Use of electronic diaries within treatment of obesity and binge eating disorder: First experiences

Abstract

After initial use for treatment-documentation within the scope of follow-up studies, electronic diaries are increasingly implemented in clinical settings. Particularly, diaries seem to fit very well in areas where "paper and pencil-diaries" yet constitute well established elements of symptom-focussed treatment settings, including a detailed description and analysis of problem behaviour. This e.g. applies to treatment of eating disorders like anorexia nervosa, bulimia nervosa or binge eating disorder (BED). BED is characterised by ingestion of a large amount of food in a discrete period of time, accompanied by a sense of loss of control. BED in particular appears to be predisposed for the use of electronic diaries: By the mean of self-observation based on diary recording, information about triggers of problem behaviour, thoughts, somatic symptoms, and feelings experienced during a binge, as well as patient's reactions in a detailed manner may be assessed. Therefore, as a therapeutic mean, electronic diaries are fostering taking-over of self-responsibility and thus, will raise treatment motivation. Especially when binge eating and loss of control occur, the use of diaries enhances self-control and self-regulation. Electronic diaries realised on handheld-computers (Palm 100m) are used within the scope of an intervention study realised by the Dept. of General Internal and Psychosomatic Medicine of the University of Heidelberg, focussing on treatment of obese patients with binge eating disorder. Purpose of the study is the registration of therapeutic relevant information as well as the assessment of progression within a multimodal, out-patient group therapy. First experiences demonstrate the feasibility of mobile computing systems even with elder out-patients with no or little technical knowledge. However, implementation of the system requires focussing particularly on technical aspects. Limitations which may result from insertion of innovative technical equipment (particularly, a susceptibility to electronic problems and maybe resulting in restrictions of data) should be considerated in an adequate manner during scheduling.