The results of clinical trials on the first ever web-based self help guide for people suffering from Bulimia Nervosa, funded under the Fifth Framework Programme (FP5), have been very positive, project coordinator Tony Lam has told CORDIS News. The Salut project is developing software offering treatment support in six languages for people with the eating disorder bulimia. The self help guide comprises seven steps, each involving lessons, exercises and examples illustrated by a virtual character. One of the most important exercises is a food diary, which requires users to analyse their eating behaviour using a weekly summary generated from their food diary. Weekly e-mail contact between the user and a therapist is used for encouragement. While self help guides do exist in CD-ROM and book format, this is the first attempt to develop an online version. Asked why the project team believes that interaction with a computer will benefit people with this eating disorder, Mr Lam explained that many of those who suffer from bulimia feel a sense of shame about their behaviour, which prevents them from seeking help. The fear of being judged, which often constitutes a barrier to visiting a psychologist, is reduced with a self help guide. Research also shows that, when dealing with emotional issues, it is sometimes easier to talk to a neutral medium such as a computer first, added Mr Lam. The self help method is therefore regarded as adding to the therapeutic relationship, and not replacing trained professionals. Clinical trials are currently being carried out in Sweden, France, Switzerland and Spain. The multilingual aspect is of particular importance in this project, as, while a great deal of work has already been done in English, relatively little has been done in other languages. Some 80 patients are participating in the trials, the results of which have been extremely encouraging. An initial analysis involving 25 users showed significant improvements, and indicated in questionnaires that they had found the guide useful and easy to use. Asked why they decided to use the self help guide, 73 per cent replied that they liked the idea of self treatment, and 42 per cent highlighted the convenience of the scheme, saying that they did not have the time to attend weekly therapy sessions. The system has also proved popular with therapists, who have praised the time saving element of the initiative, as well as the ease of progress monitoring. The self help guide may also reduce the risk of burnout among therapists, explained Mr Lam. Psychologists spend a lot of their time speaking to individuals suffering from eating disorders, many of whom have issues in common. The project has also won acclaim from other stakeholders. Since being introduced to the Salut project at conferences, two new teams have joined the consortium, which already brings together eight partners from five European countries. The new teams found the project so interesting that they decided to join even though there was no additional EU funding available. It is estimated that four per cent of women in developed countries suffer from bulimia, and while the number of people suffering from another eating disorder, anorexia, is stable, cases of bulimia are increasing, and therefore putting a strain on national health systems. The final results of the Salut project, expected in March 2004, are therefore likely to be eagerly awaited by clinicians and health ministries alike.