between groups in TFEQ disinhibition approached but did not reach significance (F(2,37)=3.4, p=.075).

    “Weight concern (F(2,37)=3.4, p=.073) and disinhibition (F(2,37)=3.4, p=.075) differences approached but did not reach significance.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.
  • Findingown data

    The difference between groups in EDE-Q weight concern approached but did not reach significance (F(2,37)=3.4, p=.073).

    “Weight concern (F(2,37)=3.4, p=.073) and disinhibition (F(2,37)=3.4, p=.075) differences approached but did not reach significance.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.
  • May combine two claims. 23
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Findingown data

    At post evaluation, 45% (n=9) of patients in the Internet program group were abstinent from binge eating, compared to 15% (n=3) in the control group, a significant difference (Pearson's chi-square=4.3, p<.05).

    “Forty-five percent (n=9) of patients in the Internet program group were abstinent at post evaluation, compared to 15 % (n=3) in the control group (Pearson’s chi-square= 4.3, p<.05).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    32% of participants wanted to begin something quickly.

    “- 32 % wanted to begin something quickly”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At follow-up, the BDI-II difference between groups only approached but did not reach significance (F(2,35)=4.0, p=.052), with a medium effect size.

    “At follow-up the difference between groups only approached but did not reach significance (F(2,35)=4.0, p=.052) and effect size was medium.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The six-month WLT that both groups received does not differentially affect them, so follow-up differences reflect the Internet program.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    People most enjoyed the physical activity module together with the relapse prevention module (only rated by 3 participants).

    “People most enjoyed the physical activity module together with the relapse prevention module (only rated by 3 participants).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After six months of the Internet program, patients' quality of life progressed on all IWQOL-Lite dimensions, with all subscales exhibiting significant comparisons between groups and medium to large effect sizes.

    “after six months of Internet program, patients’ quality of life progressed on all dimensions, with all IWQOL-Lite subscales exhibiting significant comparisons between groups and medium to large effect sizes”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    23% of participants reported having searched for an eating disorder treatment without finding anything suitable.

    “- 23 % reported having searched for an eating disorder treatment without finding anything suitable”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At follow-up evaluation, the effect size between groups for SCL-90R GSI was large and significant (F(2,35)=6.7, p=.014).

    “At follow-up evaluation, the effect size between groups for SCL-90R GSI was large and significant (F(2,35)=6.7, p=.014).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The six-month WLT that both groups received does not differentially affect them, so follow-up differences reflect the Internet program.

  • May combine two claims.

    Findingown data

    Among the 22 persons included in the study, all exhibited symptoms of eating disorder, with 54.5% meeting full BED criteria.

    “Among the 22 persons included in the study, all exhibited symptoms of eating disorder, with 54.5 % meeting full BED criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Participants rated the Internet program as useful and easy to use.

    “Participants rated the program as useful and easy to use.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    SCL-90R GSI scores between groups approached but did not reach significance at post assessment (F(2,37)=3.0, p=0.91), with a medium effect size.

    “SCL-90R GSI scores between groups approached but did not reach significance at post assessment (F(2,37)=3.0, p=0.91), with a medium effect size.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants from 21 to 70 years old (mean 44 years) were included.

    “Participants from 21 to 70 years old, (with a mean of 44 years) were included.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All modules were estimated as easy to understand, with all means above 7.

    “As shown in Table 4, all modules were estimated as ‘easy to understand’ with all means above 7.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A large and significant effect for depression and a medium effect for psychological health were found in favour of the Internet program group.

    “A large and significant effect for depression and a medium effect for psychological health were found in favour of the Internet program group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Quality of life was significantly enhanced by the Internet program and the effect was sustained over time in the domains of work, public distress, physical function and self-esteem.

    “Quality of life was significantly enhanced by the Internet program and the effect was sustained over time in the domains of work, public distress, physical function and self-esteem.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The observed prevalence of BED in obese individuals seeking weight loss treatment is 30% to 50%.

    “The observed prevalence in obese individuals seeking weight loss treatment reached 30 % to 50% [5, 6].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5] Marchesini G, Natale S, Chierici S, et al. Effects of cognitive-behavioural therapy on health-related quality of life in obese sub-jects with and without binge eating disorder Int J Obes Relat Metab Disord 2002; 26 (9) : 1261-7. source

      Not checked in the free run.

    • cites [6] de Zwaan M. Binge eating disorder and obesity Int J Obes Relat Metab Disord 2001; 25 (Suppl 1) : S51-5. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The Internet has become a promising tool to deliver interventions for promoting healthy lifestyle and behaviors.

    “With the increased development of new technologies, the Internet has become a promising tool to deliver interventions for promoting healthy lifestyle and behaviors [21].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Tate DF, Zabinski MF. Computer and Internet applications for psychological treatment: update for clinicians J Clin Psychol 2004; 60 (2) : 209-. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Online approaches reduce risk factors and improve symptoms across a broad spectrum of mental illness and related conditions, including depression, stress, insomnia, headache or eating disorders.

    “A review of online approaches indicated a reduction of risk factors and an improvement of symptoms across a broad spectrum of mental illness and related conditions: depression, stress, insomnia, headache or eating disorders [22].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] Griffiths KM, Christensen H. Review of randomised controlled trials of internet interventions for mental disorders and related conditions Clin Psychol 2004; 10 : 16-29. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Cognitive Behavioral Therapy for BED is effective in reducing the number of binge episodes and in improving restraint, disinhibition and hunger.

    “A review of several treatment studies suggested that Cognitive Behavioral Therapy (CBT) for BED was effective in reducing the number of binge episodes and in improving related factors such as restraint, disinhibition and hunger [18].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] Brownley KA, Berkman ND, Sedway JA, Lohr KN, Bulik CM. Binge eating disorder treatment: a systematic review of randomized controlled trials Int J Eat Disord 2007; 40 (4) : 337-48. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A 16-week Internet program with cognitive-behavioral principles for BED, weight loss intervention and hunger and satiety awareness skills had a significant effect on binge eating and weight maintenance simultaneously in adolescents.

    “This 16-week Internet program with cognitive-behavioral principles for BED, weight loss intervention and hunger and satiety awareness skills, had a significant effect on binge eating and weight maintenance simultaneously.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Jones M, Luce KH, Osborne MI, et al. Randomized, controlled trial of an internet-facilitated intervention for reducing binge eating and overweight in adolescents Pediatrics 2008; 121 (3) : 453-62. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Obese people with BED differ significantly from obese people without BED and show more psychological disturbances, such as lower self-esteem, lower self-efficacy, difficulties identifying emotions and internal states, and higher impulsivity.

    “Obese people with BED differ significantly from obese people without BED and show more psychological disturbances, such as lower self-esteem, lower self-efficacy, difficulties in accurately identifying emotions and other internal states, and higher levels of impulsivity [7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] de Zwaan M, Mitchell JE, Seim HC, et al. Eating related and general psychopathology in obese females with binge eating disorder Int J Eat Disord 1994; 15 (1) : 43-52. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the control group, two people withdrew during the first six months of WLT, resulting in a final sample of 18 patients that completed the three evaluation sessions.

    “Two people withdrew from the research during the first six months of WLT, resulting in a final sample of 18 patients that completed the three evaluation sessions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The EDO was translated from English to French for this study, back-translated and approved by the author.

    “It was translated from English to French for this study [38], back-translated and approved by the author.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Carrard I, Crépin C. Troubles du comportement alimentaire et obésité (TAO) unpublished 2007.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Participants all gave their written informed consent.

    “Participants all gave their written informed consent.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Twenty participants in the Internet program group were evaluated at second and third assessments.

    “Twenty participants were evaluated at second and third assessments.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Dropouts were excluded from the longitudinal analyses.

    “Dropouts were excluded from the longitudinal analyses.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding dropouts from the longitudinal analyses does not bias the between-group comparisons.

  • May combine two claims.

    Study design and conductown data

    All data were approximately normally distributed, allowing the use of parametric analyses.

    “All data were approximately normally distributed, allowing the use of parametric analyses.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The protocol was approved by the local ethical committee (number 07-167).

    “The protocol was approved by the local ethical committee (number 07-167).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Acceptance and satisfaction with the Internet delivery mode were high.

    “Acceptance and satisfaction with the Internet delivery mode were high.”
    • Also stated in: § CONCLUSION · boosted
      “A six-month Internet CBT-based self-help treatment program for BED was well-accepted by users and demonstrated promising results on binge eating, eating disorders key related factors, depression and quality of life, compared to a control group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Internet had already proved valuable for overweight adolescents with eating disorders.

    “The Internet had already proved valuable for overweight adolescents with eating disorders [28]; in the present study it appeared to be equally acceptable for obese BED adults.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Jones M, Luce KH, Osborne MI, et al. Randomized, controlled trial of an internet-facilitated intervention for reducing binge eating and overweight in adolescents Pediatrics 2008; 121 (3) : 453-62. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The website met Health on the Net (HON) quality and ethics standards.

    “The website met Health on the Net (HON) quality and ethics standards.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Higher quality of life improvement was correlated with further progress with the Internet program modules and fewer e-mails written by participants to their coach.

    “Secondly, higher quality of life was correlated with further progress with the Internet program modules and fewer e-mails written by participants to their coach.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mindfulness techniques have proved efficient in previous studies.

    “The significant and sustained medium effect size on ‘susceptibility to hunger’, which refers to perception of hunger and satiety, might have been enhanced by the mindfulness techniques, which have proved efficient in previous studies [54].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [54] Smith BW, Shelley BM, Leahigh L, Vanleit B. A preliminary study of the effects of a modified mindfulness intervention on binge eating Complement Health Pract Rev 2006; 11 : 133-43. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Depression is an important factor in BED obese patients, linked to poorer weight loss outcome and higher dropout rates.

    “Depression is an important factor in BED obese patients, linked to poorer weight loss outcome and higher dropout rates [55].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] Pagoto S, Bodenlos JS, Kantor L, et al. Association of major depression and binge eating disorder with weight loss in a clinical setting Obesity (Silver Spring) 2007; 15 (11) : 2557-9. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    This result is consistent with studies comparing behavioral weight loss treatment and CBT in the treatment of BED, indicating similar effects on binge eating in the short-term.

    “This is consistent with studies comparing behavioral weight loss treatment and CBT in the treatment of BED, indicating similar effects on binge eating in the short-term [51].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Stunkard AJ, Allison KC. Binge eating disorder: disorder or marker? Int J Eat Disord 2003; (34 Suppl) S107-16. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    CBT group treatment has been shown to improve quality of life for patients with BED.

    “CBT group treatment has been shown to improve quality of life for patients with BED [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Marchesini G, Natale S, Chierici S, et al. Effects of cognitive-behavioural therapy on health-related quality of life in obese sub-jects with and without binge eating disorder Int J Obes Relat Metab Disord 2002; 26 (9) : 1261-7. source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The study was underpowered, as many effects failed to reach significance.

    “Effect sizes suggest interesting findings but many effects failed to reach significance suggesting that this study was underpowered.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The present study suggests that unlike WLT, CBT delivered by the Internet led to similar improvements in quality of life.

    “The present study suggests that unlike WLT, CBT delivered by the Internet led to similar improvements.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A previous study indicated that CBT was more effective than behavioral weight loss treatment in eliminating binge eating at two-year follow-up.

    “A previous study indicated that CBT was more effective than behavioral weight loss treatment in eliminating binge eating at two-year follow-up [53].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] Wilson GT, Wilfley DE, Agras WS, Bryson SW. Psychological treatments of binge eating disorder Arch Gen Psychiatry 2010; 67 (1) : 94-101. source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    The trial was controlled but not randomized.

    “This preliminary trial was controlled but not randomized.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    BED among obese individuals is associated with a lower quality of life, especially in the domains of work, public distress, physical function and self-esteem, even when controlling for depression and self-esteem.

    “It is established that BED among obese individuals is associated with a lower quality of life, especially in these domains [10], even when controlling for depression and self-esteem [9].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [10] Rieger E, Wilfley DE, Stein RI, Marino V, Crow SJ. A comparison of quality of life in obese individuals with and without binge eating disorder Int J Eat Disord 2005; 37 (3) : 234-40. source

      Not checked in the free run.

    • cites [9] de Zwaan M, Mitchell JE, Howell LM, et al. Two measures of health-related quality of life in morbid obesity Obes Res 2002; 10 (11) : 1143-51. source

      Not checked in the free run.

40 of 40

  • The paper relies on this without support.

    The waiting-list control condition is an adequate comparator; participants on the waiting list would not improve substantially without the Internet program.

    “Patients in the control group had to wait for WLT on the standard waiting list for six months and were not contacted during that time.”

  • The paper relies on this without support.

    Excluding dropouts from the longitudinal analyses does not bias the between-group comparisons.

    “Dropouts were excluded from the longitudinal analyses.”

  • The paper relies on this without support.

    The six-month WLT that both groups received does not differentially affect them, so follow-up differences reflect the Internet program.

    “At follow-up evaluation, after six months of WLT, both groups reached the same result, with 55 % abstinence in each group (Pearson’s chi-square= 0.001, ns).”

  • The paper relies on this without support.

    The sample of obese BED patients wait-listed for WLT is representative of the broader population of obese BED patients.

    “Forty-two obese BED patients wait-listed for a multi-disciplinary obesity treatment took part in the study.”

  • The paper relies on this without support.

    This study is among the first studies evaluating online self-help treatment programs for BED.

    “This study is among the first studies evaluating online self-help treatment programs for BED.”

  • The paper relies on this without support.

    BED is still not well known amongst the general population.

    “BED is still not well known amongst the general population and some of the participants were relieved to learn that they had a diagnosable condition with a recommended treatment plan.”

  • The paper relies on this without support.

    BED is often denied and weight loss is the primary and only goal among obese people seeking weight loss treatment.

    “BED is often denied and weight loss is the primary and only goal.”

  • The paper relies on this without support.

    Most individuals to whom the program was offered were not searching for a psychological treatment for their eating disorder.

    “This is a surprisingly high number considering that these people were for the most part not searching for a psychological treatment for their eating disorder.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value across alpha = .05: F(2,35)=4.0, p = .052

    Major

    The paper reports p = .052 here; recomputing from the test statistic and its degrees of freedom gives p = .027. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .052 · recomputed p = .027

  • Inconsistent p-value across alpha = .05: F(2,35)=3.8, p = .060

    Major

    The paper reports p = .06 here; recomputing from the test statistic and its degrees of freedom gives p = .032. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .06 · recomputed p = .032

  • Inconsistent p-value across alpha = .05: F(2,37)=3.4, p = .073

    Major

    The paper reports p = .073 here; recomputing from the test statistic and its degrees of freedom gives p = .044. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .073 · recomputed p = .044

  • Inconsistent p-value across alpha = .05: F(2,37)=3.4, p = .075

    Major

    The paper reports p = .075 here; recomputing from the test statistic and its degrees of freedom gives p = .044. The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .075 · recomputed p = .044

  • Inconsistent p-value: F(2,37)=4.5, p = .042

    Minor

    The paper reports p = .042 here; recomputing from the test statistic and its degrees of freedom gives p = .018. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .042 · recomputed p = .018

  • Inconsistent p-value: F(2,37)=6.3, p = .017

    Minor

    The paper reports p = .017 here; recomputing from the test statistic and its degrees of freedom gives p = .004. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .017 · recomputed p = .004

  • Inconsistent p-value: F(2,37)=3.0, p = .91

    Minor

    The paper reports p = .91 here; recomputing from the test statistic and its degrees of freedom gives p = .062. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .91 · recomputed p = .062

  • Inconsistent p-value: F(2,35)=6.7, p = .014

    Minor

    The paper reports p = .014 here; recomputing from the test statistic and its degrees of freedom gives p = .003. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .014 · recomputed p = .003

  • Inconsistent p-value: F(2,35)=8.0, p = .008

    Minor

    The paper reports p = .008 here; recomputing from the test statistic and its degrees of freedom gives p = .001. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .008 · recomputed p = .001

  • Inconsistent p-value: F(2,37)=5.2, p = .028

    Minor

    The paper reports p = .028 here; recomputing from the test statistic and its degrees of freedom gives p = .010. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .028 · recomputed p = .010

10 of 10

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upF(2, 37) = 3.4reported p = .073 · recomputed p = .044The two fall on opposite sides of .05

    “F(2,37)=3.4, p = .073”

  • Doesn’t add upF(2, 37) = 3.4reported p = .075 · recomputed p = .044The two fall on opposite sides of .05

    “F(2,37)=3.4, p = .075”

  • Doesn’t add upF(2, 35) = 3.8reported p = .06 · recomputed p = .032The two fall on opposite sides of .05

    “F(2,35)=3.8, p = .060”

  • Doesn’t add upF(2, 35) = 4reported p = .052 · recomputed p = .027The two fall on opposite sides of .05

    “F(2,35)=4.0, p = .052”

  • Doesn’t add upF(2, 37) = 4.5reported p = .042 · recomputed p = .018

    “F(2,37)=4.5, p = .042”

  • Doesn’t add upF(2, 37) = 5.2reported p = .028 · recomputed p = .010

    “F(2,37)=5.2, p = .028”

  • Doesn’t add upF(2, 37) = 6.3reported p = .017 · recomputed p = .004

    “F(2,37)=6.3, p = .017”

  • Doesn’t add upF(2, 37) = 3reported p = .91 · recomputed p = .062

    “F(2,37)=3.0, p = .91”

  • Doesn’t add upF(2, 35) = 6.7reported p = .014 · recomputed p = .003

    “F(2,35)=6.7, p = .014”

  • Doesn’t add upF(2, 35) = 8reported p = .008 · recomputed p = .001

    “F(2,35)=8.0, p = .008”

  • ConsistentF(2, 37) = 14.2reported p = .001 · recomputed p < .001

    “F(2,37)=14.2, p = .001”

    The paper prints p at a floor (such as p < .001)

11 of 11

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Abstract says all 22 Internet-program patients completed treatment

    Minor

    The abstract describes 22 patients as completing the program, but the results say 22 began it, two dropped out, and 20 completed the assessments.

  • Discussion places post evaluation after WLT

    Minor

    The discussion says post evaluation followed six months of WLT, whereas the procedure places post evaluation just before WLT began.

2 of 2

Cites

Flagged first, then by citations

1 of the 56 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. American Psychiatric Association, Diagnostic and statistical manual of mental disorders. 4th. Washington, DC: American Psychiatric Press 1994.

Cited by

Sorted by citations

Related

Authors
Isabelle, C., Christelle, C., Patrick, R., Tony, L., Martial, V. D. L., & Alain, G.
Affiliations
  • University Hospital of Geneva (CH)
  • NetUnion (Switzerland) (CH)
  • University of Geneva (CH)
Venue
Clinical Practice & Epidemiology in Mental Health
Publisher
Bentham Science Publishers Ltd.
Published
2011-03-04
Volume
07
Issue
1
Pages
08-18
ISSN
1745-0179 (ISSN-L)
DOI
10.2174/1745017901107010008
PMC
PMC3087972
OpenAlex
W2083350123
Semantic Scholar
10c56d92e7fb50b929c228a8129db0aa8e8ae02d
Cited by
51
References
56
Citations by year
2026: 3 · 2024: 2 · 2023: 3 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 3
FWCI
5.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Practice and Epidemiology in Mental Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
  • ORBi (University of Liège) (submittedVersion, cc-by-nc)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
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
binge eating disorder, obesity, online self-help, guided self-help, cognitive behavioral therapy, treatment dissemination, eating disorder symptoms, quality of life, mental health, treatment acceptance, weight concern

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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