Preventing Eating Disorder Pathology: Common and Unique Features of Successful Eating Disorders Prevention Programs

Abstract

Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors’ descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research.

StudentBodies-eating disorders: A randomized controlled trial of a coached online intervention for subclinical eating disorders

“…A large proportion of ED prevention research, either in person or Internet-delivered, has focused on targeted prevention, in which individuals exhibiting eating disorder risk factors are assigned to an intervention (Ciao et al, 2014). A smaller number of studies has examined indicated prevention programs, which aim to reduce symptoms and cease symptom progression among individuals who already present with ED symptoms but do not meet full criteria for diagnosis (Ciao et al, 2014).…”

Long-term effectiveness of a school-based primary prevention program for anorexia nervosa: A 7-to 8-year follow-up

“…Those were mainly carried out in schools and addressed the first and second stages according to the stage model (Ciao, Loth, & Neumark-Sztainer, 2014;Stice, Shaw, & Marti, 2007;Treasure et al, 2015;Yager, Diedrichs, Ricciardelli, & Halliwell, 2013). According to Levine and Smolak (2006), schools are highly appropriate settings for the delivery of prevention programs.…”

“…They have potential for sustained interactions with young students in different developmental stages. In systematic and meta-analytic reviews, important features of prevention programs were identified, leading to successful program outcomes (Ciao et al, 2014;Stice & Shaw, 2004;Stice et al, 2007;Yager et al, 2013). Successful programs were theory-driven, interactive, delivered in multiple group sessions by professionals, and targeted at least one eating disorder risk factor.…”

“…Recent reviews provided information about the low-to-moderate impact of prevention programs on risk factors and disordered eating (Ciao et al, 2014;Stice, Becker, et al, 2013;Stice et al, 2007;Yager et al, 2013). In addition, intervention effects of universal prevention programs in elementary or primary schools are even lower (Holt & Ricciardelli, 2008).…”

Epidemiology of eating disorders part III: social epidemiology and case definitions revisited

“…Thus, findings from prevention trials may be flawed with false positive findings. In the literature, over 60 programmes have been identified, most of them with no or just short-lived effects (Ciao, Loth & Neumark-Sztainer, 2014). Hence, the issue has pertinently been raised (Becker et al, 2014) about the feasibility of spending societal money as well as time and energy on disseminating ineffective programmes.…”