As reported this week in The American Journal of Psychiatry, cognitive behavioral therapy (CBT) delivered through an mHealth app with telehealth capabilities showed success in helping people with a variety of eating disorders for at least a year. The results show promise for the estimated 6.5 million Americans living with issues that range from binge eating disorder to bulimia nervosa.
“We know the platform is acceptable to patients, feasible to deliver, and when combined with CBT-GSH (guided self-help) with a trained clinician, improves symptoms,” 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, said in a press release. “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.”
The year-long study, focusing on 225 patients of the Kaiser Permanente health system in the Pacific Northwest, found that the connected health platform reduced so-called objective binge days by three per month, while boosting the remission rate to 56.7 percent, compared to 30 percent in a control group treated with standard care protocols.
In addition, those using telehealth saw a reduction in compensatory behaviors, eating disorder symptoms and clinical impairment.
The telehealth platform offers hope for improving treatment in an area with a limited amount of specialists, leading to access problems for people living in remote areas of the country. By using the mHealth app, developed by Noom, patients can connect with care providers from anywhere and at any time.
For the study, participants first connected with care providers by phone, going through a progression of steps to establish self-monitoring, regular eating, alternative activities, problem solving, reduction is dietary restraint, importance of shape and weight and relapse prevention. The telehealth-based coaching process ended at 12 weeks, after which the patients continued to monitor their activities through the mHealth app.
The study analyzed outcomes at four, eight, 12, 26 and 52 weeks.
“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,” Hildebrandt said. “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.”