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Randomized controlled trial comparing smartphone assisted versus traditional guided self‐help for adults with binge eating
Author(s) -
Hildebrandt Tom,
Michaelides Andreas,
Mackin Dianna,
Greif Rebecca,
DeBar Lynn,
Sysko Robyn
Publication year - 2017
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22781
Subject(s) - bulimia nervosa , binge eating , randomized controlled trial , binge eating disorder , cognitive behavioral therapy , eating disorders , medicine , psychiatry , psychology , clinical psychology
Objective Guided self‐help treatments based on cognitive‐behavior therapy (CBT‐GSH) are efficacious for binge eating. With limited availability of CBT‐GSH in the community, mobile technology offers a means to increase use of these interventions. The purpose of this study was to test the initial efficacy of Noom Monitor, a smartphone application designed to facilitate CBT‐GSH (CBT‐GSH + Noom), on study retention, adherence, and eating disorder symptoms compared to traditional CBT‐GSH. Method Sixty‐six men and women with DSM‐ 5 binge‐eating disorder (BED) or bulimia nervosa (BN) were randomized to receive eight sessions of CBT‐GSH + Noom ( n = 33) or CBT‐GSH ( n = 33) over 12 weeks. Primary symptom outcomes were eating disorder examination objective bulimic episodes (OBEs), subjective bulimic episodes (SBEs), and compensatory behaviors. Assessments were collected at 0, 4, 8, 12, 24, and 36 weeks. Behavioral outcomes were modeled using zero‐inflated negative‐binomial latent growth curve models with intent‐to‐treat. Results There was a significant effect of treatment on change in OBEs (β = −0.84, 95% CI = −1.49, −0.19) favoring CBT‐GSH + Noom. Remission rates were not statistically different between treatments for OBEs (β logit = −0.73, 95% CI = −1.86, 3.27; CBT‐GSH‐Noom = 17/27, 63.0% vs. CBT‐GSH 11/27, 40.7%, NNT = 4.5), but CBT‐GSH‐Noom participants reported greater meal and snack adherence and regular meal adherence mediated treatment effects on OBEs. The treatments did not differ at the 6‐month follow‐up. Discussion Smartphone applications for the treatment binge eating appear to have advantages for adherence, a critical component of treatment dissemination.