What is Digital CBTe and who is it for?
Only a minority of individuals who could benefit from psychological treatments for eating disorders currently receive them, in part due to the increasingly limited availability of evidence-based, therapist-led interventions. Expanding access is possible through digital solutions. In response, the Centre for Research on Eating Disorders at Oxford (CREDO) has developed Digital CBTe, the digital self-help version of Enhanced Cognitive Behaviour Therapy.
The initial development of Digital CBTe was funded by the Wellcome Trust. Preliminary research and NHS service improvement work have been supported by the NIHR Oxford Biomedical Research Centre, the Digital Health and Mental Health Themes of the NIHR Applied Research Collaboration Oxford and Thames Valley, and an NIHR Clinical Doctoral Research Fellowship.
Digital CBTe is a cognitive-behavioural self-help programme for people with eating disorders, such as bulimia nervosa and binge eating disorder, who are not underweight and who are experiencing recurrent binge eating. It is a programme-led approach designed to reach people directly via their phones and computers. It is intended for two groups in particular:
- Those in the early stages of an eating disorder. The goal is to help them break out of it before the problem becomes more established.
- Those with an established eating disorder who are unable or do not wish to access specialist therapist-led treatment. This can be for a variety of reasons including reluctance to disclose the problem, lack of local treatment resources, waiting lists, cost of treatment, and practical difficulties attending.
Digital CBTe is designed to be an engaging intervention which matches the eating problem of the person. The programme is closely derived from Enhanced Cognitive Behaviour Therapy (CBT-E) for eating disorders (CBT-E) and its associated printed self-help programme, Overcoming Binge Eating. It was originally developed by the Centre for Research on Eating Disorders at Oxford (CREDO), and is now provided by Credo Therapies Ltd. Credo Therapies is an innovative social impact company delivering Digital CBTe.
How can Digital CBTe be used?
Digital CBTe can currently be offered by a limited number of healthcare services who have partnered with Credo Therapies. It can be used in two ways:
- Pure Self-Help: Patients independently complete the programme, which can support services in various ways, including for patients on waiting lists.
- Guided Self-Help (GSH): Delivered alongside brief supportive sessions, it can serve as a first-line treatment for binge eating disorder and bulimia nervosa where appropriate. This option is supported by a clinician dashboard provided by Credo Therapies, enabling effective monitoring of progress.
Evaluations of Digital CBTe
Digital CBTe has been evaluated in both community and NHS settings for people experiencing binge eating.
Community evaluations
Digital CBTe was piloted for independent use as a programme-led intervention for people in the community reporting features consistent with binge eating disorder or bulimia nervosa. In a programme-led intervention, the treatment is delivered by the programme itself, in this case Digital CBTe, rather than by a therapist.
Read the publication: Breaking the Cycle: A Pilot Study on Autonomous Digital CBT-E for Recurrent Binge Eating
We’ve created an infographic summarising the findings from this study:
Digital CBTe was also piloted as a supported programme-led intervention. People in the community reporting features consistent with binge eating disorder or bulimia nervosa completed the digital programme alongside regular, brief support calls with a non-specialist supporter (coach).
Read the publication: A Little Support Goes a Long Way: A Mixed-Methods Pilot Study of Supported Digital CBTe for Recurrent Binge Eating
We’ve created an infographic summarising the findings from this study:
NHS evaluations
Digital CBTe has also been evaluated in specialist NHS eating disorder services.
In Dorset All Age Eating Disorders Service, Digital CBTe was evaluated for independent use as a programme-led intervention for people waiting for assessment.
Read the publication: Bridging the gap: a mixed-methods real-world pilot of a digital intervention for adults with binge eating
In Kent and Medway All-Age Eating Disorder Service, Digital CBTe was evaluated as a supported programme-led intervention, combining the digital programme with short scheduled calls from trained supporters (coaches) as part of the routine care pathway.
Read the publication: Implementing Supported Digital Enhanced Cognitive Behavior Therapy for Binge Eating Disorder in Routine Care: Mixed Methods Service Evaluation
We’ve created an infographic summarising the findings from this NHS evaluation:
Following these evaluations, Digital CBTe is now ready for implementation in other healthcare services.
We are always interested in hearing from people with binge eating, healthcare professionals, and services who would like to be involved in future research on Digital CBTe.
If you are interested, please contact us at credoenquiries@psych.ox.ac.uk.
Please note that we may not always be recruiting participants immediately, but with your permission we can keep your details for future studies.
Further reading
Murphy, R., Osborne, E. L., & Khera, C. K. (2026). A little support goes a long way: A mixed-methods pilot study of supported Digital CBTe for recurrent binge eating. International Journal of Eating Disorders, 1–9. https://doi.org/10.1002/eat.70188
Osborne, E. L., Powell, J., Brown, C., Cresswell-Nash, G., Debrou, L., Defever, E., Greenwood, S., Horton, J., Hunter, E., Lees, A., Moore, M., Newell, C., Randell, B., Rosten, C., Shaw, N., Yao, V., & Murphy, R. (2026). Implementing supported digital enhanced cognitive behavior therapy for binge eating disorder in routine care: Mixed methods service evaluation. Journal of Medical Internet Research, 28, e92069. https://doi.org/10.2196/92069
Osborne, E. L., Powell, J., Barker, L., Birtwell, C., Debrou, L., Defever, E., Francis, V., Hunter, E., Kotze, N., Lees, A., Newell, C., Randell, B., Rosten, C., Yao, V., & Murphy, R. (2025). Bridging the gap: A mixed-methods real-world pilot of a digital intervention for adults with binge eating. Journal of Eating Disorders, 14(1), 11. https://doi.org/10.1186/s40337-025-01487-5
Murphy, R., Khera, C., & Osborne, E. L. (2025). Breaking the cycle: A pilot study on autonomous Digital CBTe for recurrent binge eating. Frontiers in Digital Health, 6, 1499350. https://doi.org/10.3389/fdgth.2024.1499350
Fairburn, C. G., & Patel, V. (2017). The impact of digital technology on psychological treatments and their dissemination. Behaviour Research and Therapy, 88, 19–25. https://doi.org/10.1016/j.brat.2016.08.012
Fairburn, C. G., & Murphy, R. (2015). Treating eating disorders using the internet. Current Opinion in Psychiatry, 28(6), 461–467. https://doi.org/10.1097/YCO.0000000000000195
