Treating eating disorders over the internet: A systematic review and future research directions

Abstract

Future research should determine the utility of internet-based treatment by comparing them to face-to-face treatment. Research should furthermore focus on unraveling predictors and mediators of treatment outcome, compliance, and dropout, respectively. Studies with good methodological quality are needed with reports according to CONSORT guidelines.

Comparison of face-to-face versus email guided self-help for binge eating: study protocol for a randomised controlled trial

“…A further aim is to evaluate the possibility of providing supervision over the Internet for eating disorder interventions, an idea that has not received much empirical attention, although some studies have used online supervision forums as part of mental health treatment (for example, [59]). As is also suggested in the recent review of Aardoom and colleagues [60], future studies would benefit from investigating therapeutic alliance across face-to-face and Internet-delivered treatments. Although some limitations of the current design exist (for example, imperfect allocation concealment, lack of blinding, lack of a placebo control (see [31]), it is hoped that the results of this methodology will produce high ecological and external validity, as this (clinical) sample is recruited through a typical UK healthcare service, and may be described as a ‘pragmatic RCT’ [51].…”

“…Although Internet-delivered interventions have promise and appear to be highly acceptable ( [60]; see also [61]), there are many potential drawbacks. Some studies report negative feedback regarding email communication (for example, [7,62]), and individuals may require additional commitment or motivation than a treatment requiring face-to-face attendance.…”

A Randomized Controlled Trial of an Internet-Based Posttreatment Care for Patients with Eating Disorders

“…[38][39][40][41] Overall, the findings are promising with respect to feasibility and efficacy of such interventions, but there is a clear need for further research as only very few adequately powered randomized controlled trials (RCTs) have been completed so far. 42,43 A relapse prevention program using short message service (SMS) and text messaging technology proved feasible 38 and efficacious 39 among patients with BN and related EDNOS. Bauer et al 39 studied the efficacy of this intervention among 165 patients after discharge from inpatient treatment against a treatment-as-usual (TAU) control condition.…”

Is the Eating Disorder Questionnaire-Online (EDQ-O) a valid diagnostic instrument for the DSM-IV-TR classification of eating disorders?

“…Internet interventions are effective in reducing eating disorder psychopathology, binge eating and purging, as well as in improving quality of life [8]. The diagnostic classification process according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [9] is different for online interventions than for face-to-face treatment.…”