Smart Eating

Description:

Smart Eating is a self-help programme designed to help people improve their eating behaviours and overcome eating disorders. It has 6 sections, comprising components to promote healthy eating, address the needs of families with eating disorders, provide health assessment, enhance motivation in self-help, offer self-help strategies and improve psychological health. Users are asked to complete a set of questionnaires when first joining the programme, then at 1-month, 3-month and 6-month follow-up time-points. The self-help strategies in the programme aim to help users restore weight; normalise eating patterns; manage dieting, bingeing and purging behaviours; challenge negative automatic thoughts and thinking errors; develop problem-solving ability; and prevent relapse. The component on psychological health promotion introduces strategies to cope with stress, body image alteration, low self-esteem, depression and anxiety.

Service URL:

http://www.smart-eating.com/en/

Agency Responsible:

The University of Sydney and The Hong Kong Polytechnic University.

Details

Format:

Website.

Intervention Type:

Educational (primarily educational material or psychoeducation). Utilises psychoeducation with some automated feedback

Course Length:

Long (more than 5 modules). Individuals complete the program in 3 to 6 months depending on their individual pace

Support Option:

Automated only.

Target Audience

Primary Category:

Eating Distress (Body image, Anorexia, Bulimia).

Target Audience:

Adult.

Languages:

English and Chinese.

Access

Fee:

Free.

Access:

Open: With registration.

Contact Details:

sau.fong.leung@polyu.edu.hk

Research evidence

Research Trials:

2

Research RCTs:

0

Outcome Summary:

The effectiveness of Smart Eating has been examined in two open trials involving participants who registered to use the program online.  In the first trial, participants who completed health assessment questionnaires at baseline and after 1 month follow-up showed significant improvements in eating disorder psychopathology, and specifically on measures of restraint in eating, eating, shape and weight concerns, dieting, binge eating and compulsive exercise behaviour.  Further, participants also displayed significant improvements in severity of depression, motivational stage of change and perceived health status. Moreover, among those participants who specifically completed the motivational enhancement exercises and the assessment relating to motivational stage of change, significant improvements in relation to motivation to change and eating disorder psychopathology were demonstrated both after 1 month and 3 month follow-ups. Furthermore, an embedded qualitative study involving telephone interviews with 12 participants from the wider study produced similarly positive outcomes.  Overall these participants provided positive feedback about the program, indicating it was user-friendly and improved their understanding of the causes of their problems and enhanced their motivation.  All participants identified some improvements in their eating disorders after using the program, and it was also associated with some other improvements in physical and psychological health. 

The second open trial examined quality of life of participants with eating disorders. Among  participants who continued to use the programme for the duration of at least one month, results from the Wilcoxon signed ranks test showed significant improvements in overall quality of life (Z = -2.581, p<0.05) from baseline to 1-month follow-up. Improvement sustained in 3-month and 6-month follow-ups for continuing participants. In addition to quality of life, participants showed significant improvements in eating disorder psychopathology, level of depression and motivational stages of change at 1 month, 3 month and 6 month follow-ups. Since more than half the participants were also in receipt of professional treatment for eating disorder, this programme may be useful as a supplement to usual treatment.

Although the findings from these initial open trials are promising, further controlled studies are needed to provide stronger evidence.

Recommended rating, reviewer 1:

Recommended rating, reviewer 2:

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Research paper citations

Leung, S.F., Ma, J. and Russell, J. (2012) Breaking the silence of eating disorders with the hope of an online self-help programme.  Contemporary Nurse, 40(2): 245-257. 

Leung, S. F., Joyce Ma, L. C., Russell, J. (2012) An open trial of self-help behaviours of clients with eating disorders in an online programme.  Journal of Advanced Nursing.  [ahead of publication]

Leung, S. F., Ma, J. and Russell, J. (2012) Enhancing motivation to change in eating disorders with an online self-help program.  International Journal of Mental Health Nursing [ahead of publication]

Leung, S. F., Ma, J. L., & Russell, J. (2013). Enhancing quality of life in people with disordered eating using an online self-help programme. Journal of Eating Disorders, 1, 9. http://doi.org/10.1186/2050-2974-1-9