Delivering Evidence-Based Treatment to Patients Who Are Out of Reach

BY: Kate Scheyer El-Sharkawy

DATE: 30 November 2017

One of the Nine Truths of Eating Disorders is that eating disorders affect people from all walks of life.[1] This includes people who live in rural areas and may find it challenging to access specialized eating disorder treatment providers.[2] They may find that their only option is to temporarily relocate for treatment, but this is often cost-prohibitive and a huge endeavor that requires total upheaval of their lives. Also, an individual’s family and community can be crucial components of eating disorder recovery. Anderson, Byrne, Crosby & Le Grange1 addressed this dilemma with a study that proposes a way of bringing family-based therapy (FBT) to those who are geographically out of reach.2

FBT is an evidence-based treatment for adolescents with anorexia nervosa (AN). During the course of treatment, patients in FBT attend therapy sessions alongside their family members, who learn and have opportunities to practice ways to support the patient. In their study, Anderson et al.1 employed a HIPAA-compliant videoconferencing tool to deliver 20 sessions of FBT over the course of six months. The participants who received this treatment were ten adolescents who had been diagnosed with AN or atypical AN and lived in areas without access to face-to-face FBT.

Anderson et al.1 were interested in both the feasibility of this treatment mode and its acceptability to patients. The researchers reached their target numbers for participation, indicating sufficient interest in this form of treatment delivery. Furthermore, this study had an unusually high retention rate; none of the participants withdrew from the study during treatment. Levels of acceptability to patients and their families were also high.

Even though it was a small trial, the researchers wanted to determine preliminarily if treatment outcomes seemed promising. In order to do so, they assessed participants for weight gain and eating disorder symptoms using the Eating Disorders Examination (EDE). As a group, participants experienced significant weight gain during treatment and six months afterward. Likewise, scores on the EDE were significantly lower than baseline at the end of treatment, and significantly lower again at the six-month follow-up, reflecting an overall reduction in symptoms.

This study’s small sample size limits the generalizability of the findings and encourages replication with larger sample sizes. However, it is a promising addition to a growing body of knowledge about incorporating technology into treatment and could have meaningful implications for individuals without access to face-to-face treatment for eating disorders.


1Anderson, K.E., Byrne, C.E., Crosby, R.D. & Le Grange, D.  (2017). Utilizing Telehealth to deliver family-based treatment for adolescent anorexia nervosa.  International Journal of Eating Disorders, 50, 1235-1238.  doi:

2Mental health care health professional shortage areas (HPSAs).  (2016). Retrieved from The Henry J. Kaiser Family Foundation website:,%22sort%22:%22asc%22%7D