Does internet-based prevention reduce the risk of relapse for anorexia nervosa?

Technological advancements allow new approaches to psychotherapy via electronic media. The eating disorder literature currently contains no studies on internet intervention in anorexia nervosa (AN). This study presents a RCT on an internet-based relapse prevention program (RP) over nine months after inpatient treatment for AN.The sample comprised 258 women, randomized to the RP or treatment as usual (TAU). Expert- and self-ratings were evaluated by intent-to-treat analyses.Concerning age, age at onset and comorbidity, both groups were comparable at randomization. During the RP, the intervention group gained weight while the TAU group had minimal weight loss. RP completers gained significantly more body weight than patients in the TAU condition. Group-by-time comparisons for eating-related cognitions and behaviors and general psychopathology showed a significantly more favorable course in the RP program for “sexual anxieties” and “bulimic symptoms” (interview), and “maturity fears” and “social insecurity” (EDI-2). General psychopathology showed no significant group-by-time interaction. Important factors for successful relapse prevention were adherence to the intervention protocol and increased spontaneity.Considering the unfavorable course and chronicity of anorexia nervosa (AN), internet-based relapse prevention in AN following inpatient treatment appears a promising approach. Future internet-based programs may be further improved and enhanced.

► Guided relapse prevention via internet after inpatient treatment for anorexia nervosa is feasible.
► Program completers gained additional weight during relapse prevention.
► Treatment as usual resulted in minimal weight loss after inpatient treatment.
► Concerning non eating-related psychopathology patients did not profit from eating-specific relapse prevention.
► Adherence to the relapse prevention protocol and higher spontaneity are important factors for successful relapse prevention.