Long-term effectiveness of web-based cognitive behavioral therapy for patients with eating disorders

Eat Weight Disord. 2021 Apr;26(3):911-919. doi: 10.1007/s40519-020-00929-0. Epub 2020 May 24.

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 ).

Keywords: Binge eating disorder; Bulimia nervosa; Eating disorders; Long-term effectiveness; Web-based treatment; eHealth.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bulimia Nervosa*
  • Cognitive Behavioral Therapy*
  • Feeding and Eating Disorders* / therapy
  • Humans
  • Internet
  • Quality of Life