The Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa: A Systematic Review and Recommendations for Future Research

Abstract

BackgroundPrevious studies have shown an unmet need in the treatment of eating disorders. In the last decade, interest in technology-based interventions (TBIs) (including computer- and Internet-based interventions [CBIs] or mobile interventions) for providing evidence-based therapies to individuals with different mental disorders has increased.ObjectiveThe aim of this review was to systematically evaluate the potential of TBIs in the field of eating disorders, namely for anorexia nervosa (AN) and bulimia nervosa (BN), for both prevention and treatment, and also for carers of eating disorder patients.MethodsA systematic literature search was conducted using Medline and PsycINFO. Bibliographies of retrieved articles were also reviewed without date or study type restrictions.ResultsForty studies resulting in 45 publications reporting outcomes fulfilled the inclusion criteria: 22 randomized controlled trials, 2 controlled studies, and 16 uncontrolled studies. In total, 3646 patients were included. Overall, the studies provided evidence for the efficacy of guided CBIs, especially for BN patients and for compliant patients. Furthermore, videoconferencing also appeared to be a promising approach. Evaluation results of Internet-based prevention of eating disorders and Internet-based programs for carers of eating disorder patients were also encouraging. Finally, there was preliminary evidence for the efficacy of mobile interventions.ConclusionsTBIs may be an additional way of delivering evidence-based treatments to eating disorder patients and their use is likely to increase in the near future. TBIs may also be considered for the prevention of eating disorders and to support carers of eating disorder patients. Areas of future research and important issues such as guidance, therapeutic alliance, and dissemination are discussed.

Treating eating disorders using the internet

“…The search date was up to April 2014 and eight studies met its inclusion criteria. The third systematic review [12] focused on anorexia nervosa and bulimia nervosa, and included studies of treatment and prevention and of help for carers of those with an eating disorder. The search date was up to August 2014.…”

The role of digital communication in patient–clinician communication for NHS providers of specialist clinical services for young people [the Long-term conditions Young people Networked Communication (LYNC) study]: a mixed-methods study

“…In a review of technology-based interventions for anorexia and bulimia nervosa, only one study out of the 40 identified (outcomes noted in 45 publications), observed differences between the preferences of patients and health-care professionals. 356 The authors of the review concluded that videoconferencing provides little benefit for clinical staff in terms of cost or time savings, but may assist patients who live in remote places and find it difficult to access specialist psychological services.…”

Evolution of cognitive-behavioral therapy for eating disorders

“…Hence, there is a large unmet need for treatment, and as highlighted by Wilson and colleagues (Fairburn & Wilson, 2013; Wilson & Zandberg, 2012), technology has the potential to make evidence-based treatment for eating disorders, such as CBT, more widely available and to address barriers to care. There has been a growing number of reviews on the use of technology, the Internet, and mobile applications (“apps”) for the treatment of eating disorders (i.e., Aardoom et al, 2013; Aardoom, Dingemans, & Van Furth, 2016; Ambwani, Cardi, & Treasure, 2014; Bauer & Moessner, 2013; Dölemeyer et al, 2013; Fairburn & Rothwell, 2015; Loucas et al, 2014; Schlegel, Bürger, Schmidt, Herbst, & Voderholzer, 2015; Shingleton, Richards, & Thompson-Brenner, 2013). Given the focus of the current paper on the evolution of CBT for eating disorders, we focus our overview specifically on RCTs that have utilized technology for CBT delivery with individuals with clinical eating disorders (see Table 1).…”