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Psychol Med. 2014 Jul;44(9):1947-63. doi: 10.1017/S0033291713002481. Epub 2013 Oct 16.

An Internet-based program to enhance motivation to change in females with symptoms of an eating disorder: a randomized controlled trial.

Author information

Department of Psychology, Clinical Psychology and Psychotherapy,Osnabrück University,Germany.
Section of Eating Disorders, Institute of Psychiatry,King's College London,UK.
Research School of Psychology,Australian National University,Australia.
Department of Social Sciences and Cultural Studies,University of Applied Sciences Düsseldorf,Germany.
German Pediatric Pain Center, Children's and Adolescents' Hospital,Witten/Herdecke University,Datteln,Germany.
Department of Psychology, Clinical Psychology and Psychotherapy,Ruhr-University Bochum,Germany.



Previous research has demonstrated an association between low motivation to change and an unfavorable treatment outcome in patients with an eating disorder. Consequently, various studies have examined the effects of motivational enhancement therapy (MET) on motivation to change and treatment outcome in eating disorders. In each of these studies, MET was administered in a face-to-face setting. However, because of its anonymity and ease of access, the internet provides several advantages as the format for such an intervention. Therefore, the current study investigated the effects of an internet-based program ('ESS-KIMO') to enhance motivation to change in eating disorders.


In total, 212 females were accepted for participation and assigned randomly to the intervention condition (n = 103) or waiting-list control condition (n = 109). The intervention consisted of six online MET sessions. Before and after the intervention or waiting period respectively, participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the Stages of Change Questionnaire for Eating Disorders (SOCQ-ED), the Pros and Cons of Eating Disorders Scale (P-CED), the Self-Efficacy Scale (SES), and the Rosenberg Self-Esteem Scale (RSES). A total of 125 participants completed the assessment post-treatment. Completer analyses and intent-to-treat analyses were performed.


Significant time × group interactions were found, indicating a stronger increase in motivational aspects and self-esteem, in addition to a stronger symptom reduction on some measures from pre- to post-treatment in the intervention group compared to the control group.


Internet-based approaches can be considered as useful for enhancing motivation to change in eating disorders and for yielding initial symptomatic improvement.

[Indexed for MEDLINE]

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