Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether “In adults with eating disorders, is the use of online-based cognitive behavioral therapy (CBT) effective in reducing eating disorder (ED) psychopathologies?”

STUDY DESIGN: Systematic review of three peer-reviewed studies published between 2015 and 2017.

DATA SOURCES: Articles included are data from three randomized controlled trials (RCTs) found via PubMed and Cochrane Collaboration database sites in the English language.

OUTCOME(S) MEASURED: The outcomes measured were eating disorder psychopathologies using a global score obtained from the Eating Disorders Examination Questionnaire (EDE-Q). The global score is comprised of four categorical subsets relative to the symptoms of eating disorders: restraint, eating concern, weight concern and shape concern.

RESULTS: All studies found large within-group effect sizes for experimental groups, indicating symptom reduction after online-CBT. The first study had a large effect size (d = 0.83) with a statistically significant (p < 0.001) reduction in EDE-Q scores. Between-group analysis showed moderate treatment effect (d = 0.54) (Strandskov SW, Ghaderi A, Andersson H, et al. Behav Ther. 2017;48(5):624-637. doi: S0005-7894(17)30023-0 [pii].). The second indicates that both experimental and control groups had lower EDE-Q scores following the 15 week trial (p <0.001); treatment effect was large for the experimental group (d = 0.82) and moderate for the control group (d = 0.43)( ter Huurne ED, de Haan HA, Postel MG, van der Palen J, VanDerNagel JE, DeJong CA. J Med Internet Res. 2015;17(6):e152. doi: 10.2196/jmir.3946 [doi].). The third RCT found within-treatment group effect size was large (d = 1.33), with small effect size (d=0.25) for the waitlisted group. Between-group comparison was also large (d = 1.18) ( Wagner B, Nagl M, Dolemeyer R, et al. Behav Ther. 2016;47(4):500-514. doi: 10.1016/j.beth.2016.01.006 [doi]).

CONCLUSIONS: The findings of all three RCTs are supportive of the use of online-based cognitive behavioral therapy (CBT) in efficaciously reducing eating disorder psychopathology.