A Mobile-Based Intervention to Address Heavy Drinking and Binge Eating in College Students - Project Summary/Abstract
More than 52 million American adults report binge drinking in the past month. Binge drinking is intricately
linked to, and exponentially increases the risk for, the development of an alcohol use disorder - a pernicious
illness linked to severe medical and psychiatric morbidity, elevated mortality, and a resistance to conventional
treatments. In tandem, up to 43 million Americans engage in episodes of binge eating, characterized by the
consumption of a large amount of food coupled with a loss of control. Binge eating is inherently linked to the
development of binge eating disorder, the most prevalent eating disorder phenotype, and obesity, which is
among the leading causes of global preventable death. Crucially, binge drinking and binge eating frequently
co-occur, with robust data illustrating a bidirectional antagonistic effect of one binge type behavior upon the
severity and frequency of the other, indicative of shared underlying mechanisms. Although the shared
mechanisms underpinning both binge drinking and binge eating have been well-explicated, few treatments to
date have been developed to target these transdiagnostic maintaining factors. Addressing these mechanisms
early through the use of accessible prevention approaches has important public health implications for
preventing the development of harmful and difficult-to-treat disorders. Importantly, the risk for both binge
drinking and binge eating are substantially elevated in young adults, and particularly among college students,
where paradoxically, rates of treatment seeking for these problematic behaviors are reliably low. Since both
alcohol use disorder and binge eating disorder most typically onset in late adolescence, precision methods to
target these symptomatic behaviors prior to their conversion to full threshold disorders, in the populations most
at-risk, is of critical importance. Moreover, and owing to the reliably low rates of treatment seeking in college
students, the development of precision approaches that are personalized and accessible on a large scale are
especially warranted. In this study, we propose to leverage our group’s experience in developing mobile
phone-based behavioral health interventions, to develop a mobile intervention to dually reduce co-occurring
binge drinking and binge eating by targeting their shared underlying mechanisms. This two-phase study will
first seek to develop and conduct a systematic beta test of the intervention, comprised of components of
evidence-based treatments vetted with experts, in 20 male and female college students who engage in binge
drinking and eating. Subsequently, we will pilot test the refined intervention in a randomized controlled trial of
300 college students who engage in both behaviors, and who will receive the intervention (N=150) or standard
receipt of resources (control; N=150), to ascertain intervention efficacy in reducing binge frequency and related
problems. Results will provide the first known data relating to a scalable and transdiagnostic approach to
reducing binge drinking and eating frequency in a population at heightened risk and limited treatment-seeking.