Treatment Delivery Strategies for Eating Disorders

Paulo P.P. Machado; Tânia F. Rodrigues


Curr Opin Psychiatry. 2019;32(6):498-503. 

In This Article

Smartphone Applications in the Treatment of Eating Disorders

Developments in mobile technology created an incredible surge in health-related mobile applications (apps) or m-Health,[22] and the use of all sort of mobile devices. Until now, two reviews were published, aimed at identifying available apps for eating disorders treatment[23,24] and assess their functions and clinical utility. Fairburn and Rothwell,[23] identified 39 apps designed for people with eating disorders. The authors, at the time, identified only 2 apps providing good information, and 2 providing good self-assessment tools. Generally, the authors considered the full potential of existing apps at the time yet to be achieved.

The most recent review[24] analyzed the 6 apps identified as providing some kind of intervention for eating disorders. The authors signaled out Recovery Record[25] as the app delivering the most empirically supported content. A recent study[26] explored the experiences of 49 Danish outpatients with this app as part of their eating disorder treatment. Results were mixed, with some patients experiencing the app as supportive, whereas others considered it obstructive of day-to-day life.

Most recently, Hildebrandt and colleagues[27] tested the efficacy of using a smartphone app (Noom Monitor, Noom Inc., New York, USA), developed to facilitate CBT-GSH by simplifying and digitizing self-monitoring records, on study retention, adherence, and eating disorder symptoms compared to traditional CBT-GSH. Patients receiving CBT-GSH and Noom experienced a greater reduction in binge and purging than in standard CBT-GSH by end-of-treatment. However, remission rates and binge frequency were not significantly different at 6-month follow-up and there were no significant effects on abstinence rates.

In another study, Lyzwinski and colleagues[28] tested the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress, comparing it to a control condition – use of a behavioral self-monitoring electronic diary for diet and exercise. Results showed that the app assisted with some weight-related behaviors, including emotional eating and binge eating, as well as with increasing mindfulness, mindful eating, and reducing stress in adherers. The e-diary group had higher moderate-to-vigorous physical activity levels. Although this study did not include participants with an eating disorder, it might shed some light on the use of apps based on approaches that depart from traditional CBT.

The current status of the research on m-Health provides insufficient empirical support for any particular app in the treatment of eating disorders. Thus, to the best of our knowledge there is no current study on the efficacy of available apps in the treatment of eating disorders.