Expanding access to free eating disorder support

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Published: September 2026. Next review: 2031.

The InsideOut eClinic is Australia’s first free and completely online national treatment platform for people with eating disorders. It enables people to access support regardless of where they live.

The InsideOut Institute, a partnership between the University of Sydney and Sydney Local Health District (LHD), developed the eClinic through more than a decade of research, including 4 clinical trials. Funded by the Australian Government, the eClinic is accredited under the National Safety and Quality Digital Mental Health Standards.

Improving access

  • Eating disorders are among the most serious and undertreated mental health conditions in Australia.
  • On average, there is a 10-year gap between the onset of symptoms and receiving treatment, with only 1 in 5 people receiving care.
  • Cost, long waitlists, geographic barriers, workforce shortages and stigma are the most common barriers to people accessing timely and evidence-based support.
  • The InsideOut eClinic was established to address these challenges.
  • People aged 16 years and over can access the eClinic without a referral.
  • All programs, eTherapies and guided self-help training is free for clients, carers and health professionals.

Available programs

  • BEeT (Binge Eating eTherapy): for people aged 16 years and over experiencing binge eating disorder or bulimia nervosa symptoms. It is available as a 4-session brief program or 10-session full program.
  • SkillED: for people aged 12 years and over experiencing a range of eating disorder symptoms, including restrictive eating. Those aged 12 to 15 years may access with parental consent under clinical trial conditions.
  • SupportED: a free 5-module program for carers and family members. It covers communication strategies, managing distress, self-care and understanding eating disorders.
  • Toolbox: a digital self-monitoring companion available through a web browser and mobile app. Users can track meals, thoughts, urges, behaviours and set goals.

Advantages of providing care virtually

  • Rural and regional communities: people can access specialist care from anywhere with an internet connection, removing the need to travel.
  • People on waitlists: people can access support while waiting for treatment. Those referred by a health professional are 3 times more likely to complete the program.
  • Neurodivergent individuals: the platform is designed to be inclusive and accessible, and considers the user needs.
  • Young people: With parental consent, young people aged 12 to 15 years can participate in SkillED, under clinical trial conditions.
  • Carers and support people: the clinic’s free SupportED program provides dedicated skills-based support for families and carers.

Consumer experience

The eClinic was co-designed with people who have lived and living experience of eating disorders. This helps to ensure its programs reflect the reality of recovery. Around 74% of people using the eClinic have never accessed eating disorder treatment before, showing the platform is reaching people who would otherwise go without support.

  • No referral needed: people can self-refer and access support via the eClinic website.
  • Flexible care options: individuals can complete programs on their own, with monitoring, or with guidance from their chosen health professional.
  • Anonymous and private: reduces stigma and shame as barriers when seeking support.
  • Supports connected care: people can download their questionnaire results and share them with their general practitioner (GP) or health professional.

Consumer feedback

Research trials found up to 93% of participants reported being extremely satisfied with the program.

“This was the most rewarding program I have ever done, I have learnt so much.”

“You have really helped me where no one else could and I can’t explain my gratitude enough.”

“[The program] helped me go for days without binging and purging which has not happened in 7 years.”

Clinical feedback

“Our goal is to make effective eating disorder care more accessible to everyone, regardless of their location, cultural or socioeconomic background.”

– Professor Sarah Maguire, Director, InsideOut Institute for Eating Disorders

“The eClinic helps break down the barriers of stigma, shame and secrecy that so often surround eating disorders, offering a safe and approachable way to access care.”

– Dr Sarah Barakat, Research Lead, InsideOut eClinic

Accessing support through the eClinic

The InsideOut eClinic is accessible through a web browser on a computer, tablet or smartphone. The Toolbox is also available as a mobile app.

When a user signs up for an eTherapy program, they answer a series of eligibility questions to determine whether the program is the right fit for their needs. People who are unsure where to start can complete the InsideOut Screener (IOI-S), a 6-question digital screening tool that assesses broad eating disorder risk and recommends the most appropriate program.

Programs are self-paced and involve completing 30 to 60 minutes of modules and homework per week.

Flexible ways to use the eClinic

People can choose the level of support that best suits their needs:

  1. Self-help: users can complete the modules independently at their own pace.
  2. Monitored by a health professional: people connect with their chosen clinician via the Health Professional Hub. Using a unique code, the clinician can view the user’s progress, questionnaire results and self-monitoring check-ins.
  3. Guided by a health professional: weekly appointments, which can be delivered in-person, by phone or via videoconference.

InsideOut does not provide direct clinical care. Instead, it provides resources and programs allowing people to connect with and be guided by a health professional of their choosing.

Health Professional Hub

Health professionals registered with Australian Health Practitioner Regulation Agency (AHPRA), or equivalent can access the Health Professional Hub for free. No specialist eating disorder knowledge is required.

Through the Hub, health professionals can refer clients to the eClinic via a short online form and can access free guided self-help training (approximately 4 hours).

Safety and risk monitoring

InsideOut does not actively monitor people who use the programs independently as a self-help model.

People using the eClinic complete questionnaires at multiple points throughout their program. These include the:

  • Eating Disorder Examination Questionnaire (EDE-Q)
  • Kessler Psychological Distress Scale (K10), Eating Disorder Symptoms (7-Day Frequency)
  • World Health Organization Quality-of-Life Scale (WHOQoL)
  • PHQ‑9 (Patient Health Questionnaire‑9): select questions related to suicidality and deliberate self-harm
  • Questions to assess people’s motivation and confidence to engage in treatment.

If a person’s responses indicate they may be at risk, the platform provides an immediate on-screen alert and an email with information about crisis support services and a database to help find local support. Clinicians supporting a person through the eClinic are notified automatically.

Key enablers

Evidence-based design: each eTherapy program is clinically validated before being added to the platform.
Australian Government funding: the Australian Government Department of Health, Disability and Ageing funds the eClinic under the National Leadership in Mental Health program.
National accreditation: accredited under the National Safety and Quality Digital Mental Health Standards, ensuring safety and high-quality care.
Simple referrals: people can self-refer or directly receive a registration link from clinician referral.
Co-design with lived experience: clinicians and researchers developed the programs in partnership with people with lived and living experience of eating disorders, an active Lived Experience Advisory Group and families and carers.
Flexible integration into clinical care: the eClinic can be used as a standalone service, waitlist intervention, alongside existing treatment, or as a step-down tool. The platform supports care by providing evidence-based programs, while health professionals provide standard care. No specialist eating disorder knowledge is required.

Implementation

The eClinic launched nationally in July 2025 and offers services a simple and accessible referral process.

It can be integrated at multiple points along the care pathway to enhance service capacity and client outcomes. The eClinic can be used as:

  • a referral option: providing immediate access to free, evidence-based treatment
  • support between appointments: helping clients maintain motivation and reduce deterioration
  • a waitlist management tool: providing support while people wait to access treatment
  • additional support to existing care: providing structured programs without increasing clinician workload
  • a self-monitoring tool: enabling clients to track progress alongside clinician-led care
  • ongoing self-management: through step-down, discharge, and relapse prevention support
  • Workforce training and development: to support health professionals to build skills in eating disorder care and guided self-help approaches.

Clinical risk

The eClinic is not suitable for all presentations, each program has a different eligibility criteria.

They are not appropriate for:

  • people who are medically unstable or very underweight
  • people who are actively suicidal or self-harming and require in-person intervention.

The eClinic does not replace a clinical diagnosis or in-person treatment. Instead, it complements existing services and fills gaps where accessibility and treatment options are limited.

Impacts and outcomes

Clinical outcomes

  • Research across 4 clinical trials found the eClinic can improve outcomes for people experiencing eating disorder symptoms.
  • The program reduced binge eating episodes by 37‑81% across self-help and clinician-supported versions.
  • The program reduced eating disorder-related thoughts and behaviours (e.g. body image concerns and restrictive thinking) by 40‑58%.
  • Participant improvement was visible by session 4, informing the development of the 4-session brief version of the Binge Eating eTherapy Program (BEeT).
  • Participants sustained the benefits of the program at 3, 6 and 12‑month follow‑up.

Consumer benefits

  • Approximately 74% of people using the eClinic have never previously accessed eating disorder treatment.
  • Top reasons for people choosing the eClinic are because it is free, convenient, private and helps overcome barriers such as long waitlists and geographic location.
  • Up to 93% of participants report being extremely satisfied with the program.

System benefits

  • Reduces burden on health services by providing immediate, free and standardised treatment without the need to increase clinician capacity.
  • Supports early intervention and reduces the duration of untreated illness.
  • Reaches rural and regional communities and people who have never engaged with eating disorder services.

Future vision

  • Addition of new eTherapies as research progresses through clinical trials.
  • Broader integration into NSW Health services and LHD referral pathways.

Lessons learned

  • You don’t need to be an eating disorder specialist: any AHPRA-registered health professional (or equivalent) can sign up for free, access training, and start guiding or monitoring their clients.
  • Refer rather than just recommend: clients referred by a health professional are more than 3 times as likely to engage and complete the program, compared with those who self-refer.
  • Use it flexibly: the eClinic can be used at multiple points along the care pathway. Use it in a way that makes most sense for your service.
  • Don’t overlook SupportED: the program is free for carers and provides evidence-based resources to increase carer skills and reduce the burden on supporting a loved one with an eating disorder.

Acknowledgement

Thank you to Rachel Denzel, eClinic Service Manager, for the support and information provided for this spotlight.

References

  • Barakat S, et al. (2023). A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa. Psychiatry Research, 329, 115534.  DOI: 10.1016/j.psychres.2023.115534
  • Rom S, Miskovic-Wheatley J, Barakat S, Aouad P, Kim M, Fuller-Tyszkiewicz M, Maguire S. The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder. Front Psychiatry. 2023 Oct 4;14:1229261. doi: 10.3389/fpsyt.2023.1229261. PMID: 37860164; PMCID: PMC10584326
  • Rom S, Miskovic-Wheatley J, Barakat S, Aouad P, Fuller-Tyszkiewicz M, & Maguire, S. (2022). Evaluating the feasibility and potential efficacy of a brief eTherapy for binge-eating disorder: A pilot study. International Journal of Eating Disorders, 55(11), 1614–1620. https://doi.org/10.1002/eat.23803
  • Barakat S, Maguire S, Surgenor L, Donnelly B, Miceska B, Fromholtz K, Russell J, Hay P, Touyz S. The Role of Regular Eating and Self-Monitoring in the Treatment of Bulimia Nervosa: A Pilot Study of an Online Guided Self-Help CBT Program. Behav. Sci. 2017, 7, 39. https://doi.org/10.3390/bs7030039
  • Barakat S, Touyz S, Maloney D, et al. Supported online cognitive behavioural therapy for bulimia nervosa: a study protocol of a randomised controlled trial. J Eat Disord 9, 126 2021. https://doi.org/10.1186/s40337-021-00482-w
  • Miskovic-Wheatley J, Schlage J, Pehlivan MJ, Simone R, Koreshe E, Hunt C, Maguire S. Skills-based online self-help program for carers of people with an eating disorder (SupportED): A case series evaluation. Int J Eat Disord. 2024 Feb;57(2):423-436. doi: 10.1002/eat.24112. Epub 2023 Dec 27. PMID: 38149436.
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