Secondary effects of body dissatisfaction interventions on adolescent depressive symptoms: A meta‐analysis

Abstract

Objective: Depression is a leading cause of disability among adolescents, yet existing treatments are variably effective, suggesting needs to identify novel intervention targets. Body dissatisfaction (BD) may be a promising, but understudied, target: BD is common among adolescents; prospectively associated with future depression; and modifiable through intervention. BD interventions are typically evaluated in terms of impacts on eating disorders, but many trials also measure depression-related secondary outcomes. However, BD intervention effects on depression have not been systematically examined. We, therefore, conducted a meta-analysis to estimate secondary effects of BD interventions on depression symptoms and related outcomes in adolescents (ages 12-19).Method: Our systematic review included randomized controlled trials (RCTs) published between January 2006 and December 2020. Across-group effect sizes were analyzed using robust variance estimation. Preregistered methods, data, and analytic code are available at https://osf.io/734n8/. Results:The meta-analysis included 13 RCTs, 50 effect sizes, and 6,962 participants. BD interventions led to significant postintervention reductions in depression-related outcomes versus control conditions (g = À0.19 at postintervention, 95% confidence interval: À0.07, À0.31, p = .005). No evidence emerged for moderators of this metaanalytic effect. Discussion: Overall, BD-focused interventions significantly reduced adolescent depression, with mean postintervention effect sizes comparable to those observed for interventions targeting depression explicitly. Results are bolstered by preregistered methods and robustness checks. Limitations include a lack of data on participants' sexual and gender identities and a significant risk of bias in the underlying literature. Future research on BD interventions should measure depression symptom severity as a secondary outcome.

Project Body Neutrality: Piloting a digital single‐session intervention for adolescent body image and depression

“…In line with calls for more interventions to target shared risk factors (Ahuvia et al, 2022;Puccio et al, 2016;Becker et al, 2014), Project Body Neutrality targets transdiagnostically-relevant risk factors connected to depression and EDs. Its single-session format recognizes the dropout characteristic of longer-term interventions (Fleming et al, 2018;Clough et al, 2022), and capitalizes on the changes that can be accomplished in a short timeframe (Schleider et al, 2020a).…”

“…A systematic review of 26 ED prevention and early intervention trials found that 42% significantly reduced depression symptoms, in addition to eating pathology (Rodgers & Paxton, 2014). Additionally, a meta-analysis of 13 RCTs found that interventions designed to reduce adolescent body dissatisfaction significantly reduced depression symptoms, as well (Ahuvia et al, 2022). These studies suggest that interventions mitigating ED pathology can reduce depression symptoms, even when depression is not intentionally targeted.…”

“…Reductions in both ED and depression symptoms could be improved by designing programs that address their shared risk factors (Ahuvia et al, 2022; Becker et al, 2014; Puccio et al, 2016). Some existing interventions already target shared risk factors.…”

Not Niche: Eating Disorders and the Dangers of Over-specialization

“…34 Overspecialization of EDs also makes it more difficult to identify transdiagnostic mechanisms that account for comorbidity with other disorders, impeding progress on both EDs and other disorders. 15 For instance, one review found that body image interventions generate improvements in depression of the same magnitude as treatments specifically targeting depression, 35 suggesting that other fields could also benefit from dialogue with ED researchers.…”

The role of emotion regulation in the relationship between mindfulness and risk factors for disordered eating: A longitudinal mediation analysis

“…Mindfulness is increasingly investigated within eating disorder prevention and early intervention (Beccia et al, 2018 ). Examining processes through which mindfulness affects risk can support more efficient and effective prevention of eating disorders and other psychiatric conditions (Ahuvia et al, 2022 ). Emotion regulation is commonly proposed to be a mechanism of mindfulness (e.g., Chiesa et al, 2014 ; Hölzel et al, 2011 ; Roemer et al, 2015 ; Vanzhula & Levinson, 2020 ); however, few longitudinal studies have examined emotion regulation as a mediator.…”