E-therapy in the treatment and prevention of eating disorders: A systematic review and meta-analysis

Abstract

The widespread availability of the Internet and mobile-device applications (apps) is changing the treatment of mental health problems. The aim of the present study was to review the research on the effectiveness of e-therapy for eating disorders, using the methodology employed by the UK's National Institute for Health and Care Excellence (NICE). Electronic databases were searched for published randomised controlled trials of e-therapies, designed to prevent or treat any eating disorder in all age groups. Studies were meta-analysed where possible, and effect sizes with confidence intervals were calculated. The GRADE approach was used to determine the confidence in the effect estimates. Twenty trials met the inclusion criteria. For prevention, a CBT-based e-intervention was associated with small reductions in eating disorder psychopathology, weight concern and drive for thinness, with moderate confidence in the effect estimates. For treatment and relapse prevention, various e-therapies showed some beneficial effects, but for most outcomes, evidence came from single studies and confidence in the effect estimates was low. Overall, although some positive findings were identified, the value of e-therapy for eating disorders must be viewed as uncertain. Further research, with improved methods, is needed to establish the effectiveness of e-therapy for people with eating disorders.

StudentBodies-eating disorders: A randomized controlled trial of a coached online intervention for subclinical eating disorders

“…However, some studies have shown significant changes, but only small to medium effect sizes for self-reported depressive symptoms (Jones et al, 2014;Ohlmer et al, 2013). A 2014 review of e-therapies for anxiety and depression concluded that in computerized CBT programs, the amount of therapist input given is an important feature that likely affects outcome (Loucas et al, 2014). While the current study did include feedback/input from coaches, the majority of the feedback focused on ED-related pathology, rather than depressive symptoms.…”

Efficacy of a Parent-Based, Indicated Prevention for Anorexia Nervosa: Randomized Controlled Trial (Preprint)

“…Several previous reviews and meta-analyses suggest that prevention programs for ED in general reduce risk factors for, symptoms of and -in few caseseven onset ED of mostly bulimic or binge eating-type ED [16][17][18][19][20][21]. Prevention programs reviewed in these analyses include universal and indicated programs, school-based vs. individually-based, face-to-face vs. Internet-based, and directed at age ranges from younger children to young adults.…”

The effect of pre-treatment psychoeducation on eating disorder pathology among patients with anorexia nervosa and bulimia nervosa

“…These include online family-based early interventions to reduce risk behaviour (Jones, Volker, Lock, Barr Taylor, & Jacobi, 2012), mirroring in-person prevention work (Sadeh-Sharvit, Zubery, Mankovski, Steiner, & Lock, 2016). However, little support has been found to date for online psychoeducational interventions in clinical groups (Loucas et al, 2014), suggesting that future developments may need to be in the domain of face-to-face interventions. It will also be important to assess the viability of such interventions in a group format, to ensure costeffectiveness.…”