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Randomized Controlled Trial
. 2022 Oct;55(10):1361-1373.
doi: 10.1002/eat.23785. Epub 2022 Jul 30.

Effectiveness of an online self-help program, expert-patient support, and their combination for eating disorders: Results from a randomized controlled trial

Pieter J Rohrbach  1   2 , Alexandra E Dingemans  1 , Philip Spinhoven  2   3 , Joost R Van Ginkel  3 , Marjolein Fokkema  3 , Tom F Wilderjans  3   4   5 , Stephanie Bauer  6 , Eric F Van Furth  1   2
Affiliations
Randomized Controlled Trial

Effectiveness of an online self-help program, expert-patient support, and their combination for eating disorders: Results from a randomized controlled trial

Pieter J Rohrbach et al. Int J Eat Disord. 2022 Oct.

Abstract

Objective: Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the effectiveness of Featback, a fully automated online self-help intervention, online expert-patient support and their combination.

Method: A randomized controlled trial with a 12-month follow-up period was conducted. Participants aged 16 or older with at least mild eating disorder symptoms were randomized to four conditions: (1) Featback, a fully automated online self-help intervention, (2) chat or email support from a recovered expert patient, (3) Featback with expert-patient support and (4) a waiting list control condition. The intervention period was 8 weeks and there was a total of six online assessments. The main outcome constituted reduction of eating disorder symptoms over time.

Results: Three hundred fifty five participants, of whom 43% had never received eating disorder treatment, were randomized. The three active interventions were superior to a waitlist in reducing eating disorder symptoms (d = -0.38), with no significant difference in effectiveness between the three interventions. Participants in conditions with expert-patient support were more satisfied with the intervention.

Discussion: Internet-based self-help, expert-patient support and their combination were effective in reducing eating disorder symptoms compared to a waiting list control condition. Guidance improved satisfaction with the internet intervention but not its effectiveness. Low-threshold interventions such as Featback and expert-patient support can reduce eating disorder symptoms and reach the large group of underserved individuals, complementing existing forms of eating disorder treatment.

Public significance statement: Individuals with eating-related problems who received (1) a fully automated internet-based intervention, (2) chat and e-mail support by a recovered individual or (3) their combination, experienced stronger reductions in eating disorder symptoms than those who received (4) usual care. Such brief and easy-access interventions play an important role in reaching individuals who are currently not reached by other forms of treatment.

Keywords: eHealth; eating disorders; expert patient; internet-based intervention; randomized controlled trial; treatment gap.

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Conflict of interest statement

P. Rohrbach reports a grant from ZonMw during the conduct of the study. No other disclosures were reported.

Figures

FIGURE 1
FIGURE 1
Participant flow during the study
FIGURE 2
FIGURE 2
Distribution of eating disorder examination questionnaire (EDE‐Q) total scores at baseline (a) and postintervention (b)
See this image and copyright information in PMC

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