Randomized Clinical Trial Evaluating AcceptME—A Digital Gamified Acceptance and Commitment Early Intervention Program for Individuals at High Risk for Eating Disorders

Abstract

Eating disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat, as these disorders are ego-syntonic, and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs for individuals presenting at risk and are on a trajectory towards developing EDs. This study is a randomized controlled trial evaluating an innovative digital gamified Acceptance and Commitment early-intervention program (AcceptME) for young females showing signs and symptoms of an ED and at high risk for an ED. Participants (n = 92; Mage = 15.30 years, SD = 2.15) received either AcceptME (n = 62) or a waitlist control (n = 30). Analyses indicated that the AcceptME program effectively reduced weight and shape concerns with large effects when compared to waitlist controls. Most participants scored below the at-risk cut-off (WCS score < 52) in the AcceptME at end-of-intervention (57.1%) compared to controls (7.1%), with odds of falling into the at-risk group being 14.5 times higher for participants in the control group. At follow-up, 72% of completers reported scores below the at-risk cut-off in the AcceptME group. The intervention also resulted in a decrease in ED symptomatology and increased body image flexibility. Overall, results suggest that the AcceptME program holds promise for early-intervention of young women at risk for developing an ED.

Predictors, mediators, and moderators of response to digital interventions for eating disorders: A systematic review

“…Although many studies included in this review incorporated some interactive features in their interventions (i.e., discussion groups, quizzes, and progress monitoring tools), Linardon, Messer, et al (2022) suggest such “rudimentary” features common across most digital programs have little impact on enhancing outcomes; instead, more advanced technological features (i.e., chatbots, gamification) may be needed to boost engagement, particularly for younger people. While more recent digital programs have begun to incorporate more advanced features (Fitzsimmons‐Craft et al, 2022; Karekla et al, 2022), it is not yet clear whether these features lead to improved retention amongst younger people or not. Thus, it may be useful for future research to explore how advanced technological features impact engagement across age groups, as this may shed light on whether there are specific features that may boost retention amongst young people.…”

Learning by observing: a systematic exploration of modulatory factors and the impact of observationally induced placebo and nocebo effects on treatment outcomes

“…In a study concerning diabetes type 1, the participants themselves were responsible for developing a video as part of the intervention ( Massouh et al, 1989 ). In another study, participants guided a fictional character through a gamified intervention ( Karekla et al, 2022 ) and in a third study, participants in a substance use prevention program had the option to select content that interested them and respond to questions via a mobile phone application ( Haug et al, 2021 ). Although the video development intervention by Massouh et al (1989) did not yield a significant effect, the two more recent digitally delivered interventions both reported significant results, at least for some of the main outcomes.…”

Virtual prevention of eating disorders in children, adolescents, and emerging adults: a scoping review

“…Children and adolescents One RCT randomized adolescent girls at high-risk for EDs (based on WCS score) to either AcceptME , intervention (n = 62) or waitlist control (n = 30) [ 78 ]. Compared to controls, participants in the intervention group had significantly lower weight and shape concerns at the end of the program, with effects maintained at 1-month follow-up.…”