Ecological Momentary Interventions in the Management of Eating Disorders and Obesity: A Systematic Review
Abstract
Objective: This systematic review evaluated the feasibility, efficacy, adherence, and methodological quality of ecological momentary intervention (EMI)-based treatments for individuals with diagnosed eating disorders (EDs) and/or obesity.
Method: Eight electronic databases were systematically searched from inception to January 2026. Randomized, non-randomized, and uncontrolled studies evaluating EMI-based treatments for individuals with diagnosed EDs and/or obesity were included. Data on intervention characteristics, clinical and behavioral outcomes, feasibility, acceptability, and adherence were extracted. Risk of bias was assessed using RoB 2 and ROBINS-I, and findings were synthesized narratively.
Results: Fourteen studies met inclusion criteria (eight obesity-focused, six ED-focused), including nine randomized controlled trials. In ED studies, EMI-augmented interventions were associated with significant within-group reductions in binge-eating frequency and ED psychopathology. However, superiority over active cognitive-behavioral therapy-based controls was inconsistent and primarily observed during maintenance phases. Obesity-focused trials demonstrated small to moderate within-group improvements in weight-related outcomes, with generally small and non-sustained between-group effects. Feasibility and acceptability were generally high, although retention and engagement varied across studies. Risk of bias was low in most randomized trials but higher in non-randomized…
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