Bulimia nervosa and binge eating disorder are marked by significant levels of impairment and psychiatric comorbidity, affecting approximately 5-7% of the US population. Guided self-help cognitive behavioral (CBT-GSH) therapy has been show to be an effective treatment to reduce binge eating for patient with both disorders. However, there is limited uptake among both clients and therapists. One significant factor is self-monitoring, the central component of cognitive- behavioral therapy, which is both time-intensive and cumbersome in its traditional paper format for clients, as well as difficult to comprehensively address in a time-limited session for the therapist. This grant proposes to utilize emerging mobile application technology, as a tool for increasing the potency, accessibility, and efficacy of guided self-help. This will be accomplished by adapting WorkSmart Lab's current commercial mobile product for healthy eating and exercise, Noom Monitor, into a self-monitoring application integrating CBT-GSH tools for binge eaters. Additionally, the application will be used to facilitate real-time feedback to therapists about their patient progres. Therapists will be notified in real-time about any drastic changes in client eating patterns through pre-set alerts designed to assign a grade to therapists, representing each client's well-being. The feasibility and efficacy of the adapted Noom Monitor application will be examined through a randomized control trial comparing CBT-GSH + APP with CBT-GSH conducted at the Mount Sinai School of Medicine's Eating and Weight Disorders Program. The innovative utilization of technology to assist in mental health interventions has widespread implications outside of this proposal, which will be used to strategize the further development and commercialization of this product.

Public Health Relevance

Guided self-help cognitive behavioral therapy (CBT-GSH) has been shown to be a cost-effective and efficacious treatment for BN and BED, but has limited uptake among both clients and therapists, partly due to the time-intensive and cumbersome nature of the primary CBT-GSH intervention, self-monitoring. This grant proposes to utilize a mobile application, Noom Monitor, to reduce the burden of self-monitoring and provide real-time feedback to therapists, to enhance both therapist and client uptake of CBT-GSH. The findings from this grant has widespread implications for public health, as the use of mobile applications to strengthen treatment adherence and augment existing interventions has enormous potential for use within both mental and medical health care service delivery models.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Small Business Technology Transfer (STTR) Grants - Phase I (R41)
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Special Emphasis Panel (ZRG1-BBBP-V (10))
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Haim, Adam
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Noom, Inc.
New York
United States
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Hildebrandt, Tom; Michaelides, Andreas; Mackinnon, Dianna et al. (2017) Randomized controlled trial comparing smartphone assisted versus traditional guided self-help for adults with binge eating. Int J Eat Disord 50:1313-1322
Grotzinger, Andrew; Hildebrandt, Tom; Yu, Jessica (2015) The benefits of using semi-continuous and continuous models to analyze binge eating data: A Monte Carlo investigation. Int J Eat Disord 48:746-58