Case Study

Innovative digital programme shows real-world impact in treating binge eating in the NHS

9 June 2025

Case Study Mental health & neurodiversity Health and care professionals

Summary

An innovative digital programme for treating binge eating has shown clinical benefits for patients and clinicians, according to independent evaluations of NHS pilot studies in Kent and Medway, and Dorset. The programme, Digital CBTe, the digital version of Enhanced Cognitive Behaviour Therapy (CBT-E), has shown clinical benefits in reducing binge eating episodes and impact on people’s lives, offering a potential alternative for the treatment of binge eating. This evaluation suggests that Digital CBTe could be a scalable treatment to support patients with binge eating across different health settings.

Originally developed by the Centre for Research on Eating Disorders at Oxford (CREDO) and now delivered by social impact company Credo Therapies Ltd, the programme was evaluated through two pilot projects funded by NHS England and the Office for Life Sciences. Supported by Health Innovation Kent Surrey Sussex and Health Innovation Wessex, the pilots explored both self-help and guided self-help versions of the digital programme.

“Credo Therapies has demonstrated that Digital CBTe provides a key intervention for people living with eating disorders, in particular those with binge eating. Being able to work with two trusts in the south east to pilot this intervention in real-world settings has clearly demonstrated the impact of this therapeutic intervention” – Becca Randell, Mental Health Lead, Health Innovation Kent Surrey Sussex

The challenge

There is currently significant unmet need in eating disorder treatment and care. According to Beat, the UK’s eating disorder charity, approximately 1.25 million people in the UK are affected by an eating disorder. Binge eating is a key feature of bulimia nervosa and binge eating disorder. These are common mental health problems affecting all genders, ages and socioeconomic groups. Only a small proportion of people with eating disorders seek treatment, often because of feelings of shame and the stigma that can surround these conditions, and there are typically long waits for those who do. There is an urgent need for more accessible, effective and evidence-based eating disorder treatments.

The approach

Accessible as a mobile app or website, Digital CBTe empowers users to navigate recovery independently or with the guidance of a non-specialist supporter. A non-specialist supporter is someone with basic training to encourage and support people with eating disorders in using the programme, but who is not a specialist therapist.

North East London Foundation NHS Trust (NELFT) and Dorset HealthCare University NHS Foundation Trust (DHUFT) piloted Digital CBTe as part of their All Age Eating Disorders services, during 2023 and 2024. The Dorset pilot examined the effectiveness and acceptability of the self-help version of the programme, while the Kent and Medway pilot examined the guided self-help version, where patients received additional support from non-specialist staff.

“At first, I was very negative about myself… but the prompts and support helped me realise—I could make a change,” – service user from Kent and Medway.

To ensure an independent and rigorous evaluation, the Health Innovation Wessex Insight team was commissioned by Health Innovation KSS through their Office for Life Sciences commission and NHSE funding. The evaluations were designed and delivered collaboratively with the NHS trusts, Credo Therapies, and CREDO. Each pilot used a mixed-methods approach combining analysis of standardised self-reported data collected through the Digital CBTe programme with semi-structured interviews with patients and staff, and a staff survey.

“The support from Health Innovation Wessex and Health Innovation KSS was instrumental in helping us evaluate and understand the real-world impact of Digital CBTe. Whilst each pilot offered a different perspective on how Digital CBTe can fit into the care pathway, overall it has helped to shape our future roadmap. We want to ensure that our programme serves the needs of people who may benefit from it, so the insights from patients and staff were invaluable to us. We look forward to working together with the NHS Trusts and health innovation teams to communicate the findings, as ultimately, we want to help more people” – Dr Lisa Debrou, Chief Clinical Officer, Credo Therapies.

The findings

Both evaluations found that patients who completed Digital CBTe reported statistically and clinically significant decreases in the frequency of objective binge eating, other features of eating disorders (eating disorder psychopathology), impact of the eating problem on various aspects of life (secondary impairment), and features of depression.

It should be noted that small sample sizes (14 in Dorset and 16 in Kent and Medway) mean that the results may be less generalisable than those gathered from a larger population.

“Following on from the pilot we are now able to offer our adult patients in the community service the guided self-help version of Digital CBTe as one of our first-line interventions.” – Catherine Birtwell, CBT Lead in Eating Disorders / BABCP Accredited Therapist for Dorset All Age Eating Disorders Service.

“This has been an innovative pilot study to be a part of. Our team have enjoyed supporting our patients to engage with the digital programme; and have appreciated the opportunity to develop our skills with an additional treatment method.” – Natasha Shaw, Senior CBT Therapist, Interim Clinical Lead, Kent & Medway Eating Disorders Service

Patient impact

Patients reported that the programme provided helpful advice, used a clear and flexible structure, and helped them feel more in control of their recovery. They valued the quick access to support, especially while on waiting lists. The digital format was seen as accessible and easy to use. Support sessions (Kent and Medway only) were highly valued for reinforcing learning, providing accountability and offering emotional support and reframing concerns. Dorset patients, who used the programme without guided support, expressed a desire for more human interaction or touchpoints to address any concerns or practical issues.

“It’s given me more a sense of structure really and a sense of freedom… you’re not a total failure for wanting to actually eat something.” – service user from Dorset.

“At first, I was very kind of feeling negative about myself… would I be able to make this digital side of it work… but with her kind of keep prompting, giving me different ideas… it really helped me… to actually think… I could make a change here.” – service user from Kent and Medway.

Staff impact

Staff in both pilots noted improved patient flow, reduced treatment intensity needed post-programme, and increased job satisfaction and confidence. At the same time, they also shared concerns that the programme may not be suitable for some of their patients with co-occurring conditions or severe depression.

Staff in Kent and Medway appreciated the structured support model, and Dorset staff highlighted the need for flexibility and guided options.

“I am able to manage more patients under my caseload as the contact time is significantly reduced compared to treatment as usual.” – staff member from NELFT, Kent and Medway.

“Seeing the waiting list and hearing about patient adversity… can be emotionally difficult. I feel good about my role when I know that there are effective interventions that can be delivered within two to three weeks.” – staff member from DHUFT, Dorset.

Scalability: Wider adoption across the NHS

Following the success of the pilot studies, Credo Therapies, in collaboration with NHS trusts and Health Innovation KSS and Wessex, is actively working to expand access to Digital CBTe across the UK. The findings are being shared through the Health Innovation Network, Integrated Care Boards and NHS trusts nationwide to support the future scale and integration of Digital CBTe into eating disorder care pathways.

As part of these efforts, Credo Therapies will host a learning event in July, in partnership with Health Innovation KSS and Health Innovation Wessex, to showcase the Digital CBTe programme and share key insights from real-world evaluations.

Looking ahead, Credo Therapies is also exploring opportunities to implement Digital CBTe in other NHS services. The positive outcomes from the pilots show potential for broader adoption, with the goal of improving access to evidence-informed treatment for people affected by binge eating.

Find out more about Digital CBTe:

For more information visit the Credo Therapies website or contact Dr Lisa Debrou at lisa.debrou@credotherapies.com