Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial

Elke D Ter Huurne,Hein A De Haan,Cor Aj Dejong,Marloes G Postel

doi:10.1186/1471-244x-13-310

Abstract

BackgroundDisordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified.Methods/designThis randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants’ motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs.DiscussionThis study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified.Trial registrationThe protocol for this study is registered with the Netherlands Trial Registry NTR2415.

Highlights

Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity
This study protocol presents the design of a randomized controlled trial (RCT) for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified
The RCT showed that the intervention was effective in decreasing disordered eating behavior and body dissatisfaction [37]

Summary

Introduction

Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. According to a recent review on the epidemiology of eating disorders, the incidence of anorexia nervosa (AN) in the Netherlands over the past decade has remained stable at around 7 per 100,000 persons per year [1]. For bulimia nervosa (BN) the incidence rate has been estimated at 6.1 per 100,000 persons per year [1]. In a population-based study in six European countries, including the Netherlands, the lifetime prevalence of AN and BN was estimated to be 0.48% and 0.51%, respectively [2]. In the six European countries studied, the lifetime prevalence of BED was 1.12% [2]

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