Abstract/Summary

The internet has been increasingly employed in the treatment of binge eating, including to facilitate guided self-help (GSH). However, few studies have investigated provision of GSH over email and there are questions regarding the viability of this approach, and how facilitators might best deliver this treatment. We describe a case study of a woman in her early 50s with a diagnosis of binge-eating disorder (BED) who received email-supported GSH over 12 weeks within a larger randomised controlled trial. At assessment, she presented with regular binge eating episodes (approximately twice a week) in addition to co-morbid medical and psychiatric issues, for which she was prescribed several medications. Treatment, provided within the UK National Health Service, involved provision of a self-help manual (Overcoming Binge Eating; Fairburn, 2013) in addition to email support over 12 weeks. A summary of the intervention is provided, along with email excerpts to demonstrate practice, illustrate how treatment might be delivered, and outline the type of interaction that may occur during email support. Consistent with larger studies, improvement on several self-report symptom measures was seen, including eating disorder symptoms, psychosocial impairment, psychological distress, self-esteem, and therapeutic alliance, all of which met criteria for reliable improvement at post-treatment. This case study, which provides data from one individual, demonstrates delivery of GSH with email support for regular binge eating, which could be considered as an alternative to face-to-face treatment. Future work might look to enhance outcomes following GSH, including reducing drop-out, and increase dissemination and uptake of GSH.