Digital Mindfulness Meditation-enhanced Cognitive Behavioral Therapy (CBT-MM) for Binge Eating Disorder

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PROJECT SUMMARY/ABSTRACT Binge eating disorder (BED) is a prevalent disorder, affecting 3.5% of Americans. BED is maintained by two- pathways: (1) dietary over-restriction and (2) emotion dysregulation. Current treatments for BED, such as Cognitive Behavioral Therapy (CBT) produce suboptimal results because they only target over-restriction. Mindfulness meditation (MM) targets emotion dysregulation and could thus be an important addition to CBT for Eating Disorders. Furthermore, digital delivery of an MMT for BED would offer unprecedented scalability, but there are no current digital MMTs for BED. The current K23 proposal involves developing a digital Mindfulness Meditation-enhanced Cognitive Behavioral Therapy (CBT-MM) for BED via two phases. CBT-MM will target the two different mechanisms of BED (dietary over-restriction and emotion dysregulation). In Phase 1, I will finalize the development of digital CBT-MM via interview-based user testing. In Phase 2, I will conduct a pilot feasibility randomized controlled trial (RCT). For the RCT, 40 individuals with BED recruited nationally will be randomized to digital: 1) CBT-MM (n = 20); or 2) an already developed digital CBT treatment (iTakeControl) only (n = 20). The RCT will be conducted virtually, with video-based assessments at baseline, mid- and post-treatment, and 3-month follow up. Aim 1 is to develop digital CBT-MM. Aim 2 is to evaluate feasibility and acceptability. Aim 3 is to measure within-group changes from pre-to post treatment on binge eating remission, binge eating frequency, weight, quality of life, depressive symptoms, emotion dysregulation, dietary over-restriction, and trait mindfulness. This project has the potential for developing an innovative, theory-driven, efficacious, and scalable mindfulness-based treatment for BED that can have a large public health impact. To carry out this K23, I will receive mentorship from a leading team of experts in the areas of mindfulness, CBT for eating disorders, technology-based treatment development, and qualitative methods. This K23 will specifically facilitate my training in: (1) developing and refining mindfulness-based eating and weight disorder treatments; (2) technology-based treatment development, (3) formalized training in conducting clinical trials, and (4) qualitative methods for intervention development. This award will serve as a launching point for my career as I leverage the training and research skills afforded by this award to become a leader in the field of digital mindfulness-based treatment development for eating and weight disorders.