Real-world patient outcomes for telehealth-delivered, remote eating disorder treatment: a scoping review
摘要
Only 30% of individuals with eating disorders receive specialized treatment. While preliminary evidence suggests that telehealth-delivered, remote eating disorder treatment may offer improved accessibility with similar effectiveness to in-person treatment, research on these services remains limited, particularly regarding the communities that are disproportionately affected by barriers to standard care. This scoping review sought to map the existing research on real-world patient outcomes in remote eating disorder treatment, identify knowledge gaps, and prioritize areas for future studies.
MethodsThis review followed the Joanna Briggs Institute methodology for scoping reviews. It comprises observational evaluations of telehealth-delivered, remote eating disorder treatment conducted in routine clinical settings. An electronic database search was performed in PsycINFO, PubMed, and ProQuest Dissertations & Theses Global in August 2024 and updated in September 2025.
ResultsFollowing the search and screening process, 27 articles, comprising six case reports and 21 cohort/case series designs, were deemed eligible for inclusion. Remote treatments evaluated differed across level of care, therapeutic modalities, provider types, dosage, and adjunctive technologies used. Just under half of the studies compared outcomes from remote and in-person treatment, while the remainder examined remote treatment alone. Articles were published between 2011 and 2025 and, when excluding case reports, nearly 60% evaluated programs that rapidly transitioned to remote delivery due to COVID-19. While demographic reporting was limited and inconsistent, available information indicated that participants ranged from three to 75 years old and were predominantly White, cisgender women/females diagnosed with anorexia nervosa. Though preliminary, findings tentatively suggest that remote eating disorder treatment can yield improvements across core outcome domains, largely comparable to in-person settings. Less is known about how outcomes may differ across demographic groups.
ConclusionsOverall, this body of literature remains small and characterized by limitations and inconsistencies, including differences in the treatment services evaluated as well as disparities in study design, methodology, and reporting. Utilization of remote treatment by historically excluded groups remains low, calling for further reflection around its accessibility for target communities. Additional studies with more rigorous, intentional designs are needed. The field would also benefit from standardization in relation to data collection and reporting to allow for better synthesis of findings.