The Light and Shadow of Smartphone Applications for Eating Disorders: Commentary on Cruz et al. (2025).

Abstract

Smartphone applications (apps) represent promising tools to overcome common barriers to treatment in individuals within the Eating Disorders (EDs) spectrum, thanks to their constant availability and cost-effectiveness. In this context, Cruz et al. (2025) conducted the first meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy of app-based interventions for EDs. Their findings provided evidence supporting the use of app-based interventions over control conditions in reducing ED symptoms and risk factors, although effect sizes were generally small. Despite these promising findings, caution is needed due to methodological concerns in the included trials, such as limited sample diversity, inconsistent follow-up durations, and the frequent use of waitlist controls. Notably, no significant effects were observed for key ED dimensions such as body dissatisfaction/disturbance and drive for thinness, pointing to the need for interventions grounded in robust body image theory and frameworks. Furthermore, the current evidence does not adequately address the efficacy of these apps across different populations, including adolescents, gender-diverse individuals, and those from varied racial, ethnic, and socioeconomic backgrounds. To maximize the clinical utility of these tools, future research should prioritize methodologically rigorous trials, adopt inclusive and intersectional frameworks, and expand evaluative outcomes beyond symptom reduction to include multiple indicators of psychological flourishing. These directions are essential to unlock the full potential of app-based interventions for EDs across diverse populations.