# Open Pilot Trial of a Coached Digital Program for Lower‐Income Adults With Eating Disorders

## TL;DR

A digital therapy program for low-income adults with eating disorders showed promise in improving symptoms and was well accepted by participants.

## Contribution

This is the first digital intervention tailored for lower-income adults with eating disorders, showing feasibility and preliminary effectiveness.

## Key findings

- Participants showed large improvements in eating disorder symptoms and mental health outcomes.
- Most participants engaged with the program and reported satisfaction with the intervention.
- The study indicates good feasibility and acceptability of the digital program.

## Abstract

This study evaluated the feasibility, acceptability, and preliminary effectiveness of the first digital intervention tailored for lower‐income adults with eating disorders, who are poorly served by the public health care system.

Adults (N = 30) with public insurance or without insurance coverage who endorsed ≥ 6 binge eating episodes, ≥ 6 vomiting episodes, and/or ≥ 6 laxative/diuretic episodes in the past three months with a body mass index ≥ 18.5 kg/m2 were enrolled in this open pilot trial. Participants received access to the coached digital CBT‐based intervention, which included individualized guidance and twice‐weekly SMS feedback from a program coach over three months.

Almost all participants (93.3%, n = 28) accessed the program after enrollment, completing about half (M = 4.15, SD = 2.68) of the 8 sessions and sending an average of 32.5 (SD = 35.2) texts to their coach over three months. From pre‐ to post‐intervention, there were large improvements in eating disorder psychopathology (d = 0.79, p < 0.001) and moderate decreases in binge eating (d = 0.62, p = 0.003) and self‐induced vomiting episodes (d = 0.43, p = 0.031). There were also large improvements in clinical impairment (d = 0.83, p < 0.001) and moderate to large reductions in anxiety (d = 0.47, p = 0.019) and depression (d = 0.84, p < 0.001). Most participants indicated that they were somewhat to very satisfied with the program (67.9%, n = 19).

The results from this pilot trial testing a brief online guided self‐help intervention are promising, with relatively high treatment engagement, indicating good feasibility and acceptability and signals of preliminary effectiveness. Future research is needed to examine longer‐term effectiveness relative to other active treatments or waitlist control.