Key result
Ecological momentary interventions show short-term behavioral improvements but lack sustained benefit over active controls.
Why the study?
To evaluate the feasibility, efficacy, adherence, and methodological quality of ecological momentary intervention-based treatments for individuals with diagnosed eating disorders, obesity, or both.
Do ecological momentary interventions improve clinical and behavioral outcomes in individuals with eating disorders and obesity?
Systematic Review (n=14)
Do ecological momentary interventions improve clinical and behavioral outcomes in individuals with eating disorders and obesity?
Answers are grounded in this paper and cite their sources.
Ecological momentary interventions are feasible and acceptable for extending evidence-based treatments for eating disorders and obesity into daily life, improving short-term behavioral outcomes but lacking consistent long-term clinical benefits.
OBJECTIVE: This systematic review evaluated the feasibility, efficacy, adherence, and methodological quality of ecological momentary intervention (EMI)-based treatments for individuals with diagnosed eating disorders (EDs) and/or obesity. METHOD: Eight electronic databases were systematically searched from inception to January 2026. Randomized, non-randomized, and uncontrolled studies evaluating EMI-based treatments for individuals with diagnosed EDs and/or obesity were included. Data on intervention characteristics, clinical and behavioral outcomes, feasibility, acceptability, and adherence were extracted. Risk of bias was assessed using RoB 2 and ROBINS-I, and findings were synthesized narratively. RESULTS: Fourteen studies met inclusion criteria (eight obesity-focused, six ED-focused), including nine randomized controlled trials. In ED studies, EMI-augmented interventions were associated with significant within-group reductions in binge-eating frequency and ED psychopathology. However, superiority over active cognitive-behavioral therapy-based controls was inconsistent and primarily observed during maintenance phases. Obesity-focused trials demonstrated small to moderate within-group improvements in weight-related outcomes, with generally small and non-sustained between-group effects. Feasibility and acceptability were generally high, although retention and engagement varied across studies. Risk of bias was low in most randomized trials but higher in non-randomized studies. DISCUSSION: EMIs appear to be a feasible and acceptable approach for extending evidence-based treatments for EDs and obesity into daily life. Current evidence suggests that EMIs may exert a beneficial adjunctive effect by enhancing engagement and improving short-term behavioral outcomes. However, their impact on long-term clinical outcomes remains limited and inconsistent, underscoring the necessity for conducting rigorously designed clinical trials with extended follow-up periods.
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Mao et al. (2026) conducted a systematic review in Eating disorders and/or obesity (n=14). Ecological momentary interventions (EMIs) vs. Active cognitive-behavioral therapy-based controls or unaugmented treatments was evaluated on Clinical and behavioral outcomes, feasibility, acceptability, and adherence. Ecological momentary interventions for eating disorders and obesity showed short-term behavioral improvements, but superiority over active controls was inconsistent and not sustained.
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