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. 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." 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
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. Related Stories
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