Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help

Abstract

Student Bodies, an internet-based intervention, has successfully reduced weight/shape concerns and prevented eating disorders in a subset of college-age women at highest risk for an eating disorder. Student Bodies includes an online, guided discussion group; however, the clinical utility of this component is unclear. This study investigated whether the guided discussion group improves program efficacy in reducing weight/shape concerns in women at high risk for an eating disorder. Exploratory analyses examined whether baseline variables predicted who benefitted most. Women with high weight/shape concerns (N=151) were randomized to Student Bodies with a guided discussion group (n=74) or no discussion group (n=77). Regression analyses showed weight/shape concerns were reduced significantly more among guided discussion group than no discussion group participants (p = 0.002; d = 0.52); guided discussion group participants had 67% lower odds of having high-risk weight/shape concerns post-intervention (p = 0.02). There were no differences in binge eating at post-intervention between the two groups, and no moderators emerged as significant. Results suggest the guided discussion group improves the efficacy of Student Bodies in reducing weight/shape concerns in college students at high risk for an eating disorder.

Benefits of Individualized Feedback in Internet-Based Interventions for Depression: A Randomized Controlled Trial

“…These findings are consistent with the results of previous studies that found no difference or small but statistically nonsignificant differences between different levels of guidance, not only in online interventions targeting depression, but also in online interventions for anxiety disorders [65,66], posttraumatic stress disorder [67], eating disorders [68], and alcohol abuse [69]. Given the level of standardization found in the IC arm of this study and in similarly constructed guided IBI, the guidance itself oftentimes consists of individualizing only a minor amount of text and might thus be considered a small “add-on” to already effective treatments.…”

Online prevention of disordered eating in at-risk young-adult women: a two-country pragmatic randomized controlled trial

“…The early and high drop-off rates for SB were inconsistent with previous SB trials. In the most comparable study, Kass et al (2014) reported that approximately half the participants in an unmoderated group completed at least half the SB program, much higher usage than observed in the current trial. The Kass et al trial included journal log prompts and guided discussions, both of which may reinforce participation.…”

“…Although no main effects were shown for prevention of ED onset, prevention effects were found for two subsets of users at two-year follow-up: those who were overweight at baseline (i.e., SB= 0% vs controls= 10.8%); and, at one site, amongst those engaging in compensatory behaviours at baseline (i.e., SB= 14.4% vs controls=30%). A comparison of guided vs self-help versions of SB (conducted concurrently to the current trial) found the guided group had significantly lower weight concerns and lower odds of remaining at high risk of an ED than the non-guided group at post-intervention (M age=20.1 years: Kass et al , 2014). While a recent RCT for those at ‘very high risk’ of an eating disorder (Taylor et al , 2016) found amongst participants with high shape and weight concerns, ED onset was significantly lower in the SB group compared to controls ( SB=2 0% vs controls= 42%).…”

“…SB has been evaluated in eleven RCTs, seven in the USA (Bruning Brown et al , 2004, Celio et al , 2000, Kass et al , 2014, Low et al , 2006, Taylor et al , 2006, Taylor et al , 2016, Winzelberg et al , 2000, Winzelberg et al , 1998) and four in Germany (Jacobi et al , 2005, 2007, Jacobi et al , 2012). These samples have included young-adult or late adolescent females from college and high-school settings.…”

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

“…Individuals are screened with a brief online assessment, and responses are used to classify individuals as low-risk for, high-risk for, or with a clinical or subthreshold ED. Users receive individualized feedback about their risk/clinical profile, and screen results inform the specific interventions that users are offered: (a) an online universal or targeted preventive intervention (i.e., Staying Fit™ or StudentBodies™, respectively)(Jones, Taylor Lynch, et al, 2014; Kass et al, 2014; Taylor et al, 2006, 2012); (b) an online cognitive-behavioral guided self-help treatment program (i.e., StudentBodies-Eating Disorders™); or (c) referral to in-person treatment services. The online platform is anonymous, accommodating to students’ schedules via access at any time by computer or Smartphone, and can easily incorporate new modules for subpopulations of users.…”