Objective To evaluate the feasibility, acceptability, and preliminary efficacy of an innovative therapist‐guided smartphone‐based aftercare intervention following inpatient treatment of patients with severe anorexia nervosa (AN). Method Forty female patients with AN (ICD‐10: F50.0/F50.1) (aged: 15–36 years) were randomized either to an 8‐week smartphone‐based aftercare intervention (German version of “Recovery Record”) with therapist feedback as an adjunct to treatment as usual (intervention group [IG]) or to treatment as usual alone (control group [CG]). Body mass index (BMI) and eating disorder (ED) symptoms were assessed at discharge (baseline), postintervention (after 8 weeks), and at 6‐month follow‐up. Additionally, patients' satisfaction, adherence to the smartphone‐based intervention, and postdischarge health care utilization were evaluated. Results Patients showed a high level of adherence and reported a very high acceptance of the app and the aftercare intervention. We found at postintervention nonsignificant small to moderate between‐group effect sizes favoring the IG regarding BMI (d = −0.24; 95% confidence interval [CI] [−0.90, 0.41]) and ED symptoms (Eating Disorder Examination‐Questionnaire global: d = 0.56; 95% CI [−0.10, 1.22]). At 6‐month follow‐up, effects wore off and no significant differences between the IG and CG were evident. Discussion This was the first study to evaluate a therapist‐guided smartphone‐based aftercare intervention for discharged inpatients with AN. Results suggest that such an intervention is highly accepted by patients and that it could support symptom stabilization or continued improvement as an add‐on therapy to treatment as usual. A larger scale randomized controlled trial is now planned to further evaluate the efficacy of this aftercare intervention for patients with AN.

Smartphone apps have the capacity to reach and engage traditionally underserved individuals with eating disorders at a large scale. Additional work is indicated for the evaluation of the clinical effectiveness of applications for specific user groups and in clinical treatment contexts.

Eating disorders (EDs) often develop during adolescence and early adulthood but may persist, arise, or reemerge across the life span. Research and treatment efforts primarily focus on adolescent and young adult populations, leaving large knowledge gaps regarding ED symptoms across the entire developmental spectrum. The current study uses network analysis to compare central symptoms (i.e., symptoms that are highly connected to other symptoms) and symptom pathways (i.e., relations among symptoms) across five developmental stages (early adolescence, late adolescence, young adulthood, early-middle adulthood, middle-late adulthood) in a large sample of individuals with EDs (N = 29,902; N = 32,219) in two network models. Several symptoms related to overeating, food avoidance, feeling full, and overvaluation of weight and shape emerged as central in most or all developmental stages, suggesting that some core symptoms remain central across development. Despite similarities in central symptoms, significant differences in network structure (i.e., how symptom pathways are connected) emerged across age groups. These differences suggest that symptom interconnectivity (but not symptom severity) might increase across development. Future research should continue to investigate developmental symptom differences in order to inform treatment for individuals with EDs of all ages.

People attending substance abuse treatment show extremely high rates of smoking (77%). With the large majority of participants showing multiple risk factors for CVD, it is important that residential services consider strategies to address smoking and the other potentially modifiable health risk factors in an integrated fashion.