Donate Contact our Helpline
Looking for eating disorder support in your area? Visit HelpFinder

Digital Support for Binge Eating: Evidence, Gaps, and Digital CBTe

What is binge eating?

Binge eating means having distressing episodes of eating a large amount of food in a short time, while feeling out of control. It’s common, distressing, and treatable, and people from all backgrounds can experience it.

Two of the most common eating disorders are binge eating disorder and bulimia nervosa, and both involve binge eating. In bulimia nervosa, binge eating is followed by behaviours aimed at trying to “make up for” the binges, such as vomiting or fasting.

Both disorders can have a big impact on day-to-day life and are often linked with other mental and physical health difficulties.

Compiled for Beat Eating Disorders by Dr Rebecca Murphy and Dr Emma Osborne

The Treatment Gap

Right now, there’s a big gap between how many people need treatment for an eating disorder and how many actually get it. This gap is especially wide for people who binge eat.

Estimates suggest that only 16% of people with bulimia nervosa and 29% of people with binge eating disorder had received treatment for emotional problems in the past year.

A range of barriers contribute to this gap, including:

These barriers mean that even when people do seek support, they may wait years before receiving treatment.

Digital Treatments

Digital treatments have the potential to help close this gap. They can:

EXPAND THESE SECTIONS TO READ MORE ABOUT DIGITAL TREATMENTS FOR BINGE EATING

What are the research gaps?

Research suggests that digital treatments can be effective for eating disorders. A recent review of eight randomised controlled trials found improvements in overall eating disorder symptoms, concerns about weight and shape, and risky dieting behaviours.

However, there are still important gaps in the research. For example, future studies need to:

  • involve people with lived experience in designing digital programmes, to ensure they are meaningful and help people stay engaged
  • improve access and digital equity, especially for underserved groups such as those with low income or limited digital access
  • better support neurodivergent people and people from different cultural backgrounds
  • understand how best to help people with additional mental or physical health needs
  • conduct larger, long-term randomised controlled trials to determine who benefits most and whether improvements last over time
What is Digital CBTe?

Digital CBTe is one example of a digital treatment for binge eating. It is the digital, programme-led version of Enhanced Cognitive Behaviour Therapy (CBT-E), a leading evidence-based treatment for eating disorders.

Programme-led means that the programme itself provides the treatment, in contrast to therapist-led, which is where the treatment is provided by a therapist. Some people complete it independently, while others receive short support calls with a trained professional (often called “guided self-help”).

Digital CBTe is based on the same approach as the book Overcoming Binge Eating and was developed by the Centre for Research on Eating Disorders at Oxford (CREDO). It is designed for people who binge eat, including those with binge eating disorder or bulimia nervosa, whether or not they have a formal diagnosis.

The programme contains 12 structured sessions, usually completed over 8–12 weeks, through a website or app. Participants complete brief questionnaires before, after, and several months following the programme to track progress.

Digital CBTe pilot study

A pilot study led by CREDO, delivered directly to people in the community, found that adults who completed all 12 sessions experienced significant reductions in binge eating and related distress. These improvements were still present six months later.

Digital CBTe has also been evaluated within NHS services:

  • Kent and Medway All-Age Eating Disorders Service offered Digital CBTe alongside short support calls. People who completed the programme reported noticeable improvements in binge eating, general eating disorder symptoms, distress, and symptoms of depression. Staff valued the programme and found it helped them support more patients more quickly.
  • Dorset HealthCare University NHS Foundation Trust offered Digital CBTe in a fully self-guided format to people on their waiting list. Those who completed it showed improvements in eating behaviours, daily functioning, and wellbeing. Some people felt they no longer needed further treatment and left the waiting list.
How to access Digital CBTe

At the moment, Digital CBTe is available through research studies and NHS partnerships while it continues to be tested and refined.

We are currently running a UK study on Supported Digital CBTe for binge eating. If you experience binge eating and are interested in taking part, please see www.psych.ox.ac.uk/credo/be-guided

For other questions or partnership enquiries, please email credoenquiries@psych.ox.ac.uk

Why this research matters

Digital treatments could make a real difference for people living with binge eating. They can help reduce the treatment gap by offering private, flexible support that can be started sooner and used anywhere. While they are not intended to replace face-to-face therapy entirely – as some individuals will still need therapist-led treatments – digital programmes can enable some people to begin recovery sooner. For some, they may be sufficient on their own to support lasting change; for others, they may work best alongside traditional care or provide a first step towards recovery.

By increasing accessibility, digital services can complement existing options and help more people receive support when they need it. Approaches such as Digital CBTe may widen access and provide meaningful support to those who might otherwise wait years for help.

Lived Experience Spotlight

We asked someone with lived experience what this research means to them. Read what they said below

Spotlight

"This would have been really helpful for my partner. They faced challenges accessing support, and didn't feel comfortable attending in person due to struggling with autism related difficulties. Because of this, they had to go private. Having a digital option for receiving help would have been really beneficial for them; it feels like a great accessible alternative to in person treatment.

From a loved one's perspective, I can certainly see how the barriers listed contribute to the treatment gap. Shame was a significant factor preventing them from reaching out too, but I'm so proud of them for overcoming this.

If you're reading this and feeling the same way, please remember that you are deserving and worthy of support"

Click to expand further reading and resources

Further Reading & Resources

Aardoom, J. J., Dingemans, A. E., & Van Furth, E. F. (2016). E-health interventions for eating disorders: emerging findings, issues, and opportunities. Current Psychiatry Reports, 18(4), 42. https://doi.org/10.1007/s11920-016-0673-6

Ágh, T., Kovács, G., Pawaskar, M., Supina, D., Inotai, A., & Vokó, Z. (2015). Epidemiology, health-related quality of life and economic burden of binge eating disorder: S systematic literature review. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 20(1), 1–12. https://doi.org/10.1007/s40519-014-0173-9

Ali, K., Farrer, L., Fassnacht, D. B., Gulliver, A., Bauer, S., & Griffiths, K. M. (2017). Perceived barriers and facilitators towards help-seeking for eating disorders: A systematic review. International Journal of Eating Disorders, 50(1), 9–21. https://doi.org/10.1002/eat.22598

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.

Austin, A., Flynn, M., Richards, K., Hodsoll, J., Duarte, T. A., Robinson, P., Kelly, J., & Schmidt, U. (2021). Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature. European Eating Disorders Review, 29(3), 329–345. https://doi.org/10.1002/erv.2745

de Zwaan, M., Herpertz, S., Zipfel, S., Svaldi, J., Friederich, H. C., Schmidt, F., Mayr, A., Lam, T., Schade-Brittinger, C., & Hilbert, A. (2017). Effect of internet-based guided self-help vs individual face-to-face treatment on full or subsyndromal binge eating disorder in overweight or obese patients: the INTERBED randomized clinical trial. JAMA psychiatry, 74(10), 987–995. https://doi.org/10.1001/jamapsychiatry.2017.2150

Fairburn, C. G. (2013). Overcoming Binge Eating (2nd ed.). New York: Guilford Press.

Fairburn, C. G., & Patel, V. (2017). The impact of digital technology on psychological treatments and their dissemination. Behaviour Research and Therapy, 88, 19–25. https://doi.org/10.1016/j.brat.2016.08.012

Hudson, J. I., Hiripi, E., Pope, H. G., Jr, & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040

Kazdin, A. E., Fitzsimmons-Craft, E. E., & Wilfley, D. E. (2017). Addressing critical gaps in the treatment of eating disorders. The International Journal of Eating Disorders, 50(3), 170–189. https://doi.org/10.1002/eat.22670

Linardon, J., Shatte, A., Messer, M., Firth, J., & Fuller-Tyszkiewicz, M. (2020). E-mental health interventions for the treatment and prevention of eating disorders: An updated systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 88(11), 994–1007. https://doi.org/10.1037/ccp0000575

Murphy, R., Khera, C., & Osborne, E. L. (2025). Breaking the cycle: A pilot study on autonomous Digital CBTe for recurrent binge eating. Frontiers in digital health, 6, 1499350. https://doi.org/10.3389/fdgth.2024.1499350