Smartphone-delivered ecological momentary interventions for disordered eating following intense shame experiences

It is well-established that intense emotional experiences are associated with the engagement in disturbed eating behaviors, making it crucial to explore real-time interventions that can mitigate these behaviors. This study aimed to test the efficacy of brief self-compassion-based interventions delivered during moments of high shame, using ecological momentary interventions (EMIs) and assessments (EMA), on disturbed eating behaviors at next prompt.

Women with elevated levels of eating disorders symptoms from community (N = 93) were randomized into an intervention group, who received self-compassion instructions via a mobile app when reporting high levels of shame, and a control group that only monitored mood and eating behaviors. Both groups completed mood and eating behaviors ratings 5 times a day for 1 week.

The intervention group showed significant reductions in body checking behaviors following episodes of high shame compared to the control group. For binge eating behaviors, participants in the control group demonstrated an increase following shame events, while the experimental group exhibited stable levels, suggesting that self-compassion strategies mitigated shame's impact on binge eating. Additionally, participants in the intervention group were significantly less likely to report high-shame episodes during the final days of the intervention, suggesting reduced shame reactivity in daily life.

These results highlight the potential of targeted, real-time interventions in reducing specific disordered eating behaviors, though broader strategies may be needed for others. The study emphasizes the importance of personalized, context-sensitive approaches and suggests future research should explore these methods in more diverse populations.