We’re proud to share that new peer‑reviewed research from stem4 has been published in JMIR Formative Research, highlighting the potential effectiveness, safety, and acceptability of the Worth Warrior app for young people experiencing low self‑esteem and mild eating difficulties.

Why this research matters

Eating difficulties and body image concerns are rising sharply among young people, while access to timely support has become increasingly limited. Many young people don’t meet the threshold for specialist services, yet still struggle daily with low self‑worth, body dissatisfaction, and disordered eating thoughts or behaviours. Evidence‑based, accessible early support is urgently needed.

Low self‑esteem is widely recognised as a key risk factor in the development and maintenance of eating disorders. When self‑worth becomes tied to appearance, weight, or shape, young people can become trapped in a cycle of negative self‑evaluation and harmful coping strategies. Worth Warrior was developed to directly target this cycle.

The newly published paper, “Preliminary Case Series of the Worth Warrior Mobile App for Young People With Low Self‑Esteem and Mild Eating Disorders” by Rachel Edwards and Dr Nihara Krause, presents a pilot case series evaluating Worth Warrior.

Five young people aged 19–25 with low self‑esteem and mild eating disorder symptoms used the app over a seven‑week period. The app is grounded in principles of enhanced cognitive behavioural therapy (CBT‑E) and focuses on:

  • Building self‑esteem that is not dependent on weight or appearance
  • Challenging negative self‑beliefs and body image concerns
  • Developing healthier coping and emotional regulation strategies

Participants completed standardised measures of eating disorder symptoms and self‑esteem before, during, and after using the app, alongside detailed feedback on usability, acceptability, and safety.

While this was a small, exploratory study, the findings are encouraging:

  • Significant improvements in eating disorder symptoms were observed in 3 out of 5 participants, with the strongest benefits seen in those with milder symptoms.
  • Self-esteem increased in 4 out of 5 participants, with two moving from the “low” range into the “normal” range by the end of the study.
  • Participants reported reductions in eating concerns, weight concerns, and related behaviours in most cases.
  • The app was rated positively for usability and acceptability, with users particularly valuing the interactive CBT-based activities and journalling features.
  • Importantly, support was found for the app’s acceptability and safety in standalone use for those with mild eating disorder symptoms, with potential for clinician-supported use in those with greater symptom severity.

Participants’ own words help to bring these findings to life. One young person described the impact of the app as:

“More than I expected – with confidence, self‑respect and thought, changing perspective.”

Another highlighted how the CBT-based activities translated beyond the app itself:

“It’s more personalised and it helps me to keep that frame of mind outside the app.”

Two participants also reported that using Worth Warrior helped them reach out for support when they needed it, something that can be a crucial step in early intervention.

The authors conclude that Worth Warrior shows promise as:

  • A standalone early‑intervention tool for young people with mild symptoms
  • An adjunct to clinical care, alongside professional support, for those with more complex needs

They also emphasise that, as a preliminary case series, these findings are not generalisable but provide a strong foundation for larger, controlled studies in the future.

This publication represents an important milestone for Worth Warrior. It adds to the growing evidence base for carefully designed, clinically informed digital mental health tools and reinforces the importance of targeting self‑esteem and body image as part of early intervention.

At stem4, our mission has always been to create free, accessible, evidence‑based mental health resources for young people. We’re proud to see Worth Warrior contributing to that mission and to ongoing research into how digital tools can safely support young people before difficulties escalate.

Read the full paper

The full paper is open access and available in JMIR Formative Research.

We’re excited to continue building the evidence base for Worth Warrior and to keep listening to young people as we refine and improve the app.

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