Motivational interventions in the eating disorders: what is the evidence?

Abstract

Background: Eating disorder treatments are plagued by poor engagement and high drop-out. People who disengage from eating disorder treatment appear poorly motivated to change, and may benefit from adaptations of Motivational Interviewing (AMIs).

Objective: To investigate whether the use of interventions specifically designed to enhance motivation in the eating disorders is supported empirically.

Method: Literature was reviewed for relevant studies.

Results: Eight studies have investigated the efficacy of AMIs. AMIs improve motivation to change bingeing and reduce actual bingeing behavior. There was little support for AMIs for compensatory or restrictive behaviors. There was mixed evidence that AMIs may improve motivation, but little to suggest they are more effective than other approaches.

Discussion: The widespread interest in using motivational approaches in the eating disorders is not strongly supported by the literature. The current evidence base does not support the widespread dissemination of motivation-enhancing interventions in the eating disorders.