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.