Online help programme recommended for people with eating disorders
An online therapy programme can be used to help people aged 16 and over with eating disorders whilst they wait for specialist NHS treatment, an independent NICE has said.
The programme called Overcoming Bulimia Online can be offered to NHS patients while further evidence is generated over the next two years on its clinical and cost effectiveness.
Accessed via the internet, the online self-help programme is for people who binge eat, particularly those with bulimia nervosa, binge eating disorder, and similar eating problems. It's designed for people aged 16 and over to use by themselves at their own pace over 8 sessions.
People must initially receive an eating disorder assessment by their GP, or after further assessment by specialist eating disorder services to be offered access. It can be used by people waiting to be seen by a specialist, but alongside usual waiting list care such as regular check-ups and routine physical monitoring with their GP or eating disorder service.
Unguided self-help is not intended for people with severe eating disorders or at a high medical risk. Self-help is not suitable for people with any form of anorexia nervosa.
The online programme helps people learn to manage their eating disorder using eating-disorder-focused cognitive behavioural therapy (CBT-ED).
Research has shown that people using Overcoming Bulimia Online experienced fewer binge eating episodes and had reduced eating disorder symptom severity compared to those on waiting lists.
The programme costs £5.91 per person when 500 or more licences are purchased.
At least 1.25 million people in the UK have an eating disorder. These are serious mental health problems where people use food to cope with difficult feelings and situations. Many people must wait a long time to see a specialist, which can make their condition worse. Recent analysis has shown that some adults with eating disorders wait up to 700 days for care from community teams.
This recommendation is really important for eating disorder care at a time when services are under huge pressure. Overcoming Bulimia Online gives people with eating disorders immediate access to proven therapy that can start working straight away, rather than waiting months for specialist treatment.
Dr Chalkidou added: “The research shows real benefits for patients, with reduced binge eating episodes and less severe symptoms. What's particularly encouraging is that this digital therapy can work alongside existing NHS care, providing extra support without needing more healthcare staff.
“We're confident this technology will make a real difference to thousands of people struggling with eating disorders whilst we continue to build specialist services across the country."
We welcome NICE's recommendation which opens up access to proven digital support for people with eating disorders while they wait for specialist treatment. This complements NHS care, giving people support sooner and at their own pace – and builds on our updated guidance to identify and help children and young people with eating disorders earlier.
Umairah Malik, Beat's clinical and co-production manager, said: “Anyone affected by an eating disorder should be able to access timely, tailored support, but we know that wait times can still vary wildly between age groups and locations. Digital treatment can help to address some of these gaps, allowing more people to access support on a waiting list, whilst still benefiting from regular check-ins and routine monitoring.
“We’re pleased to see NICE’s conditional recommendation for the Overcoming Bulimia Online programme so that those who need it most can get the help they deserve more quickly. Alongside this, it’s crucial that part of the evidence generation process for this programme over the coming years, and others more broadly, consider underserved groups in eating disorders so that they work for all communities.”
The programme works particularly well for people with less severe eating disorders who might otherwise wait longer for treatment, and people who live in areas where there are fewer specialist eating disorder services.
Two other digital programmes called Digital CBTe and Worth Warrior need more research before they can be recommended for NHS funding. However, they may be available through research studies.
NICE’s independent Diagnostics Advisory Committee highlighted that more work is needed to make sure these digital programmes work well for all communities. Most people in the research studies were white women, so more diverse groups need to be included in future research.