Patients with binge eating disorder reported significant reductions in symptoms and impairment after receiving cognitive behavioral therapy-guided self-help treatment delivered over the phone by a health coach and assisted by the smartphone app Noom Monitor. Researchers published their findings online in The American Journal of Psychiatry.
Noom Monitor was developed to facilitate cognitive behavioral therapy with guided self-help (CBT-GSH), researchers explained.
“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 study lead author Thomas B. Hildebrandt, PsyD, chief of the Center of Excellence in Eating and Weight Disorders at The Mount Sinai Hospital, New York, New York.
“The purpose of this study was to evaluate the robustness of the intervention when delivered by nonspecialist health coaches in a community healthcare 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.”
The randomized controlled trial included 225 adults with binge eating disorder or bulimia nervosa, 114 of whom were assigned to the CBT-GSH plus smartphone app group and 111 assigned to standard care.
Participants in the CBT-GSH plus smartphone app group received eight telemedicine sessions administered by a health coach over 12 weeks. Sessions addressed self-monitoring, regular eating (3 meals and 2 snacks a day), alternative activities to binge eating and purging, problem solving, reduction in dietary restraint, importance of shape and weight, and relapse prevention.
Those participants also received a self-help manual and the Noom Monitor app, a customized self-monitoring system that tracks exercise, food intake, compensatory behavior, body scrutinizing, craving, and weight. Meanwhile, the standard care group had access to traditional psychiatric or medical care.
Participants were followed for 52 weeks.
Participants in the CBT-GSH plus smartphone app group reported significant reductions in objective binge eating days (about 3 fewer days per month) and had higher rates of remission (56.7% vs. 30%) compared with the standard-care group, none of whom received any specific eating disorder treatment, according to the study. Similar patterns emerged for compensatory behaviors (vomiting, laxatives, and excessive exercise), eating disorder symptoms (shape, weight, and eating concerns and dietary restraint), and clinical impairment, researchers reported.
“In addition to providing an improvement in primary eating disorder 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,” Dr. Hildebrandt said, “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.”
Hildebrandt T, Michaeledes A, Mayhew M. Randomized controlled trial comparing health coach-delivered smartphone-guided self-help with standard care for adults with binge eating. The American Journal of Psychiatry. 2020 February 1;[Epub ahead of print].