Using the Internet to Prevent Relapse in Anorexia Nervosa

One of the unfortunate realities of anorexia nervosa (AN) is that it carries very high relapse and mortality rates. Dr. Manfred M. Fichter and his colleagues wondered if the high relapse rates could be counteracted with an Internet-based relapse prevention program.

To test their theory, Dr. Fichter and his team designed a 9-month cognitive behavioral therapy program to be delivered via the Internet, and compared this with the results of treatment as usual. Based on power analyses, 258 AN patients were randomized to one of t the two types of treatment at the end of inpatient treatment. Expert interviews were conducted using a number of questionnaires, such as the Structured Interview for Anorexic and Bulimic Syndromes and the Morgan-Russell scale, as well as self-ratings, including the Barratt Impulsiveness Scale, to measure the patients progress over time. After an additional 9 months, a follow-up of all patients was done.

Relapse was lowerin the internet group

As Dr. Fichter reported at the Eating Disorders Research Society meeting, the study is ongoing, but preliminary data show that relapse rates were lower in the group treated with the Internetbased relapse prevention program, compared to the treatment as usual program. Very few adverse events (such as alarming weight loss) occurred during the study, and patients accepted the Internet program very well. Of those who completed treatment, 94% largely or fully recommended use of the Internet relapse prevention program. Complete dropouts from the Internet program were 2.7%, and 28.6% completed less than a third of the Internet program.

The researchers concluded that an Internet-based relapse prevention program can successfully reduce the relapse rate in persons with AN, but may need to be supplemented by professional guidance to ensure compliance and ultimate success.