For the approximately 8 million Americans who suffer from binge eating disorder, help could be just a download away.
Psychologists in Drexel’s Laboratory for Innovations in Health-Related Behavior Change are developing a new smartphone application that aims to tackle binge eating, and they are seeking study volunteers to test it out.
The app, called iCAT+, is for patients who suffer from binge eating disorder or bulimia nervosa. It uses an approach called Integrative Cognitive-Affective Therapy (ICAT) to identify users’ binge “triggers” and teaches coping skills to change unhealthy eating behaviors. ICAT is a type of individual psychotherapy that focuses on helping people change their behaviors, feelings and thoughts about themselves.
Binge eating disorder — only recently identified as an official diagnosis — is the most common eating disorder in the United States. During a binge episode, a person will eat large amounts of food in a short period of time. A binge is characterized by a sense of loss of control and can be accompanied by feelings of guilt or self-loathing.
In 2013, Shire Pharmaceuticals sponsored an initiative that engaged Drexel psychology researchers to develop a self-guided mobile app for binge eating disorder, based on a psychotherapy known as Cognitive behavioral therapy (CBT). Since then, the CBT content was licensed by Daylan Digital, LLC, and incorporated into their mobile health platform. The app, called iTakeControl Binge, is now available for download.
Based on the development of that app, the Drexel researchers are now finding out how technology and in-person treatment can be used together. iCAT+ may be useful, for instance, for tech-savvy patients who like the idea of treatment that travels with them, but also don’t want to give up face-to-face time with a therapist.
“When a person is experiencing an urge to binge or other distressing emotional experience, it’s often difficult to remember and utilize the skills they’ve learned in therapy,” said Adrienne Juarascio, PhD, an assistant research professor in the College of Arts and Sciences, who is leading the study. “We wanted to find out how we can help patients, in the moment, know when and how to use those skills.”
In the iCAT+ study, users answer questions about their eating behaviors, current mood states and daily activities — such as whether or not they ate a regular meal that afternoon. The iPhone tracks and stores that data to be able to predict, over time, when a user is likely to have a binge episode. The app then will send the user a warning and coping strategy if it predicts that he or she is going to binge.
Meanwhile, the data is also made available to the user’s psychologist at Drexel, who will provide 20 in-person therapy sessions to the volunteer throughout the study. The therapist can use that data to provide the patient more tailored strategies for his or her individualized risk factors that are contributing to binge eating episodes.
“Our patients don’t always know what their triggers are. But over time, the app will start to identify factors that serve as risk factors for a binge episode and this data can then be used to personalize treatment,” Juarascio said.
Going one step further, another study Juarascio is leading will see whether a patient’s physiological signs — like heart rate and skin moisture — could detect rising urges to engage in binge eating behavior even better than self-reporting data.
Researchers know that self-reporting can not only be time-consuming for a patient, but also sometimes unreliable. In Juarascio’s EMOTE study, participants will wear a wristband sensor (similar to a Fitbit) and fill out several surveys daily related to emotions and emotional eating.
Juarascio and her team will then look at the data to determine if signals, such as an increased heart rate, could indicate when a user is experiencing rising negative emotions or urges to eat in response to emotions.
“We think the sensor may be able to predict your emotions without you telling us directly,” she said.
In the future, the researchers think they can use this data to design a new kind of app — one that is synched up to a wearable device that can send a warning when a user is going to engage in unhealthy eating behavior.
The Laboratory for Innovations in Health-Related Behavior Change is currently recruiting participants for these new research studies.
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