Feasibility of a virtually delivered eating disorder prevention program for young females with type 1 diabetes

Abstract

Objective This study aimed to develop a virtual diabetes‐specific version of the eating disorder (ED) prevention program the Body Project, and to assess feasibility and preliminary efficacy of this program for young females with type 1 diabetes. Method Young females with type 1 diabetes aged 16–35 years were invited to participate in the study. A total of 35 participants were allocated to five Diabetes Body Project groups (six meetings over 6 weeks) and completed pretest assessments; 26 participants completed all sessions and posttest assessments (<7 days after last meeting). Primary measures included ED risk factors and symptoms, and secondary outcomes included diabetes‐specific constructs previously found to be associated with ED psychopathology (e.g., diabetes distress and illness perceptions). Results The ease of recruitment, timely conduct of five groups, moderate drop‐out rate and appreciation of the intervention by participants indicated that the Diabetes Body Project is feasible. Meaningful reductions occurred on the primary outcomes (i.e., ED psychopathology, body dissatisfaction, and thin ideal internalization) and on internalization of appearance ideals and appearance pressures at posttest (Cohen's d ranging from .63 to .83, which are medium to large effects). Small to medium effect sizes were found for diabetes illness perceptions and distress (.41 and .48, respectively). Discussion The virtual Diabetes Body Project is a promising and much‐needed intervention, worthy of more rigorous evaluation. A randomized controlled trial is warranted to determine its effectiveness compared with a control condition.

Effectiveness of the Body Project eating disorder prevention program for different racial and ethnic groups and an evaluation of the potential benefits of ethnic matching.

“…Fourth, future research should continue to test whether the Body Project produces similar effects in other countries outside the United States. To date, it has shown effectiveness in England (Halliwell & Diedrichs, 2014), Iceland (Danielsdottir et al, 2012), Norway (Wisting et al, in press), Mexico (Unikel-Santoncini et al, 2019), Brazil (Amaral et al, 2019), Sweden (Ghaderi et al, 2020), China (Luo et al, 2020), Japan (Ueda et al, 2021), and Saudi Arabia (AlShebali et al, 2021). An important direction for future research would be to evaluate the effectiveness of the Body Project in more countries and cultures.…”

“I am not alone”. The experiences of young females with type 1 diabetes participating in eating disorders prevention groups. A qualitative feasibility study

“…The format and the content of the groups are designed to maximize cognitive dissonance. The script was adapted to include issues speci cally related to type T1D by adding two diabetes speci c sessions following the original four sessions, delivered in the same interactive format.. Speci c details of the content of the six-hour Diabetes Body Project is described in the initial report (Wisting et al, 2021).Two user representatives with T1D contributed to the development of the diabetes-speci c content. Examples of T1D speci c content include group discussions concerning costs of not managing the illness appropriately as well as costs of misusing insulin for weight management.…”

“…These participants did not differ signi cantly from participants completing all sessions in terms of baseline demographic and clinical characteristics. For a more detailed description of recruitment and sample procedures, see Wisting et al, (2021). All participants who completed the Diabetes Body Project group intervention were invited to participate in focus group interviews after program completion.…”

Internet‐delivered eating disorders prevention program for adolescent girls with type 1 diabetes: Acceptable and feasible

“…Additional elements, such as assertive communication training, identification of type 1 diabetes “allies,” and social support, were included to help to normalize teen experiences and equip them with skills to navigate stressful situations, such as judgmental and misinformed comments from others 11 . Wisting and colleagues 25 recently conducted an uncontrolled pilot trial of a different program— Diabetes Body Project —which they adapted (in consultation with two individuals with type 1 diabetes) for young women with type 1 diabetes aged 16–35, showing acceptability, feasibility, and positive preliminary effects in a Norwegian sample. While these results provide broader support for cognitive‐dissonance ED prevention programs for women with type 1 diabetes, Body Project (T1D Style) was systematically adapted for an adolescent population, included greater integration of Body Project and diabetes‐specific material, and involved caregivers, which was deemed critical during intervention development 11 and has historically been absent in ED prevention programs 26 …”