From Mind to Mouth, Drexel’s WELL Center Seeks to Improve Eating Behaviors

A new research center opening in July at Drexel University is seeking to untangle Americans’ complicated, and often problematic, relationship with food.

Drexel’s Center for Weight, Eating and Lifestyle Science — the WELL Center — will develop, test and share new behavioral and technological solutions for treating obesity and eating disorders.

The center, which is an expansion of Drexel’s Laboratory for Innovations in Health-Related Behavior Change, is opening at a critical time, says WELL Center Director Evan Forman, PhD, a professor of psychology in the College of Arts and Sciences. Seventy percent of the country is now overweight or obese and half of the population achieves so little physical activity that they are considered sedentary. Moreover, eating disorders, like anorexia nervosa and bulimia nervosa, have serious — even deadly — health consequences. Existing treatments fail to help many patients.

From designing apps that train users to resist urges, to advancing new therapies for patients with bulimia, Forman and his colleagues are seeking unique, evidence-based methods that will create lasting lifestyle changes. Adrienne Juarascio, PhD, an assistant professor in the College of Arts and Sciences, will serve as director of training at the center and Meghan Butryn, PhD, an associate professor in the College of Arts and Sciences, will be director of research.

“We’ll have the opportunity to bring together scientists from multiple disciplines, including psychology, nutrition, neuroscience, computer science and biology,” Forman said. “Developments in technology and behavior-change science make this an exciting time to work on these critical public health issues.”

Forman said he expects the number of faculty will triple and overall center personnel will reach around 70 team members within the next five years. The center will also train the next generation of clinicians and researchers by providing mentorship at the undergraduate, graduate and post-doctoral level. 

In addition to conducting research and training emerging scientists, the WELL Center will include a clinical arm. The WELL Clinic, set to open in 2018, will provide evidence-based treatments for weight loss, binge eating, bulimia and other eating disorders. Clinicians will also provide nutritional counseling and evaluations for those who are considering bariatric surgery.

A main research focus of the WELL Center is to develop technologies, such as smartphone apps, that can help individuals change their eating and physical activity habits. While hundreds of diet and exercise apps are available to choose from, most do not offer long-term solutions for users. Almost all are devoted to either telling people what to do (“eat this, not that”) or tracking (calories, exercise minutes), according to Forman.

“Giving people tracking and prescriptions is helpful, but not at all sufficient to help them make substantive, lasting changes,” he said.

In contrast, Forman and his colleagues are designing apps that are able to “learn,” over time, the moments and situations when people struggle to follow healthy eating habits and send out warnings and tips to help him or her stick to their diet plan. Another technology Forman is developing — called DietDash — is a cognitive training computer program, which helps people “develop basic neurocognitive capacities” to resist food temptations. Instead of relying on users’ conscious decision making, which does not tend to work well for health behaviors, the game actually trains the brain to lose weight.

The psychologists have also developed a new form of weight control intervention called acceptance-based behavioral treatment (ABT). 

“Acceptance-based interventions recognize that it is often not possible to alter urges, cravings and emotions that drive eating, and instead, teach psychological strategies for responding differently to these phenomena,” Forman said.   

In a 2016 study, Forman and his colleagues found that ABT patients had lost a little over 13 percent of their starting weight after one year, compared to just under 10 percent for people in the group with standard weight-loss treatment. The ABT group also fared considerably better when they were weighed in one year later. Juarascio is currently evaluating a similar treatment for individuals with bulimia nervosa and has previously conducted clinical trials demonstrating the efficacy of this approach for binge eating disorder.

Butryn is leading several other research efforts in the area of lifestyle modification. In one new study, lifestyle coaches make visits to participants’ homes, as well as use video chat for “virtual” in-home sessions, in order to help facilitate changes to the types and amounts of foods available in the home. Another study focuses on participants’ remotely sharing data from their self-monitoring devices (like wireless scales, physical activity sensors and digital food records) as a way of increasing the supportive accountability they receive from their coaches.

“When traditional treatment sessions end, participants often tell us that they miss the accountability provided by regularly checking in with their coaches. This is a way to provide that accountability long-term in a sustainable way,” Butryn said.

Forman is hoping the WELL Center will help his team to develop more innovative solutions to the vexing problems of obesity, inactivity and eating disorders.