Objective. Multi-level treatment barriers prevent up to 80% of individuals experiencing eating disorders (EDs) from accessing care. This treatment gap creates a critical need to identify interventions that are accessible, easily completable, and optimized for effectiveness by targeting core mechanisms linked to ED onset and maintenance. We propose single-session interventions (SSIs) as a promising path toward catalyzing innovation in the development of accessible, effective ED interventions. SSIs are structured programs that intentionally involve one encounter with a program or provider; they may serve as standalone or adjunctive clinical supports. All SSIs are built to acknowledge that any session might be someone's last-and that any single session can nonetheless yield meaningful clinical benefit. Method.We define SSIs, summarize research supporting their utility for ED symptoms and other mental health problems, and recommend future directions for work in this domain. Results. SSIs may hold promise to reduce some ED symptoms and risk factors, including restrictive eating and negative body image. Steps toward realizing this promise include (1) testing whether existing evidence-based SSIs (e.g., for depression) can also reduce EDs, risk factors, and symptoms; (2) developing novel SSIs that target modifiable ED risk factors and symptoms largely unaddressed by SSIs, such as purging and binge eating;(3) studying diverse implementation pathways; (4) capitalizing on SSIs' transdiagnostic utility to broaden funding opportunities; and (5) educating ED researchers and clinicians about SSIs. Discussion.Understanding the strengths and limits of mechanism-targeted SSIs for ED-related problems could be a low-risk, high-reward avenue towards reducing EDs at scale. Public Health SignificanceStatement: Most individuals experiencing eating disorders (EDs) never access any form of treatment, creating an urgent need to identify ED interventions built to overcome barriers to engaging with care. This Forum article introduces Single-Session Interventions (SSIs) as a promising path to rapidly developing and testing accessible, evidence-based ED supports; supplementing existing ED treatment models; and reducing the individual, familial, and societal burdens of EDs at scale.

Background Anxiety is rising across the United States during the COVID-19 pandemic, and social distancing mandates preclude in-person mental health care. Greater perceived control over anxiety has predicted decreased anxiety pathology, including adaptive responses to uncontrollable stressors. Evidence suggests that no-therapist, single-session interventions can strengthen perceived control over emotions like anxiety; similar programs, if designed for the COVID-19 context, could hold substantial public health value. Objective Our registered report evaluated a no-therapist, single-session, online intervention targeting perceived control over anxiety in the COVID-19 context against a placebo intervention encouraging handwashing. We tested whether the intervention could (1) decrease generalized anxiety and increase perceived control over anxiety and (2) achieve this without decreasing social-distancing intentions. Methods We tested these questions using a between-subjects design in a weighted-probability sample of US adults recruited via a closed online platform (ie, Prolific). All outcomes were indexed via online self-report questionnaires. Results Of 522 randomized individuals, 500 (95.8%) completed the baseline survey and intervention. Intent-to-treat analyses using all randomized participants (N=522) found no support for therapeutic or iatrogenic effects; effects on generalized anxiety were d=–0.06 (95% CI –0.27 to 0.15; P=.48), effects on perceived control were d=0.04 (95% CI –0.08 to 0.16; P=.48), and effects on social-distancing intentions were d=–0.02 (95% CI –0.23 to 0.19; P=.83). Conclusions Strengths of this study included a large, nationally representative sample and adherence to open science practices. Implications for scalable interventions, including the challenge of targeting perceived control over anxiety, are discussed. Trial Registration ClinicalTrials.gov NCT04459455; https://clinicaltrials.gov/show/NCT04459455

Objective: Eating disorders (EDs) and depression are impacting youth at alarming rates, yet most adolescents do not access treatment. Single-session interventions (SSIs) can reach youth in need. This pilot examines the acceptability and short-term utility of an SSI designed to help adolescents adopt a body neutrality mindset. Method: Pre- to post-intervention data was collected, and within-group effect sizes and 95% confidence intervals were computed, to evaluate the immediate effects of the SSI on hopelessness, functionality appreciation, and body dissatisfaction. Patterns of use, demographics, program feedback, and responses from within the SSI were also collected. Results: The SSI and all questionnaires were completed by 75 adolescents (ages 13-17, 74.70% White/Caucasian, 48.00% woman/girl) who reported elevated body image and mood problems. Analyses detected significant pre-post improvements in hopelessness (dav = 0.60, 95% CI 0.35, 0.84; dz = 0.77, 95% CI 0.51, 1.02), functionality appreciation (dav = 0.72, 95% CI 0.46, 0.97; dz = 0.94, 95% CI 0.67, 1.21), and body dissatisfaction (dav = 0.61, 95% CI 0.36, 0.86; dz = 0.76, 95% CI 0.50, 1.02). The SSI was rated as highly acceptable, with a mean overall score of 4.34/5 (SD = 0.54). Qualitative feedback suggested adolescents' endorsement of body neutrality as a personally-relevant, helpful target for intervention. Discussion: This evaluation supports the acceptability and preliminary effectiveness of a body neutrality-focused SSI for adolescents with body image and mood concerns.

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Objective: Depression is a leading cause of disability among adolescents, yet existing treatments are variably effective, suggesting needs to identify novel intervention targets. Body dissatisfaction (BD) may be a promising, but understudied, target: BD is common among adolescents; prospectively associated with future depression; and modifiable through intervention. BD interventions are typically evaluated in terms of impacts on eating disorders, but many trials also measure depression-related secondary outcomes. However, BD intervention effects on depression have not been systematically examined. We, therefore, conducted a meta-analysis to estimate secondary effects of BD interventions on depression symptoms and related outcomes in adolescents (ages 12-19).Method: Our systematic review included randomized controlled trials (RCTs) published between January 2006 and December 2020. Across-group effect sizes were analyzed using robust variance estimation. Preregistered methods, data, and analytic code are available at https://osf.io/734n8/. Results:The meta-analysis included 13 RCTs, 50 effect sizes, and 6,962 participants. BD interventions led to significant postintervention reductions in depression-related outcomes versus control conditions (g = À0.19 at postintervention, 95% confidence interval: À0.07, À0.31, p = .005). No evidence emerged for moderators of this metaanalytic effect. Discussion: Overall, BD-focused interventions significantly reduced adolescent depression, with mean postintervention effect sizes comparable to those observed for interventions targeting depression explicitly. Results are bolstered by preregistered methods and robustness checks. Limitations include a lack of data on participants' sexual and gender identities and a significant risk of bias in the underlying literature. Future research on BD interventions should measure depression symptom severity as a secondary outcome.