Many people who binge eat wish they could reduce the behavior, but have a hard time seeking help from a therapist or following through with therapy once they start. While there’s a lot of research on how to increase patients’ motivation once they are in therapy, a major barrier to treatment can be motivating someone to even begin therapy. A new research study released online last week describes a novel internet-based program designed to increase people’s motivation to change problematic eating attitudes and behaviors.
The study, released online ahead of print in Psychological Medicine, was conducted by researchers in Germany, UK, and Australia. They designed a six session internet-based program in which participants logged in weekly, completed different written assignments, and received individualized feedback. The written assignments included topics such as weighing the positives and negatives of the eating disorder symptoms, describing a typical day, and how eating disorder symptoms affect personal life goals.
Participants in the study endorsed symptoms of eating disorders including binge eating, purging, and restricting food intake. All participants were women ages 18-50. Unfortunately, men were excluded from the study. Also, because general eating disorder symptoms were assessed, there was no way to formally differentiate between women who may have met full criteria for anorexia, bulimia, or binge eating disorder.
How did the six session program affect participants? Compared to women who were awaiting participation (wait list control group), women who completed the internet program reported a stronger motivation to change problematic eating issues including fears of becoming fat, dieting, and purging. Motivation to specifically reduce binge eating didn't change. After completed the internet program, women also felt more burdened by their eating disorder symptoms compared to those in the control group. Despite feeling a greater burden and reporting motivation to change certain eating issues, there was no change in motivation to begin treatment. While we don't’ know if the women who completed the internet program may have been more likely to seek treatment in the future, it seems problematic that the internet program wasn’t able to increase motivation for treatment.
Another major issues is that about half of the women who started the internet program dropped out. It’s unclear why - perhaps the time commitment of six sessions felt like too much, the writing exercises were too emotionally challenging, or it was difficult to participate in the program without the accountability of a live therapist. Still there may have been many appealing aspects of the program for the other half of women – an internet program requires less time commitment than traveling to see a therapist, receiving even a little individualized feedback can feel supportive, and it’s anonymous.
Dr. Gupta is a professor at Barnard College of Columbia University and provides individual therapy at Tribeca Psychology
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