Online Therapy for Eating Disorders: How Technology Can Benefit Eating Disorder Clients
Tara Deliberto, PhD
Three teen girls laughing and walking with their arms around each other

Before the pandemic, the idea of conducting online eating therapy for eating disorders was off-putting—even incomprehensible—to some therapists. We had questions like “how can we ensure that patients are eating properly?” and “how can we weigh them without doing it in person?” Then 2020 happened, and many of us had no choice but to make the move to virtual treatment. And in doing so, we learned that online eating disorder therapy has a lot of advantages, and many of us saw clearly how technology can benefit eating disorder clients.

Online therapy for eating disorders closes the treatment gap

Beyond being safe during a pandemic, online eating disorder therapy can help close the treatment gap and provide greater opportunities for learning and psychosocial information gathering.

If you've worked in the eating disorder field, you know that the vast majority patients do not have access to evidence-based treatment. With virtual care, being licensed in a particular state means that you can practice virtually anywhere in that state. This translates into a countless number of people now having access to care who didn’t at the start of the year. On top of that, virtual care cuts down on travel time and expenses for people who have limited free time and financial resources. Of all of the benefits of virtual care, improving access to evidence-based treatment is arguably the most important.

Online therapy for eating disorders allows providers to work creatively with families

While we're mostly focused on how technology can help eating disorder clients, it can also help eating disorder therapists. For instance, a patient can be eating with their family while the therapist provides real-time feedback through a headset on what skills to use to ensure the meal is completed. This can be much better than having the family eat a meal in your office. For one thing, the family is in the comfort of their own home. On top of that, only the person with the headset can hear your feedback, rather than the whole family. This makes things much less awkward! Plus, patients and families can also pre-record meals for the therapist to view later. As it turns out, the concern about not being able to see what a patient eats is rather unfounded. In fact, technology can add transparency, making the job of the therapist easier and more efficient.

Technology make eating disorder treatment more seamless

Technology can also make care more seamless. There are scales that patients can purchase that automatically send weights to their provider without the patient ever having the information. If, for whatever reason, using one of those scales isn't feasible, there are other non-technical workarounds. For instance, a family member involved in treatment can be trained on how to take a blind weight for their loved one. Technology allows online eating disorder therapy to be, in many ways, more seamless than in-person care—and the obstacles it does present can be creatively overcome.

Virtual care allows providers to see how patients behave in their daily life

Obtaining psychosocial information can also be easier in a virtual setting. In telehealth sessions, the therapist naturally sees the inside of the patient’s home. We can also, for instance, ask to see the decorations on the wall of an adolescent’s room. Not only does this allow for rapport building, but it can provide very rich psychosocial data above and beyond what we would see in a brick-and-mortar setting.

With online therapy for eating disorders, therapists may also be privy to seeing real-life interactions between family members. For example, a patient and mother might get into an argument while the therapist is meeting with the father. Because family dynamics are particularly important to understand in when treating eating disorders (whether you're using family-based treatment or another modality), the type of psychosocial information-gathering that a virtual setting offers can really be an asset to treatment.

Online eating disorder therapy leaves room for innovation

Although many of us were hesitant to incorporate technology into eating disorder care, some of us were excited about its potential even prior to the pandemic. After all, there is nothing but room to innovate in this space!

Equip is a digital-native virtual eating disorder clinic that did not have brick-and-mortar beginnings. We use a custom-built online platform for therapists, treatment team members, patients, and their families that includes secure video calls, messaging, scheduling, medical records, symptom-tracking, and more. We're constantly exploring how technology can benefit eating disorder clients, by staying on top of developments in the field while also closely monitoring patient outcomes and family satisfaction.

Along with having a digital-native online platform customized for the treatment of eating disorders, Equip is novel in other ways as well. At Equip, each patient and their family work with a multidisciplinary care team to treat every facet of the eating disorder: emotional, nutritional, physical, psychological. This includes a therapist, a medical doctor, and a dietitian, all of whom specialize in eating disorders, as well as mentors who have lived through recovery themselves or helped a loved one through recovery. By providing virtual, wraparound care in this way, we hope to leverage technology to close the treatment gap.

Online therapy for eating disorders has a lot of benefits. In addition to allowing for a rich picture of family dynamics, home life, and meals, it can also help close the treatment gap in a meaningful way. As we continue to learn about how technology can benefit eating disorder clients, we're seeing more and more potential for increasing not only accessibility, but effectiveness of treatment. It will be exciting to see how far we can take it.

Tara Deliberto, PhD
Senior Clinical Advisor
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