The efficacy of eHealth interventions for the treatment of adults diagnosed with full or subthreshold binge eating disorder: systematic review and meta-analysis
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Abstract
BACKGROUND: There has been a recent rise in the use of eHealth treatments for a variety of psychological disorders, including eating disorders. OBJECTIVE: This meta-analysis of randomized controlled trials is the first to evaluate the efficacy of eHealth interventions specifically for the treatment of binge eating disorder (characterized by compulsive overconsumption of food, in a relatively short period, and without compensatory behaviors such as purging or fasting). METHODS: A search on the electronic databases PubMed, Web of Science, Embase, MEDLINE, and CINAHL was conducted for randomized controlled trials that compared the efficacy of eHealth treatment interventions with waitlist controls. RESULTS: From the databases searched, 3 studies (298 participants in total) met the inclusion criteria. All interventions were forms of internet-based guided cognitive behavioral therapy. The results of the analysis demonstrated that when compared with waitlist controls, individuals enrolled in eHealth interventions experienced a reduction in objective binge episodes (standardized mean difference [SMD] -0.77, 95% CI -1.38 to -0.16) and eating disorder psychopathology (SMD -0.71, 95% CI -1.20 to -0.22), which included shape (SMD -0.61, 95% CI -1.01 to -0.22) and weight concerns (SMD -0.91, 95% CI -1.33 to -0.48). There was no significant difference in BMI between the eHealth interventions and controls (SMD -0.01, 95% CI -0.40 to 0.39). CONCLUSIONS: These findings provide promising results for the use of internet-based cognitive behavioral therapy for binge eating disorder treatment and support the need for future research to explore the efficacy of these eHealth interventions.
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The authors of that meta-analysis concluded that BED eTherapies had insufficient evidence to support their efficacy compared with face-to-face CBT.
“Although these initial results appeared promising, the authors concluded that BED eTherapies had an insufficient quantity of evidence to support their efficacy compared with face-to-face CBT (31).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [31]
The reduction in EDE-Q global score from pre- to post-treatment represented a large effect (g = 1.62) which compared well to the moderate pooled reductions (d = −0.77) observed in a BED targeted eTherapy meta-analysis.
“Similarly, there was a statistically and clinically significant reduction from pre-to post-treatment in the EDE-Q global score, representing a large effect (g = 1.62) which compared well to the moderate pooled reductions (d = −0.77) observed in a BED targeted eTherapy meta-analysis (31).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [31]
The large reduction in OBE frequency from pre- to post-treatment (g = 1.03) exceeded the average moderate pooled effect (d = −0.77) observed in a meta-analysis of BED eTherapy programs.
“This large effect exceeded the average moderate pooled effect (d = −0.77) observed in a meta-analysis of BED eTherapy programs (31).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [31]
Abstinence from binge-eating at post-treatment (16%) and follow up (21%) was comparable to the range of abstinence rates (14.6-25.1%) in existing studies evaluating BED eTherapies.
“whilst abstinence from binge-eating at post-treatment (16%) and follow up (21%) was comparable to the range of abstinence rates (14.6–25.1%) in existing studies evaluating BED eTherapies (31).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [31]
The Results report reductions in binge episodes from BED eHealth interventions, but give no abstinence-rate range. The Discussion’s Principal Findings say none of the included treatment studies resulted in complete abstinence following treatment; they do not report the cited 14.6–25.1% range. Searches for both endpoints and abstinence rates found no passage establishing that range. (LLM, conf=0.76)
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Runge, E., Jensen, E. S., Mathiasen, K., Larsen, P. V., Hertz, S. P. T., Holmberg, T. T., Tarp, K., Linnet, J., & Lichtenstein, M. B. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.969338 · Cited by 3 · see citing works
Pellizzer, M. L., Zhou, Y., de Valle, M. K., Linardon, J., & Wade, T. D. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24567 · Cited by 3 · see citing works
Could the use of web-based applications assist in neuropsychiatric treatment? An umbrella review
Pelucio, L., Quagliato, L. A., Cardoso, A., Horato, N., & Nardi, A. E. (2025) · BMC Psychology · doi:10.1186/s40359-024-02263-x · Cited by 2 · see citing works
Seow, E., Chang, S. S. H., Sambasivam, R., Subramaniam, M., Lu, S. H., Assudani, H. A., Tan, C.-Y. G., & Vaingankar, J. A. (2023) · Digital Health · doi:10.1177/20552076221147411 · Cited by 2 · see citing works
Outcome: Other Specified Feeding or Eating Disorder (OSFED)
Krug, I., Fernández‐Aranda, F., Moharrampour, N. G., & Rozenblat, V. (2023) · Springer eBooks · doi:10.1007/978-3-030-97416-9_92-1 · Cited by 2 · see citing works
Galmiche, M. C., & Déchelotte, P. (2023) · Nutrition Clinique et Métabolisme · doi:10.1016/s0985-0562(24)00007-4 · Cited by 1 · see citing works
Outcome: Other Specified Feeding or Eating Disorder (OSFED)
Krug, I., Fernández‐Aranda, F., Moharrampour, N. G., & Rozenblat, V. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_92 · Cited by 1 · see citing works
Tuncer, G. Z., & Tuncer, M. (2025) · Eating Disorders · doi:10.1080/10640266.2025.2498247 · Cited by 1 · see citing works
Telemedicine in Eating Disorder Treatment: Systematic Review
Blasco‐Amaro, J. A., Dobrzynska, A., Isabel‐Gómez, R., Perez-Ostos, E. E., & Moreno, E. M. V. (2025) · JMIR Mental Health · doi:10.2196/74057 · Cited by 1 · see citing works
Goldschmidt, A. B., Ortega, A., Rooper, I. R., Obleada, K. T., Chapa, D. A. N., Silverberg, B., Stalvey, E., Camino, M. K., Levine, M. D., Yu, L., et al. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.108192 · Cited by 1 · see citing works
Acute, Longer-Term, and Transdiagnostic Outcomes After Digital Interventions for Eating Disorders
Anderson, C., Soliman, O. M., Moffitt, R. L., Ghaderi, A., Jarman, H. K., Liu, C., McClure, Z., Messer, M., & Linardon, J. (2026) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2026.0668 · Cited by 1 · see citing works
Outcome: Binge-Eating Disorder
Rösch, S. A., & Hilbert, A. (2023) · Springer eBooks · doi:10.1007/978-3-030-97416-9_90-1 · Cited by 1 · see citing works
Gangguan Makan di tengah Pandemi Covid-19 : Sebuah Perburukan Bermakna Terhadap Gizi
nur, A. S., & Ikhssani, A. (2022) · NUTRIENT · doi:10.36911/nutrient.v2i1.1307
Internet and Teletherapy in Eating Disorders
Cardi, V., & Ward, T. (2024) · Springer eBooks · doi:10.1007/978-3-030-97416-9_77-1
Internet and Teletherapy in Eating Disorders
Cardi, V., & Ward, T. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_77
Outcome: Binge-Eating Disorder
Rösch, S. A., & Hilbert, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_90
Behandlung und Therapie von Essstörungen und essgestörtem Verhalten
Kröller, K. (2026) · Springer eBooks · doi:10.1007/978-3-662-72399-9_17
Murphy, R., Osborne, E. L., & Khera, C. K. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70188
- Authors
- Moghimi, E., Davis, C., & Rotondi, M.
- Affiliations
- York University (CA)
- Corresponding author
- Moghimi, Elnaz
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2021-07-20
- Volume
- 23
- Issue
- 7
- Pages
- e17874
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC8335602
- OpenAlex
- W3161884157
- Cited by
- 36
- References
- 70
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 11 · 2022: 7 · 2021: 1
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (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
- binge eating disorder, digital health interventions, internet-based cognitive behavioral therapy, guided self-help, eating disorder psychopathology, body image concern, weight concern, body mass index, treatment efficacy
- MeSH terms
- Adult, Humans, Waiting Lists, Cognitive Behavioral Therapy, Telemedicine, Binge-Eating Disorder
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