Engagement With the Recovery Record App and Treatment Outcomes for Adolescents and Young Adults With Eating Disorders

OBJECTIVE: This retrospective cohort study sought to determine whether higher levels of engagement with the Recovery Record (RR) app were associated with better outcomes on eating disorder (ED) symptoms (Eating Disorder Examination-Questionnaire) (EDE-Q), depression (Patient Health Questionnaire-9), and generalised anxiety (GAD-7) for individuals receiving ED treatment. METHOD: Participants were 4852 adolescents and young adults receiving treatment between March 2021 and August 2024. RR was made available to all patients during their treatment. RESULTS: Cluster analysis identified three distinct groups: engagement, low engagement, and no engagement. After controlling for baseline severity and treatment duration, engagement was correlated with lower EDE-Q scores at discharge compared to low engagement (β = -0.18, p = 0.010). Engagement was also correlated with significantly lower PHQ-9 scores at discharge relative to both low (β = -0.93, p = 0.004) and no engagement (β = -0.84, p = 0.015) groups. Engagement was associated with lower GAD-7 scores at discharge compared to low engagement (β = -0.90, p = 0.003). Greater average daily logging in the RR app was associated with incremental improvements in all outcomes: EDE-Q (β = -0.042, p = 0.030), PHQ-9 (β = -0.287, p = 0.001), and GAD-7 (β = -0.216, p = 0.010). CONCLUSIONS: Findings suggest that engagement with the RR app is associated with better outcomes in terms of ED symptoms, depression, and anxiety.