An international group of researchers has demonstrated that online cognitive behavioural therapy (CBT) is an effective treatment option for people with bulimia nervosa (BN). The study is the first in Asia to demonstrate the effectiveness of guided internet-based CBT (iCBT) for this target group.
BN is a serious mental illness characterised by recurrent binge eating, followed by compensatory behaviours such as vomiting, fasting or excessive exercise. The disorder mainly affects young women and often develops during the teenage years. Without treatment, both physical and psychological symptoms can develop, ranging from dehydration and cardiac arrhythmia to depression and anxiety disorders.
Alternative to face-to-face therapy
Traditional face-to-face therapy is effective, but not accessible to everyone. Patients who live in remote areas or struggle with time constraints find it difficult to access specialist care. ICGT can play an important role in this.
The study, led by Dr Sayo Hamatani of Fukui University (Japan), involved 61 women aged between 13 and 65. The participants were randomly assigned to either a control group that received regular care or an intervention group that followed online CBT for 12 weeks. The digital treatment consisted of modules tailored to the Japanese context and was supervised by therapists via an online platform.
Promising results for online therapy
The results, published in JAMA Network Open, are promising: women in the ICGT group reported an average of ten fewer binge eating/vomiting episodes than the control group. In addition, the percentage of participants considered recovered rose from 13% (regular care) to 55% (ICGT). More than 75% of participants indicated that they would choose the programme again if they needed help in the future.
According to Dr Hamatani, digital therapy lowers the threshold to care and supports early intervention, which is crucial for recovery. The researchers advocate for the integration of ICGT into regular care provision, supported in part by insurers.
This study underlines the growing importance of digital healthcare applications in mental health care. By making innovative e-health solutions such as ICGT available, patients can be treated more quickly, more easily and more effectively. Not only does it offer a solution for people without access to specialised care, but it also contributes to a more equitable, future-proof mental health care system.
Added value of e-health
Previous doctoral research has already shown that e-health is a valuable addition to the treatment of eating disorders. PhD candidate Pieter Rohrbach demonstrated that online interventions, thanks to anonymity, accessibility and availability, can bring people into contact with help more quickly, which is crucial given the often long waiting times and psychosocial barriers.
Another study, dating from 2022, also showed that online cognitive behavioural therapy (CBT) is effective in the treatment of binge eating disorders, particularly in the form of the BEDonline programme. This digital therapy, based on CBT-Enhanced, lasts twelve weeks and combines online assignments with weekly telephone counselling. Research by Bernou Melisse (Novarum) shows that the results are comparable to regular CBT, which normally consists of 24 face-to-face sessions.
