Lessons learned from a randomised controlled trial of a digital intervention targeting eating disorder symptoms in cisgender sexual minoritized men.

BACKGROUND: There is an unmet need for evidence-based and accessible interventions designed to treat eating disorders in sexual minoritized men, given their heightened vulnerability to developing disordered eating. Digital interventions are a promising avenue for eating disorder treatment because of their accessibility and flexibility in delivery. Here, we present a randomised controlled trial of Seed, a 10-week treatment-focussed digital intervention for eating disorders, among sexual minoritized men. METHODS: Participants (N = 126 sexual minoritized men) with a binge-spectrum eating disorder diagnosis (e.g., bulimia nervosa, binge-eating disorder) were randomly allocated to one of three conditions: (1) a waitlist control (2) a personalised intervention, where participants received personalised content recommendations based on their individual symptom profile, or (3) a default intervention, in which participants received no personalised recommendations. Changes from baseline in eating disorder symptoms were evaluated via clinical interview and self-report at 10 week and 6 month follow up. RESULTS: Relative to the waitlist control and default conditions, participants in the personalised intervention condition reported significantly greater decreases in their global Eating Disorder Examination interview scores at post-intervention/10-week follow up. We did not observe any significant changes in self-reported eating disorder symptoms. Our results are tentative as we were underpowered to detect small-to-medium treatment effects. CONCLUSIONS: Our study provides preliminary evidence for the efficacy of Seed for treating eating disorders in sexual minoritized men, particularly when personalised content recommendations are provided. However, future research must provide greater quality evidence through well-powered, more rigorous clinical trials. TRIAL REGISTRATION: This trial was retrospectively registered on 04/03/2026 (Trial ID ACTRN12626000271303).