Online vs. In-Person Treatment for Bulimia

Virtual treatment for bulimia nervosa (BN), or virtual treatment for any mental health disorder, can offer high-quality care. For many people, there isn’t a tangible difference in virtual therapy sessions versus traditional in-person treatment.

Online vs in-person treatment

In-person care may sometimes be preferred when addressing BN, particularly in the early stages of treatment, when medical care may also be necessary. Some people find a sense of intimacy and safety with in-person treatment that they feel can’t be replicated with virtual care. And in-person care has also been shown to better engage some patients, particularly adolescents and teens. [1] 

Still, others prefer virtual care for its convenience. Some people may live far from viable treatment centers or have other barriers to travel that make virtual eating disorder treatment more accessible. And the option can also be helpful for those whose schedules may otherwise be packed with school, work, or childcare duties, among other responsibilities.

What Is Virtual Eating Disorder Treatment?

Teletherapy and other forms of care not taking place in person have been around since at least the 1990s. But virtual eating disorder treatment really took off during the COVID-19 pandemic, when the combination of advanced technology and public health concerns led many aspects of life to shift online.

These sessions typically involve a computer or smartphone. Using the internet, the patient can then connect to treatment providers or speak with a mental health professional through an app or other online treatment program. 

Online therapy is particularly well-suited for bulimia nervosa and other types of eating disorders, as the initial type of care used to help people recover from these conditions is typically a combination of nutritional counseling and cognitive behavioral therapy, both of which can be easily administered online. [2]

Pro-ana websites

Benefits of Online Treatment for Bulimia Nervosa

There are a few benefits to online treatment that are worth highlighting. 

Better Access

Virtual treatment generally improves access to care. [3] This can make a particular impact on individuals who don’t have appropriate mental health resources near them or who may have difficulty leaving their homes on a regular basis. In these cases, the virtual component extends the reach of quality treatment options, giving these patients access to care that they would otherwise encounter difficulty obtaining.


In a similar vein, many people prefer virtual treatment for convenience, even when other options are available. Because there’s no need to drive to a virtual appointment, it can be significantly easier to schedule. For those whose days are filled with other responsibilities, saving even a 20-minute round-trip drive can make a beneficial difference.


Many societal norms have also been molded by the digital age. A majority of people spend a significant portion of time in front of screens and other devices, and this may help extend a feeling of comfort in talking to a therapist this way. Some people may be able to achieve a greater level of vulnerability when they aren’t necessarily in the same room as their therapist. 

Are There Disadvantages of Online Therapy?

Widespread virtual eating disorder treatment is still relatively new, though some studies have already delivered findings on its quality of care and potential treatment outcomes.

One such study comparing in-person treatment to virtual therapy found the formats produced similar short-term clinical outcomes. It also noted a variety of situations where virtual therapy can be more beneficial than in-person care, particularly when those receiving treatment were geographically far from their provider or encountered other treatment barriers. [4] 

Still, there are some known limitations to online therapy.

Inpatient Treatment May Be Necessary

People with severe eating disorder symptoms, such as those in mental or emotional crisis or those who are experiencing major health complications, likely need care that can’t be provided virtually. These patients are more likely to benefit from a partial hospitalization program (PHP) or residential treatment, at least until their physical and mental health can be stabilized. Although some online treatment programs do offer PHP options, residential treatment will need to be done in person.

Virtual treatment programs like Within Health offer partial hospitalization programs.

Better Response to In-Person Treatment

Other studies have shown in-person care to be particularly beneficial for certain populations of patients. Children, adolescents, teens, and young adults, specifically, have generally responded better to face-to-face treatment. [5] 

Technology Limitations

And those who are uncomfortable with technology or have a poor or limited internet connection will likely also struggle with virtual treatment. 

How to Find Treatment for Bulimia Nervosa

Whether virtual or in-person, treatment for—and, ultimately, recovery from—BN is possible.

If you don’t know where to start seeking help, the National Eating Disorders Association (NEDA) Helpline is a good resource. Available by calling 1-800-931-2237 or texting 1-800-931-2237, this hotline lets you speak with a trained volunteer who will listen to your concerns and who can offer you useful advice and further resources for seeking treatment. [6]

Yet, while support or crisis lines can be vital in the moment, the treatment of bulimia nervosa often requires longer-term, comprehensive care. Generally, this level of treatment is available both online and in person.

Having the option between forms of care can help ensure you choose the most helpful path for you, which can help keep you on the road to recovery. It’s important to remember that help is always possible.


  1. Stewart C, Konstantellou A, Kassamali F, et al. (2021). Is this the ‘new normal’? A mixed method investigation of young person, parent and clinician experience of online eating disorder treatment during the COVID-19 pandemic. Journal of Eating Disorders; 9(78). 
  2. Bulimia: Symptoms, Diagnosis and Treatments. (2014, December). Harvard Health Publishing. Retrieved January 27, 2023.
  3. Lattie EG, Stiles-Shields C, & Graham AK. (2022). An overview of and recommendations for more accessible digital mental health services. Nature Reviews Psychology; 1:87–100.
  4. Steiger H, Booij L, Crescenzi O, Oliverio S, Singer I, Thaler L, St-Hilaire A, & Israel M. (2022). In-person versus virtual therapy in outpatient eating-disorder treatment: A COVID-19 inspired study. The International Journal of Eating Disorders; 55(1):145–150.
  5. Steinberg D, Perry T, Freestone D, Bohon C, Baker JH & Parks E. (2023). Effectiveness of delivering evidence-based eating disorder treatment via telemedicine for children, adolescents, and youth. Eating Disorders; 31(1):85-101.
  6. NEDA Helpline. National Eating Disorders Association. Retrieved January 27, 2023

Last Update | 02 - 28 - 2023

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