Long-term Effectiveness of Web-based Cognitive Behavioral Therapy for Patients with Eating Disorders

Overview

Journal Eat Weight Disord

Publisher Springer

Date 2020 May 26

PMID 32449152

Citations 4

Authors

Elke D Ter Huurne

Hein A de Haan

Marloes G Postel

Cor A J DeJong

Joanne E L VanDerNagel

Job van der Palen

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the long-term effectiveness of a web-based therapist-delivered cognitive behavioral therapy (CBT) for patients with eating disorders (ED).

Methods: We used follow-up data from a randomized controlled trial that evaluated a web-based CBT on ED psychopathology and related health, compared to a waiting list control (WL) condition. As participants of the WL condition started the intervention after their waiting period, follow-up data included participants from both groups. The primary outcome was change from baseline, at 3, 6, and 12-month intervals in ED psychopathology, analyzed using mixed models for repeated measures. Secondary outcomes included body dissatisfaction, BMI, physical health, mental health, self-esteem, quality of life, and social functioning.

Results: The population comprised 212 participants in total, in three subgroups: bulimia nervosa (BN; n = 44), binge eating disorder (BED; n = 83), and ED not otherwise specified (EDNOS; n = 85). Treatment effects were sustained during follow-up, with generally large effect sizes for the reduction of ED psychopathology and body dissatisfaction, and small to moderate effect sizes for physical and mental health, self-esteem, social functioning, and quality of life. Most effects were found for all three subgroups, except for long-term improvements in self-esteem and quality of life among participants with BN and EDNOS.

Conclusion: This study showed long-term sustainability of treatment effects up to 1-year post-treatment of a web-based therapist-delivered CBT for patients with various ED.

Level Of Evidence: Level IV, evidence obtained from multiple time series analysis, with intervention.

Unique Clinical Trial Number: NTR2415-Dutch Trial Registry ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2415 ).

Citing Articles

Psychotherapies for eating disorders: findings from a rapid review.

Russell H, Aouad P, Le A, Marks P, Maloney D, Touyz S J Eat Disord. 2023; 11(1):175.

PMID: 37794513 PMC: 10548609. DOI: 10.1186/s40337-023-00886-w.

Efficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy-Enhanced for Binge Eating Disorder: Randomized Controlled Trial.

Melisse B, van den Berg E, de Jonge M, Blankers M, van Furth E, Dekker J J Med Internet Res. 2023; 25:e40472.

PMID: 37126386 PMC: 10186189. DOI: 10.2196/40472.

The Role of Serious Video Games in the Treatment of Disordered Eating Behaviors: Systematic Review.

Tang W, Ng T, Wong J, Ho C J Med Internet Res. 2022; 24(8):e39527.

PMID: 36036967 PMC: 9468918. DOI: 10.2196/39527.

Therapeutic Alliance in Web-Based Treatment for Eating Disorders: Secondary Analysis of a Randomized Controlled Trial.

Stoeten C, de Haan H, Postel M, Brusse-Keizer M, Ter Huurne E JMIR Form Res. 2022; 6(6):e33813.

PMID: 35771608 PMC: 9284349. DOI: 10.2196/33813.

References

Aardoom J, Dingemans A, Spinhoven P, van Furth E . Treating eating disorders over the internet: a systematic review and future research directions. Int J Eat Disord. 2013; 46(6):539-52. DOI: 10.1002/eat.22135. View

Becker A, Hadley Arrindell A, Perloe A, Fay K, Striegel-Moore R . A qualitative study of perceived social barriers to care for eating disorders: perspectives from ethnically diverse health care consumers. Int J Eat Disord. 2009; 43(7):633-47. PMC: 3020364. DOI: 10.1002/eat.20755. View

Evans E, Hay P, Mond J, Paxton S, Quirk F, Rodgers B . Barriers to help-seeking in young women with eating disorders: a qualitative exploration in a longitudinal community survey. Eat Disord. 2011; 19(3):270-85. DOI: 10.1080/10640266.2011.566152. View

Cachelin F, Striegel-Moore R . Help seeking and barriers to treatment in a community sample of Mexican American and European American women with eating disorders. Int J Eat Disord. 2005; 39(2):154-61. DOI: 10.1002/eat.20213. View

Agh T, Kovacs G, Pawaskar M, Supina D, Inotai A, Voko Z . Epidemiology, health-related quality of life and economic burden of binge eating disorder: a systematic literature review. Eat Weight Disord. 2015; 20(1):1-12. PMC: 4349998. DOI: 10.1007/s40519-014-0173-9. View

Arcelus J, Mitchell A, Wales J, Nielsen S . Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011; 68(7):724-31. DOI: 10.1001/archgenpsychiatry.2011.74. View

Dejong H, Oldershaw A, Sternheim L, Samarawickrema N, Kenyon M, Broadbent H . Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified. J Eat Disord. 2014; 1:43. PMC: 4081766. DOI: 10.1186/2050-2974-1-43. View

Dickstein L, Franco K, Rome E, Auron M . Recognizing, managing medical consequences of eating disorders in primary care. Cleve Clin J Med. 2014; 81(4):255-63. DOI: 10.3949/ccjm.81a.12132. View

Hart L, Granillo M, Jorm A, Paxton S . Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clin Psychol Rev. 2011; 31(5):727-35. DOI: 10.1016/j.cpr.2011.03.004. View

10.

Rie S, Noordenbos G, Donker M, van Furth E . Evaluating the treatment of eating disorders from the patient's perspective. Int J Eat Disord. 2006; 39(8):667-76. DOI: 10.1002/eat.20317. View

11.

Escobar-Koch T, Banker J, Crow S, Cullis J, Ringwood S, Smith G . Service users' views of eating disorder services: an international comparison. Int J Eat Disord. 2009; 43(6):549-59. DOI: 10.1002/eat.20741. View

12.

Grilo C, Pagano M, Stout R, Markowitz J, Ansell E, Pinto A . Stressful life events predict eating disorder relapse following remission: six-year prospective outcomes. Int J Eat Disord. 2011; 45(2):185-92. PMC: 3275672. DOI: 10.1002/eat.20909. View

13.

Herzog D, Dorer D, Keel P, Selwyn S, Ekeblad E, FLORES A . Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study. J Am Acad Child Adolesc Psychiatry. 1999; 38(7):829-37. DOI: 10.1097/00004583-199907000-00012. View

14.

Wagner G, Penelo E, Wanner C, Gwinner P, Trofaier M, Imgart H . Internet-delivered cognitive-behavioural therapy v. conventional guided self-help for bulimia nervosa: long-term evaluation of a randomised controlled trial. Br J Psychiatry. 2012; 202:135-41. DOI: 10.1192/bjp.bp.111.098582. View

15.

Ruwaard J, Lange A, Broeksteeg J, Renteria-Agirre A, Schrieken B, Dolan C . Online cognitive-behavioural treatment of bulimic symptoms: a randomized controlled trial. Clin Psychol Psychother. 2012; 20(4):308-18. DOI: 10.1002/cpp.1767. View

16.

Mitchell J, Crosby R, Wonderlich S, Crow S, Lancaster K, Simonich H . A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behav Res Ther. 2008; 46(5):581-92. PMC: 2633728. DOI: 10.1016/j.brat.2008.02.004. View

17.

Zerwas S, Watson H, Hofmeier S, Levine M, Hamer R, Crosby R . CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa. Psychother Psychosom. 2016; 86(1):47-53. PMC: 5143175. DOI: 10.1159/000449025. View

18.

de Zwaan M, Herpertz S, Zipfel S, Svaldi J, Friederich H, Schmidt F . Effect of Internet-Based Guided Self-help vs Individual Face-to-Face Treatment on Full or Subsyndromal Binge Eating Disorder in Overweight or Obese Patients: The INTERBED Randomized Clinical Trial. JAMA Psychiatry. 2017; 74(10):987-995. PMC: 5710472. DOI: 10.1001/jamapsychiatry.2017.2150. View

19.

Ter Huurne E, de Haan H, Postel M, van der Palen J, VanDerNagel J, DeJong C . Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial. J Med Internet Res. 2015; 17(6):e152. PMC: 4526949. DOI: 10.2196/jmir.3946. View

20.

Ter Huurne E, Postel M, de Haan H, DeJong C . Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial. BMC Psychiatry. 2013; 13:310. PMC: 3840645. DOI: 10.1186/1471-244X-13-310. View