From Ecological Momentary Assessment (EMA) to Ecological Momentary Intervention (EMI): Past and Future Directions for Ambulatory Assessment and Interventions in Eating Disorders

  • Kathryn E. SmithEmail author
  • Adrienne Juarascio
Eating Disorders (S Wonderlich and S Engel, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Eating Disorders


Purpose of Review

Ambulatory assessment methods, including ecological momentary assessment (EMA), have often been used in eating disorders (EDs) to assess the type, frequency, and temporal sequencing of ED symptoms occurring in naturalistic environments. Relatedly, growing research in EDs has explored the utility of ecological momentary interventions (EMIs) to target ED symptoms. The aims of the present review were to (1) synthesize recent literature pertaining to ambulatory assessment/EMA and EMI in EDs, and (2) identify relevant limitations and future directions in these domains.

Recent Findings

With respect to ambulatory assessment and EMA, there has been substantial growth in the expansion of constructs assessed with EMA, the exploration of state- vs. trait-level processes, integration of objective and passive assessment approaches, and consideration of methodological issues. The EMI literature in EDs also continues to grow, though most of the recent research focuses on mobile health (mHealth) technologies with relatively minimal EMI components that adapt to momentary contextual information.


Despite these encouraging advances, there remain several promising areas of ambulatory assessment research and clinical applications in EDs going forward. These include integration of passive data collection, use of EMA in treatment evaluation and design, evaluation of dynamic system processes, inclusion of diverse samples, and development and evaluation of adaptive, tailored EMIs such as just-in-time adaptive interventions. While much remains to be learned in each of these domains, the continual growth in mobile technology has potential to facilitate and refine our understanding of the nature of ED psychopathology and ultimately improve intervention approaches.


Eating disorders Ambulatory assessment Ecological momentary assessment mHealth Ecological momentary intervention 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Center for Bio-behavioral ResearchSanford ResearchFargoUSA
  2. 2.Department of Psychiatry and Behavioral ScienceUniversity of North Dakota School of Medicine and Health SciencesFargoUSA
  3. 3.Department of PsychologyDrexel UniversityPhiladelphiaUSA

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