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 e-mail 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 e-mail-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 comorbid 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 e-mail support over 12 weeks. A summary of the intervention is provided, along with e-mail excerpts to demonstrate practice, illustrate how treatment might be delivered, and outline the type of interaction that may occur during e-mail 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 e-mail 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.