# Effectiveness of unguided internet-based computer self-help platforms for eating disorders (with or without an associated app): A systematic review

## TL;DR

This paper reviews how well online self-help tools for eating disorders work without therapist guidance, finding they can reduce symptoms effectively.

## Contribution

The study provides a systematic review of unguided internet-based self-help platforms for eating disorders, highlighting their effectiveness across prevention and treatment stages.

## Key findings

- Unguided online platforms effectively reduce eating disorder symptoms and behaviors in the short term.
- Psychoeducation, cognitive behavioral, and dissonance-based approaches are most commonly used and effective.
- These platforms are suitable for early intervention in a tiered healthcare system.

## Abstract

Following the COVID-19 pandemic, internet-based computer self-help platforms for eating disorders (EDs) became increasingly prevalent as a tool to effectively prevent and treat ED symptoms and related behaviours. This systematic review explored the effectiveness of unguided internet-based computer self-help platforms for EDs.

From inception to the 31st of May 2024, a systematic search of Ovid MEDLINE, Embase, Global Health, and APA PsycInfo was conducted. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcome quality assessments were conducted according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

12 RCTs, with a total of 3400 participants, were included. 2 studies explored the effectiveness as primary prevention, 7 as secondary prevention, and 3 as tertiary intervention. The gathered literature demonstrated unguided internet-based computer self-help platforms as effective in reducing ED core symptoms and related behaviours, with psychoeducation, cognitive behavioural, and dissonance-based approaches being the most prevalent approaches.

Unguided internet-based computer self-help platforms are effective in the short-term reduction of ED symptoms and associated behaviours and should be implemented in the early stages of a tiered healthcare system for ED treatments.

Prospero (CRD42024520866).

With the rise of the COVID-19 pandemic, online self-help programs for eating disorders (EDs) have become more common. These programs aim to prevent and reduce ED symptoms without direct guidance from a therapist. This review examined how effective these unguided internet-based self-help platforms are for ED prevention and treatment. Researchers systematically analyzed 12 clinical studies involving 3,400 participants. The studies explored the use of these programs in different stages of ED care: some focused on preventing EDs, while others targeted individuals already experiencing symptoms. The results showed that these online platforms effectively reduced ED symptoms and harmful behaviors, especially when using educational, cognitive-behavioral, or dissonance-based methods. Overall, the findings suggest that unguided online self-help programs can be a valuable early intervention tool in ED treatment. They provide a practical, accessible, and effective way to support individuals struggling with ED symptoms, especially in the short term. Healthcare systems should consider integrating these platforms as part of a stepped-care approach to ED management.