title: Mobile therapy: Use of text-messaging in the treatment of bulimia nervosa.
abstract: OBJECTIVE
  To examine a text-messaging program for self-monitoring symptoms of bulimia nervosa (BN) within the context of cognitive-behavioral therapy (CBT).
  
  
  METHODS
  Thirty-one women participated in 12 weekly group CBT sessions and a 12 week follow-up. Participants submitted a text message nightly indicating the number of binge eating and purging episodes and rating their urges to binge and purge. Automatic feedback messages were tailored to their self-reported symptoms.
  
  
  RESULTS
  Fully 87% of participants adhered to self-monitoring and reported good acceptability. The number of binge eating and purging episodes as well as symptoms of depression (BDI), eating disorder (EDI), and night eating (NES) decreased significantly from baseline to both post-treatment and follow-up.
  
  
  CONCLUSIONS
  Given the frequent use of mobile phones and text-messaging globally, this proof-of-principle study suggests their use may enhance self-monitoring and treatment for BN leading to improved attendance, adherence, engagement in treatment, and remission from the disorder.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina 27599, USA. jshapiro@med.unc.edu
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Shapiro
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bauer
authors.forename: Ellen
authors.initials: E
authors.lastname: Andrews
authors.forename: Emily
authors.initials: E
authors.lastname: Pisetsky
authors.forename: Brendan
authors.initials: B
authors.lastname: Bulik-Sullivan
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamer
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D052018:Bulimia Nervosa / Q000628:therapy*; D040421:Cell Phone; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D012648:Self Care; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome