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Digital self-help exposure therapy eased eating disorder fears

In a 130-person randomized trial, a five-session digital imaginal exposure program reduced fear of weight gain and eating disorder symptoms.

Illustration accompanying coverage of a 2026 eating-disorders study.

A 2026 study published in The International journal of eating disorders reports new findings relevant to eating-disorders.

What the study reported

Imaginal exposure therapy facilitates the approach of feared stimuli (e.g., fear of weight gain) not accessible in everyday life (e.g., rapidly gaining weight) and has initial promising data for the treatment of eating disorders (EDs). In the current randomized controlled trial (RCT) participants (N = 130) were randomly assigned to a five-session digital imaginal exposure condition or a control online journaling condition within 4 months of discharge from intensive (e.g., inpatient) treatment. We examined the feasibility and acceptability of the treatment conditions, target engagement, and initial clinical efficacy. This study was pre-registered. Imaginal exposure therapy significantly outperformed the control condition on our primary outcome and target mechanism: fear of weight gain. Imaginal exposure therapy also outperformed the control condition on overall ED symptoms, fear of food, food avoidance, clinical impairment, and PTSD symptoms, suggesting initial clinical efficacy. This RCT suggests that the active ingredient (i.e., exposure to feared stimuli) in imaginal exposure leads to significant decreases in fear of weight gain and associated clinical outcomes. This work supports imaginal exposure therapy as an effective intervention for fear of weight gain, a primary maintenance factor of EDs. NCT04862247.

The source

These findings are drawn from “A Randomized Controlled Trial of Self-Guided Digital Written Imaginal Exposure Therapy for Eating Disorders in Patients Recently Discharged From Higher Level Specialty Eating Disorder Care” (Levinson CA, Penwell T, Sandoval-Araujo LE, et al., 2026), published in The International journal of eating disorders. Read the full study on PubMed.

References

  1. 1.Levinson CA, Penwell T, Sandoval-Araujo LE, et al. ( 2026). A Randomized Controlled Trial of Self-Guided Digital Written Imaginal Exposure Therapy for Eating Disorders in Patients Recently Discharged From Higher Level Specialty Eating Disorder Care. The International journal of eating disorders. Link . doi:10.1002/eat.70147