Helping Patients with Binge Eating Disorders: There's an App for That

Behavioral therapy assisted by a smartphone app, delivered via telemedicine by a health coach, was an effective treatment for several symptoms of binge eating disorders, according to a study conducted by researchers from the Icahn School of Medicine at Mount Sinai and published this week in The American Journal of Psychiatry.

According to The American Psychiatric Association, psychiatric disorders characterized by binge eating, including binge eating disorder and bulimia nervosa, affect up to 6.5 million Americans. Cognitive behavior therapies (CBT) have demonstrated efficacy in individual, group, guided self-help, and pure self-help versions, yet have limitations that include the need to attend in-person sessions consistently and the limited availability of trained therapists.

Since mobile technologies are increasingly available and popular among patients and clinicians, the researchers wondered if a digital treatment platform might offer a preferred and more accessible option that could serve as a cost-effective alternative to specialized treatments. The researchers focused on the Noom Monitor, a smartphone app developed to facilitate CBT with guided self-help (CBT-GSH).

"Through a previous pilot study of the Noom Monitor by our team, we know the platform is acceptable to patients, feasible to deliver, and when combined with CBT-GSH with a trained clinician, improves symptoms," said Thomas D. Hildebrandt, PsyD, Chief of the Center of Excellence in Eating and Weight Disorders at The Mount Sinai Hospital and lead author of the study. "The purpose of this study was to evaluate the robustness of the intervention when delivered by non-specialist health coaches in a community health care system via telemedicine. We were encouraged by the results that showed that this intervention is effective and can be scaled outside of specialty clinical programs."

Specifically, this randomized, controlled telemedicine trial compared 52-week outcomes of CBT-GSH plus the Noom Monitor versus standard of care, which included traditional psychiatric or medical care, in 225 members of an integrated health care system in the Pacific Northwest who had been diagnosed with binge eating disorder or bulimia nervosa. CBT-GSH treatment involved coaching sessions with a routine health coach and use of both a CBT-GSH self-help book and the Noom Monitor, which uses a customized self-monitoring system that tracks exercise, meals/snacks, compensatory behavior, body scrutinizing, craving, and weight. The research team found that patients receiving CBT-GSH plus Noom reported significantly more reductions in objective binge days (about 3 less days per month)and achieved higher rates of remission (56.7 percent vs. 30 percent) than the control group exposed to standard care (no specific eating disorder treatment). Similar patterns emerged for compensatory behaviors (vomiting, laxatives, excessive exercise), eating disorder symptoms (shape/weight/eating concerns, restraint), and clinical impairment.

For this study, all CBT-GSH coaching sessions were conducted via telephone and involved six sequential steps establishing self-monitoring, regular eating (three meals/two snacks), alternative activities to binge eating/purging, problem-solving, reduction in dietary restraint, importance of shape/weight, and relapse prevention. The first session lasted 60 minutes, and each subsequent session was 20-25 minutes. The first four sessions occurred weekly, while the following four sessions were biweekly. All coaches completed an eight-hour training led by Dr. Hildebrandt and another eating disorders specialist. Although coaches ended their intervention at 12 weeks, participants had access to the self-help manual and Noom Monitor beyond the coaching period and were encouraged to continue using the program until they achieved remission.

"In addition to providing an improvement in primary eating disorders symptoms, related depression, and impairment in functioning, the group treated with CBT-GSH plus the Noom Monitor had an increased remission rate beyond the intervention, suggesting that the effects of the intervention continued to facilitate changes within the follow-up period that were not observed among those who received standard care," said Dr. Hildebrandt. "Scaling and implementing empirically supported interventions have become an important priority across mental health conditions and our study shows that CBT-GSH via telemedicine is effective and scalable as an intervention for binge eating disorders."

Tom Hildebrandt, Andreas Michaeledes, Meghan Mayhew, Rebecca Greif, Robyn Sysko, Tatiana Toro-Ramos, Lynn DeBar.
Randomized Controlled Trial Comparing Health Coach-Delivered Smartphone-Guided Self-Help With Standard Care for Adults With Binge Eating.
American Journal of Psychiatry 2020 177:2, 134-142. doi: 10.1176/appi.ajp.2019.19020184.

Most Popular Now

AI Harnesses Tumor Genetics to Predict T…

In a groundbreaking study published on January 18, 2024, in Cancer Discovery, scientists at University of California San Diego School of Medicine leveraged a machine learning algorithm to tackle one...

Northern Care Alliance Deploys Digital P…

The trust's Oldham laboratory has completed technical go-live, with its Salford site also set to follow. Collectively the laboratories provide a wide range of general and specialist pathology services that...

American College of Radiology Releases J…

The American College of Radiology® (ACR®), working in close collaboration with four other radiology societies from around the world, have issued a joint statement on the development and use of...

Autonomous Synthesis Robot Uses AI to Sp…

Chemists of the University of Amsterdam (UvA) have developed an autonomous chemical synthesis robot with an integrated AI-driven machine learning unit. Dubbed 'RoboChem', the benchtop device can outperform a human...

AI in Personalized Cancer Medicine: New …

The application of AI in precision oncology has so far been largely confined to the development of new drugs and had only limited impact on the personalisation of therapies. New...

AI can Predict Brain Cancer Patients…

Artificial Intelligence (AI) can predict whether adult patients with brain cancer will survive more than eight months after receiving radiotherapy treatment. The use of the AI to successfully predict patient outcomes...

Paper Calls for Patient-First Regulation…

Ever wonder if the latest and greatest artificial intelligence (AI) tool you read about in the morning paper is going to save your life? A new study published in JAMA...

Max Planck Institute for Informatics and…

The Max Planck Institute for Informatics and Google deepen their strategic research partnership. With additional financial support from the U.S. IT company, the "Saarbrücken Research Center for Visual Computing, Interaction...

JMIR Medical Informatics Invites Submiss…

JMIR Publications has announced a new section titled, "AI Language Models in Health Care" in JMIR Medical Informatics. This leading peer-reviewed journal is indexed in PubMed and has a unique...

DMEA nova Award: Wanted - Visionary Solu…

9 - 11 April 2024, Berlin, Germany. The DMEA nova Award is being presented at DMEA 2024 for the first time. The award honours a digital health startup for an outstanding...

Could ChatGPT Help or Hurt Scientific Re…

Since its introduction to the public in November 2022, ChatGPT, an artificial intelligence system, has substantially grown in use, creating written stories, graphics, art and more with just a short...

Evaluating the Performance of AI-Based L…

A new study evaluates an artificial intelligence (AI)-based algorithm for autocontouring prior to radiotherapy in head and neck cancer. Manual contouring to pinpoint the area of treatment requires significant time...