Developing more efficient, effective, and disseminable treatments for eating disorders: an overview of the multiphase optimization strategy

  • Stephanie M. ManasseEmail author
  • Kelsey E. Clark
  • Adrienne S. Juarascio
  • Evan M. Forman


The present manuscript describes the multiphase optimization strategy (MOST) and its potential applications to treatments for eating disorders (EDs). The manuscript describes the three phases of MOST, discusses a hypothetical case example of how MOST could be applied to developing a disseminable ED treatment, and reviews the pros and cons of the MOST approach. Outcomes from treatments for EDs leave room for improvement. However, traditional methods of treatment development and evaluation (i.e., the treatment package approach) make it challenging to determine how best to improve ED treatments. For example, testing full treatment packages in open trials and RCTs without systematic testing of each component is inefficient (as it is unknown which components are effective), and often does not provide concrete future directions for optimization of the treatment. Much stands to be gained by optimizing treatments in the early stages before testing them in open trials or RCTs. MOST is an alternative, engineering-inspired research framework that is well-suited to address the issues of inefficiency associated with the treatment package approach. MOST entails identifying the most promising treatment components for inclusion in interventions, then eliminating or deemphasizing less efficacious/inert components. This strategy results in a treatment comprised of only effective components that can then be tested via RCT. Though the MOST approach has limitations, it has the potential to greatly benefit ED treatment research and is worthy of application in the field.


Eating disorders Experimental design Factorial design Treatment development Treatment evaluation Treatment efficacy 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

No ethical approval was necessary for this review manuscript.

Informed consent

No informed consent was necessary for this study as no human subjects were enrolled.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Center for Weight, Eating, and Lifestyle Sciences (WELL Center)Drexel UniversityPhiladelphiaUSA
  2. 2.Department of Psychology and WELL CenterDrexel UniversityPhiladelphiaUSA

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