A 1-yr intervention program can prevent new cases of ED and symptoms associated with ED in adolescent female elite athletes.

The present study reports on the prevalence of adolescent anorexia nervosa, bulimia nervosa and binge eating disorders. Also, the hypothesis by Slade (1982) suggesting perfectionism' and`general dissatisfaction' as setting conditions for eating disorders was tested. A total of 678 15-year-old adolescents were screened, and those who scored above 10 on the`drive for thinness' subscale on the Eating Disorder Inventory (EDI) were interviewed for suspected eating disorders. A gender-and age-matched control group of low scores were also clinically interviewed. The interviewers were blind to whether individuals were suspected of having eating disorders or not. The Setting Conditions for Anorexia Nervosa Scale (SCANS) was used to test the setting condition hypothesis. Other variables included were the EDI subscales`Bulimia' and Body dissatisfaction'. Weight was calculated using the Body Mass Index. For the total material, we found 1.0 per cent with a binge eating disorder, 0.7 per cent with bulimia nervosa, 0.3 per cent with a bulimic subtype of anorexia nervosa and 0.7 per cent with subclinical bulimia nervosa. All subjects were girls. In addition, 3.5 per cent were considered`at risk', of whom we identi®ed 22 girls (3.2 per cent) and two boys (0.3 per cent). High scores on`perfectionism' were unrelated to the presence of eating disorders. Controlling for`body dissatisfaction',`general dissatisfaction', on the other hand, was related to eating disorders and an`at-risk' condition. The prevalence ®gures in this age cohort equal those for older age groups. The weak support to the setting condition hypothesis may point to an inadequate instrument and not necessarily to a theoretically blind alley.

A number of studies have shown that dieting and body dissatisfaction are highly frequent among adolescents. We here describe the relationship between dieting and body dissatisfaction in 4,952 children selected from the 11, 13 and 15 year age cohorts of the Norwegian national sample in the multinational WHO survey "Health Behavior in School Children". Body dissatisfaction was defined as the subjective experience of being a bit or much too fat and, using this definition, about 20% of the boys reported body dissatisfaction and 7% that they were on a diet. About 37% of the girls reported body dissatisfaction and 15% that they were on a diet. Within the age cohorts, respectively 22%, 30% and 32% reported body dissatisfaction, whereas about 40% overall indicated no body dissatisfaction. Being on a diet was reported by 8% of the 11-year olds, and subsequently increased to 10% (13 years) and 14% (15 years). Multiple regression analysis showed that body dissatisfaction explained 33% of the variance in dieting behaviour, and that the overall effect of gender and age was small. Dieting and body dissatisfaction should therefore be recognised as being equally important among boys, and be counteracted within the framework of a health promotion strategy aimed at the general adolescent population.

The present paper reviews current thinking and recent studies on the effect of schoolbased primary prevention programmes with respect to content, strategies and general principles. It is argued that a health promotion model should replace the disease prevention model. Suggestions as to future prevention work within this perspective are put forward.

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