Scientific evidence of online interventions for eating disorders done in randomized controlled trials: an integrative review




Eating disorders; Cognitive behavioral therapy; Internet; Web; Online.


Eating disorders are eating disorders that the individual is unable to eat, or even overeat, for various reasons. Usually, the disorder appears as an indication of a complex psychological problem, such as anxiety and even social pressure, and is often related to physical appearance or body weight. Taking into account that online therapies that have become alternatives of easy, fast and economical access to the search for psychological treatment, this research aimed to review the scientific literature on randomized clinical trials that evaluated online interventions for eating disorders. The question that guided the review was: "What is the scientific evidence for online interventions for eating disorders done in randomized controlled trials?" Data collection was obtained through two research bases (PubMed and Virtual Health Library), using the terms of the Health Sciences Descriptors (Eating disorder treatment, internet, web, online) and making combinations of the terms with the connective “and”. According to the pre-established inclusion criteria, the research resulted in 12 elected articles that served as a reference for the body of the discussion. Although some authors have found negative results among their participants, most studies have shown that cognitive behavioral therapies online have shown to be interventions of greater therapeutic value for the reduction and control of psychopathology, body dissatisfaction and health problems caused by eating disorder . However, there is a shortage of articles made in randomized clinical trials on this issue, and further studies are needed.


American Psychiatric Association. (2014). DSM-5: Manual diagnóstico e estatístico de transtornos mentais. Artmed Editora. Retrieved from:

Andersson, G., Titov, N., Dear, B. F., Rozental, A., & Carlbring, P. (2019). Internet‐delivered psychological treatments: from innovation to implementation. World Psychiatry, 18(1), 20-28. Retrieved from: doi: 10.1002/wps.20610

Abrahamsson, N., Ahlund, L., Ahrin, E., & Alfonsson, S. (2018). Video-based CBT-E improves eating patterns in obese patients with eating disorder: A single case multiple baseline study. Journal of behavior therapy and experimental psychiatry, 61, 104-112. Retrieved from: doi: 10.1016/j.jbtep.2018.06.010

Chithambo, T. P., & Huey Jr, S. J. (2017). Internet‐delivered eating disorder prevention: A

randomized controlled trial of dissonance‐based and cognitive‐behavioral interventions. International Journal of Eating Disorders, 50(10), 1142-1151. Retrieved from: doi: 10.1002/eat.22762

Ercole, F. F., Melo, L. S. D., & Alcoforado, C. L. G. C. (2014). Revisão integrativa versus revisão sistemática. Revista Mineira de Enfermagem, 18(1), 9-12. Retrieved from: doi: 10.5935/1415-2762.20140001

Fairburn, C. G., & Patel, V. (2017). The impact of digital technology on psychological treatments and their dissemination. Behaviour research and therapy, 88, 19-25. Retrieved from: doi: 10.1016/j.brat.2016.08.012

Ferreira, T. D. (2018). Transtornos Alimentares: Principais Sintomas e Características Psíquicas. Revista Uningá, 55(2), 169-176. Retrieved from:

Green, M. A., Kroska, A., Herrick, A., Bryant, B., Sage, E., Miles, L., ... & King, B. (2018). A preliminary trial of an online dissonance-based eating disorder intervention. Eating behaviors, 31, 88-98. Retrieved from: doi: 10.1016/j.eatbeh.2018.08.007

Huurne, E. D., Postel, M. G., de Haan, H. A., van der Palen, J., & DeJong, C. A. (2017). Treatment dropout in web-based cognitive behavioral therapy for patients with eating disorders. Psychiatry research, 247, 182-193. Retrieved from: doi: 10.1016/j.psychres.2016.11.034

Huurne, E. D., de Haan, H. A., Postel, M. G., van der Palen, J., VanDerNagel, J. E., & DeJong, C. A. (2015). Web-based cognitive behavioral therapy for female patients with eating disorders: randomized controlled trial. Journal of medical Internet research, 17(6), e152. Retrieved from: doi: 10.2196/jmir.3946

Hildebrandt, T., Michaeledes, A., Mayhew, M., Greif, R., Sysko, R., Toro-Ramos, T., & DeBar, L. (2020). Randomized controlled trial comparing health coach-delivered smartphone-guided self-help with standard care for adults with binge eating. American Journal of Psychiatry, 177(2), 134-142. Retrieved from: doi: 10.1176/appi.ajp.2019.19020184

Nitsch, M., Dimopoulos, C. N., Flaschberger, E., Saffran, K., Kruger, J. F., Garlock, L., ... & Jones, M. (2016). A guided online and mobile self-help program for individuals with eating disorders: an iterative engagement and usability study. Journal of medical Internet research, 18(1), e7. Retrieved from: doi: 10.2196/jmir.4972

Nicolao, A. C., Ferrari, A., & Piornedo, G. M. (2018). Culto ao corpo, dietas restritivas e o desenvolvimento de transtornos alimentares. Retrieved from:

Oliveira, M. A. P. D., Velarde, L. G. C., & Sá, R. A. M. D. (2015). Ensaios clínicos randomizados: Série Entendendo a Pesquisa Clínica 2. Femina. Retrieved from:

Schueller, S. M., Stiles-Shields, C., & Yarosh, L. (2017). Online treatment and virtual therapists in child and adolescent psychiatry. Child and Adolescent Psychiatric Clinics, 26(1), 1-12. Retrieved from: doi: 10.1016/j.chc.2016.07.011

Schuster, R., Pokorny, R., Berger, T., Topooco, N., & Laireiter, A. R. (2018). The advantages and disadvantages of online and blended therapy: survey study amongst licensed psychotherapists in Austria. Journal of medical Internet research, 20(12), e11007. Retrieved from: doi: 10.2196 / 11007

Sharma, N., Srivastav, A. K., & Samuel, A. J. (2020). Ensaio clínico randomizado: padrão ouro de desenhos experimentais-importância, vantagens, desvantagens e preconceitos. Revista Pesquisa em Fisioterapia, 10(3), 512-519. Retrieved from: doi: 10.17267/2238-2704rpf.v10i3.3039

Shaw, H., Rohde, P., & Stice, E. (2016). Participant feedback from peer‐led, clinician‐led, and internet‐delivered eating disorder prevention interventions. International Journal of Eating Disorders, 49(12), 1087-1092. Retrieved from: doi: 10.1002/eat.22605

Viana, L. T. M., de Carvalho Passos, J., Sousa, C. R. N., & da Silva, M. S. (2020). Influência dos transtornos alimentares em jovens do sexo feminino. Research, Society and Development, 9(8), e589985897-e589985897. Retrieved from: doi: 10.33448/rsd-v9i8.5897

Węgłowska-Rzepa, K. (2016). Virtual reality in psychological treatment and psychotherapy. ICTM 2016, 239. Retrieved from:

Watson, H. J., Levine, M. D., Zerwas, S. C., Hamer, R. M., Crosby, R. D., Sprecher, C. S., ... & Moessner, M. (2017). Predictors of dropout in face‐to‐face and internet‐based cognitive‐behavioral therapy for bulimia nervosa in a randomized controlled trial. International Journal of Eating Disorders, 50(5), 569-577. Retrieved from: doi: 10.1002/eat.22644

Wagner, B., Nagl, M., Dölemeyer, R., Klinitzke, G., Steinig, J., Hilbert, A., & Kersting, A. (2016). Randomized controlled trial of an internet-based cognitive-behavioral treatment program for binge-eating disorder. Behavior Therapy, 47(4), 500-514. Retrieved from: doi: 10.1016/j.beth.2016.01.006

Zwaan, M., Herpertz, S., Zipfel, S., Svaldi, J., Friederich, H. C., Schmidt, F., ... & Hilbert, A. (2017). Effect of internet-based guided self-help vs individual face-to-face treatment on full or Subsyndromal binge eating disorder in overweight or obese patients: the INTERBED randomized clinical trial. JAMA psychiatry, 74(10), 987-995. Retrieved from: doi: 10.1001/jamapsychiatry.2017.2150



How to Cite

SILVA, F. F. .; RETRÃO, Érica V. da S. .; LANDIM, L. A. dos S. R. . Scientific evidence of online interventions for eating disorders done in randomized controlled trials: an integrative review. Research, Society and Development, [S. l.], v. 9, n. 10, p. e7709109204, 2020. DOI: 10.33448/rsd-v9i10.9204. Disponível em: Acesso em: 27 jun. 2022.



Health Sciences