Objective: Research suggests that weight suppression (WS) is linked to non-suicidal self-injury (NSSI) and that drive for thinness and depression may explain this association. We conducted a proof-of-concept study using a randomized control trial design to determine if improving body esteem and reducing depressive symptoms reduced NSSI in individuals with WS.Method: Weight suppressed participants (N = 60) who engaged in NSSI were recruited from the community and randomly assigned to an on-line intervention or control condition. The on-line intervention was adapted from a cognitive-dissonance intervention originally designed to reduce thin-ideal internalization in females to an intervention to reduce internalization of unhealthy body ideals in both genders. Participants' weight/shape concerns, depressive symptoms, and NSSI were assessed at pre-and post-intervention, or at baseline and 2-week follow-up for controls.
Results: Compared to controls, participants in the treatment condition reported greater decreases in likelihood of future NSSI [Cohen's d (95% CI) = −0.38 (−0.90-0.15)], weight/shape concerns [−1.19 (−1.75 to −0.62)], depressive symptoms [−1.00 (−1.56 to −0.45)], and significant improvements in appearance [1.27 (0.70-1.84)] and weight esteem [1.38 (0.80-1.96)]. Discussion: Future work could test this intervention in a larger trial with an active alternative treatment condition. K E Y W O R D S body image, cognitive dissonance, depression, (MeSH terms) nonsuicidal self-injurious behavior, proof of concept study, weight suppression