Primary prevention of eating-related problems in the real world

Abstract

Aim: As known from meta-analyses, prevention programs for eating disorders yield significant effects under ideal conditions. However, it is still unclear how these programs can be more widely disseminated. Since 2004 in Thuringia, Germany, several programs for preadolescent girls and boys (aged 10 to 15 years) covering a wide geographical range have been developed in order to prevent eating-related problems. Subjects and Methods: Over 3,500 pupils and more than 100 schools participated in the internal evaluation following the three-step standard of the Society of Prevention Research (SPR). To examine the program efficacy (step 1) and effectiveness (step 2), we conducted pre-post design studies with control groups. In order to describe the implementation process and the program dissemination (step 3), the Health Promoting School Approach (HEPS) was applied. Results: Girls (6th grade) showed significant improvements in eating attitudes and self esteem about their bodies, whereas boys only improved their knowledge about eating and physical activity. The evaluations of the programs for 7th and 8th graders are still pending. On the HEPS checklist, our health promotion concept fulfilled 64 points out of a maximum of 74, which indicates a high intervention quality. Conclusion: Broad dissemination of prevention programs requires methodological compromises and organizational flexibility. Quality assurance should be considered to be as important as the optimal level of evidence, which depends on the needs of all stakeholders and could not be derived from the standards for clinical studies. Furthermore, health promotion needs political support that is independent of legislative periods and the turnover of institutional staff

Parents and prevention: A systematic review of interventions involving parents that aim to prevent body dissatisfaction or eating disorders

“…Table shows the CASP matrix scoring for all 20 studies included in the review. Eight studies scored zero on CASP item 4, indicating that they provided no data on the effects of involving parents in prevention programs . Many of these studies included large randomized controlled trials conducted in the school setting.…”

“…Eight studies scored zero on CASP item 4, indicating that they provided no data on the effects of involving parents in prevention programs. [34][35][36][37][38][39][40][41] Many of these studies included large randomized controlled trials conducted in the school setting. Although most of these studies provided quality data on how specific prevention programs could be effective in reducing eating disorder or body dissatisfaction risk in children or adolescents, they did not provide useful data about how the inclusion of parents can help…”

Dissonance‐based prevention of eating disorder risk factors in middle school girls: Results from two pilot trials

“…7 Others report initial significant effects on multiple eating disorder risk factors but found that effects were not sustained at follow-up. 8 A few programs offered to young adolescents have demonstrated intervention effects on multiple eating disorder risk factors with some changes being sustained up to 1-year postintervention. [9][10][11][12] Halliwell and Diedrichs 13 found that a brief (four 20-minute sessions) dissonance-based eating disorder prevention program for 12-13-yearold girls produced significantly greater prepost reductions in thin-ideal internalization (d 5 .49) and body dissatisfaction (d 5 .40) but not dieting, relative to waitlist controls.…”

“…Some programs have not significantly reduced risk factors or produced significant effects for only one eating disorder risk factor . Others report initial significant effects on multiple eating disorder risk factors but found that effects were not sustained at follow‐up . A few programs offered to young adolescents have demonstrated intervention effects on multiple eating disorder risk factors with some changes being sustained up to 1‐year postintervention .…”

Knowledge and Behaviour of Young People Concerning Fertility Risks - Results of a Questionnaire

“…Not only underweight but also overweight due to disturbances of the hormone household and ovarian dysfunction have decisive effects on fertility: women with a BMI > 25 or < 19 kg/m 2 have a higher risk that a pregnancy occurs after more than 12 months than a woman of normal weight [7]. The prevention of eating disorders already at school age is thus of major importance [8]. Smoking has both negative effects on the fertility of men with regard to the production, mobility and morphology of sperm, accompanied by an increased number of DNA damages to germ cells [9] and also in women it leads to disturbances in the maturation of egg cells and disorders of the hormone system during the luteal phase.…”