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Treatment delivery strategies for eating disorders

Machado, Paulo P.P.; Rodrigues, Tânia F.

doi: 10.1097/YCO.0000000000000542
EATING DISORDERS: Edited by Hans W. Hoek and Anna Keski-Rahkonen

Purpose of review The traditional model of treatment delivery, based on a psychotherapeutic intervention delivered by a trained professional, in a one-to-one relationship, occurring in a treatment setting context (e.g., clinic, private office, and hospital), highly restricts access to the best standards of care to all of those in need.

In this article, we will be focusing on treatment delivering methods for eating disorders that depart from the traditional mode of delivery. We will focus on the use of self-help strategies, both in a pure self-help format, and with external minimal support, guided self-help. We will additionally review the evidence on the use of internet and mobile technology (m-Health) for delivering treatment.

Recent findings Internet-based self-help interventions based on cognitive behavioral approaches have shown to be superior to no treatment for patients diagnosed with bulimia nervosa, binge eating disorder, and other specified feeding or eating disorders with binge/purge characteristics. Although face-to-face, traditional, interventions seem to be more effective than internet-based ones, the latter might have cost benefits and constitute a viable first line of treatment in a stepped care model, or as an alternative to a waitlist while treatment is not available. Other forms of mobile health (e.g., mobile apps) have experienced a surge but remain under researched.

Summary Mobile health and the internet are promising media for delivering eating disorder treatment. However, more research is needed to determine the utility of internet-based treatments by comparing them to traditional face-to-face treatments for eating disorders, and explore the moderators and mediators impacting adherence and outcome.

Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Braga, Portugal

Correspondence to Paulo P.P. Machado, PhD, FAED, University of Minho, School of Psychology, Campus de Gualtar, 4710-057 Braga, Portugal. Tel: +351 25 3604240; fax: +351 25 3606224; e-mail:

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