In-person versus virtual therapy in outpatient eating-disorder treatment: A COVID-19 inspired study

Int J Eat Disord. 2022 Jan;55(1):145-150. doi: 10.1002/eat.23655. Epub 2021 Dec 14.


Objective: Findings show virtual therapy (conducted using internet-based videoconferencing techniques) to be a viable alternative to in-person therapy for a variety of mental-health problems. COVID-19 social-distancing imperatives required us to substitute virtual interventions for in-person sessions routinely offered in our outpatient eating disorder (ED) program-and afforded us an opportunity to compare the two treatment formats for clinical efficacy.

Methods: Using self-report assessments, we compared outcomes in a historical sample of 49 adults with heterogeneous EDs (treated in-person over 10-14 weeks in individual and group therapies) to those of 76 patients receiving comparable virtual treatments, at distance, during the COVID-19 outbreak. Linear mixed models were used to study symptom changes over time and to test for differential effects of treatment modality.

Results: Participants in both groups showed similar improvements on eating symptoms, levels of weight gain (in individuals in whom gain was indicated), and satisfaction with services.

Discussion: Our results suggest that short-term clinical outcomes with virtual and in-person ED therapies are comparable, and point to potentials of virtual therapy for situations in which geographical distance or other barriers impede physical access to trained therapists or specialized treatments.

Keywords: COVID-19; anorexia nervosa; bulimia nervosa; eating disorders; online therapy; pandemic; psychotherapy; virtual therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19*
  • Feeding and Eating Disorders* / therapy
  • Humans
  • Outpatients
  • SARS-CoV-2
  • Videoconferencing