Digital CBTe: A promising digital treatment for binge eating

This story is a repost of the original on the University of Oxford Dept of Psychiatry website.

Originally developed by the Centre for Research on Eating Disorders at Oxford (CREDO), Digital CBTe is the digital programme-led version of Enhanced Cognitive Behaviour Therapy. It is now delivered by Credo Therapies, which was spun out from the university in 2022 with the support of Oxford University Innovation.

NHS Pilot Studies and Independent Evaluation

Digital CBTe was piloted in two NHS Trusts: Kent and Medway and Dorset. These pilots were independently evaluated by Health Innovation Kent Surrey Sussex and Health Innovation Wessex, with support from CREDO, and funded by NHS England and the Office for Life Sciences. They found:

• Patients who completed the programme reported statistically and clinically significant reductions in binge eating.
• The programme also reduced the impact of eating disorders on daily life and depressive symptoms.

These findings were consistent across both pilot sites, despite differences in delivery:

• In Kent and Medway, patients received guided support sessions alongside the programme.
• In Dorset, patients completed the programme independently without additional guidance.

Supporting Evidence from Oxford-Led Research

An earlier pilot study, published in the journal Frontiers in Digital Health, also confirmed the programme’s effectiveness. Led by the CREDO team at the University of Oxford, and supported by the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre (BRC) and the NIHR Oxford and Thames Valley Applied Research Collaboration, this study recruited participants via the national eating disorders charity BEAT. Among the 55 participants who completed the full programme and end-of-programme assessment:

• Binge eating episodes decreased significantly.
• Other eating disorder features and related life impairment also improved.
• These improvements were maintained at six-month follow-up.

How Digital CBTe Works

Digital CBTe consists of 12 structured sessions delivered over 8 to 12 weeks via an app or website. Participants complete self-report questionnaires at three stages:

1. Before the programme
2. Immediately after completing the programme
3. Six months after programme

The programme can be completed independently or with guided support.

Expert Perspectives                       

Dr Rebecca Murphy, Director of CREDO and lead author of the Frontiers paper, said:

“There is an urgent and growing need for effective and accessible treatments for eating disorders. Many people with disorders characterised by binge eating – such as binge eating disorder and bulimia nervosa – go untreated for long periods or never receive any help at all.

One major barrier is the sense of shame some people experience, which can prevent them from disclosing their difficulties. In addition, there is a shortage of trained therapists able to deliver evidence-based treatments.

This is why having a digital programme-led alternative that can be delivered directly to patients could be a real game-changer.”

Patient and Staff Feedback

Patients reported that Digital CBTe was:

• Helpful and easy to use
• Flexible and well-structured
• Empowering in supporting recovery

Patients in the Kent and Medway service valued the guided support sessions, which helped reinforce learning and provided emotional support.

Staff from both NHS pilots also reported benefits, including:

• Improved patient flow
• Reduced need for more intensive treatment afterwards
• Greater job satisfaction and confidence

Next Steps

• Credo Therapies is working with other NHS trusts to expand access across the UK.
• Findings from the NHS pilots are being shared via the Health Innovation Network, Integrated Care Boards, and NHS trusts nationwide to inform broader integration into care pathways.

Key Takeaways

• Digital CBTe has shown strong early evidence of effectiveness in treating binge eating.
• Both independent evaluations and Oxford-led studies support its clinical benefits.
• Broader NHS adoption could improve access to treatment for people.
• Larger trials are needed to confirm long-term clinical and cost-effectiveness.

This news story was written with support from CREDO and input from the CREDO Contributors’ Group. The Contributors’ Group includes individuals with lived experience of eating disorders, members of the public, and professionals with an interest in our work. If you would like to be invited to take part in future consultations or research, or to stay up to date with our latest studies. Email to join.