Disorders - Eating Disorders
Stice, E., Rohde, P., Shaw, H., Gau, J. M.
Objective:Compare the Healthy Weight obesity and eating disorder prevention program, which promotes participant-driven gradual lifestyle changes to bring energy intake and expenditure into balance, to a new intervention, Project Health, which adds activities to create cognitive dissonance about unhealthy eating, a sedentary lifestyle, and excess body fat, and an obesity education video-control condition.Method:College students at risk for both outcomes because of weight concerns (N=364, 72% female) were randomized to condition, completing pretest, posttest, and 6, 12 and 24-month follow-up assessments.Results:Project Health participants showed significantly smaller increases in measured body mass index (BMI) through 2-year follow-up than both Healthy Weight participants and controls (both d='0.18), and significantly lower onset of overweight/obesity over 2-year follow-up than Healthy Weight participants and controls (13 vs 21% and 22%). Healthy Weight and Project Health participants showed significantly greater eating disorder symptom reductions than controls through 2-year follow-up. Healthy Weight and Project Health participants showed marginally lower eating disorder onset over follow-up than controls (3 and 3% vs 8% respectively).Conclusions:The reduced increases in BMI and future overweight/obesity onset for Project Health relative to both an active matched intervention and a minimal intervention control condition are noteworthy, especially given the short 6-h intervention duration. The reduction in eating disorder symptoms for Healthy Weight and Project Health relative to controls was also encouraging. Results suggest that adding dissonance-induction activities increased weight loss effects. Yet, effects for both were generally small and the eating disorder onset prevention effects were only marginal, potentially because intervention groups included both sexes, which reduced eating disorder incidence and sensitivity. Copyright © 2018 Macmillan Publishers Limited, part of Springer Nature All rights reserved.
International Journal of Obesity, 42(3) : 462-468
- Year: 2018
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Cognitive dissonance therapy, Dietary advice, dietary change, Physical activity, exercise
Warschburger, P., Zitzmann, J.
Disordered eating is highly prevalent during adolescence and has a detrimental effect on further development. Effective prevention programs are needed to prevent unhealthy developmental trajectories. This study evaluated the efficacy of the POPS-program (POtsdam Prevention at Schools), a universal school-based eating disorder prevention program for adolescents. In a cluster-randomized design, we compared the intervention group receiving the prevention program to a waiting control group. Outcomes included indicators of disordered eating and relevant risk factors for eating disorders (body dissatisfaction, internalization of the thin ideal, perceived media pressure, perfectionism, emotional element of exercise, social comparison, and perceived teasing). Questionnaires were administered at the start of the intervention, 3 and 12 months post intervention. At baseline, 1112 adolescents aged 10 to 16 years participated (49% girls; 51% intervention group). Intention-to-treat analyses with the complete data set and per-protocol analyses as a completer analysis were performed. The intervention group showed a more favorable course compared to the control group regarding all observed risk factors for eating disorders except for perceived teasing. Effect sizes were small but comparable to other primary prevention programs. At 1-year follow-up, a small but significant effect on disordered eating was observed. Results of the per-protocol analyses were mostly confirmed by the intention-to-treat analyses. Results were promising for both genders although girls benefited more regarding disordered eating and internalization of the thin ideal. Further studies are warranted examining successful program elements and whether gender-specific programs are needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Youth and Adolescence, 47(6) : 1317-1331
- Year: 2018
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Wilksch, S. M., O'Shea, A., Wade, T. D.
BACKGROUND: Diagnostic outcomes in eating disorder (ED) risk reduction trials are important but rarely reported.
METHODS: An online pragmatic randomized-controlled trial was conducted with young-adult women in Australia and New Zealand seeking to improve their body image. Media Smart-Targeted (MS-T) was a 9-module program released weekly while control participants received tips for positive body image. Eating Disorder Examination-Questionnaire (EDE-Q) scores from baseline and 12-month follow-up were used to investigate two outcomes: ED onset in those who were asymptomatic at baseline (prevention effects); and, ED remission in those who met diagnosis at baseline (treatment effects).
RESULTS: MS-T participants were 66% less likely than controls to develop an ED by 12-month follow-up (nonsignificant). MS-T participants who met ED criteria at baseline were 75% less likely than controls to still meet diagnostic criteria at follow-up. This effect was significant and remained so for both those who did and who did not access external face-to-face ED treatment during the trial.
CONCLUSIONS: While further investigations are necessary, MS-T has fully automated procedures, low implementation costs, the potential to be delivered at-scale to assist those assist those where face-to-face services are limited or not available (e.g., remote areas).
International Journal of Eating Disorders, 51(3) : 270-274
- Year: 2018
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Vimalakanthan, K., Kelly, A. C., Trac, S.
This study used a novel intervention grounded in social mentalities theory to compare the effects of cultivating a caregiving versus competitive mentality when intervening with appearance comparisons. For 48hours, 120 female undergraduates were randomly assigned to use one of three strategies whenever they made unfavorable appearance comparisons: cultivating compassion and loving-kindness toward the comparison target (Caregiving); comparing themselves favorably to the target in non-appearance domains of superiority (Competition); or distracting themselves (Control). Although there was no main effect of condition, trait social comparison orientation interacted with condition to predict outcomes. Among women engaging more frequently in social comparison, the Caregiving condition was more effective than the Competition condition at reducing body dissatisfaction, restrained eating, and body, eating, and exercise-related comparisons. Findings suggest that cultivating a compassion-focused, caregiving mentality when threatened by appearance comparisons could be beneficial to women who engage more frequently in social comparison. Copyright © 2018 Elsevier Ltd. All rights reserved.
Body Image, 25 : 148-162
- Year: 2018
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions, Self-help
Wolfe, W. L., Patterson, K.
Researchers have investigated the efficacy of a gratitude intervention for decreasing body dissatisfaction (BD) in an internet treatment-seeking sample and demonstrated it worked equally well to decrease BD as cognitive restructuring. We extend this research by testing the efficacy of a gratitude intervention on BD, along with common sequelae of BD: dysfunctional eating, negative mood, and depressive symptoms. Females were randomly assigned to Gratitude, Cognitive Restructuring, or Control conditions. Pre- to post-intervention period comparisons found the gratitude intervention to perform better than the other conditions at increasing body esteem, decreasing BD, reducing dysfunctional eating, and reducing depressive symptoms. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Eating Disorders: The Journal of Treatment & Prevention, 25(4) : 330-344
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Psychoeducation, Other Psychological Interventions, Self-help
Green, M., Willis, M., Fernandez-Kong, K., Reyes, S., Linkhart, R., Johnson, M., Thorne, T., Lindberg, J., Kroska, E., Woodward, H.
Objective: We conducted a controlled randomized preliminary trial of a modified dissonance-based eating disorder program (n = 24) compared to an assessment-only control condition (n = 23) via a longitudinal design (baseline, postintervention, 2-month follow-up) in a community sample of women (N = 47) with clinical (n = 22) and subclinical (n = 25) eating disorder symptoms. Method: The traditional content of the Body Project, a dissonance-based eating disorder prevention program, was modified to include verbal, written, and behavioral exercises designed to dissuade self-objectification and maladaptive social comparison. Women with clinical and subclinical symptoms were included in the target audience to investigate both the treatment and the indicated prevention utility of the modified dissonance program. Body dissatisfaction, self-esteem, self-objectification, thin-ideal internalization, maladaptive social comparison, trait anxiety, and eating disorder symptoms were evaluated in the control and the modified dissonance condition at baseline, postintervention, and 2-month follow-up. Results: We predicted a statistically significant 2 (condition: control, modified dissonance) x 3 (time: baseline, post intervention, 2-month follow-up) interaction in the mixed factorial multivariate analyses of variance results. Results confirmed this hypothesis. Eating disorder risk factors and symptoms decreased significantly among participants in the modified dissonance condition at postintervention and 2-month follow-up compared to baseline; symptom improvement was greater among participants in the modified compared to the control condition. A secondary analysis indicated symptom improvement did not vary as a function of symptom status (clinical, subclinical), suggesting the program is efficacious in both indicated prevention and treatment applications. Conclusion: Results provide preliminary support for the modified dissonance program. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Clinical Psychology, 73(12) : 1612-1628
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Diaz-Ferrer, S., Rodriguez-Ruiz, S., Ortega-Roldan, B., Mata-Martin, J. L., Carmen-Fernandez-Santaella, M.
This study aimed to examine the psychophysiological changes resulting from two mirror exposure treatments that are effective at reducing body dissatisfaction. Thirty-five university women with body dissatisfaction and subclinical eating disorders were randomly assigned to one of two groups: pure (n =17) or guided exposure (n =18). The participants received six sessions of treatment. Their thoughts, feelings and avoidance behaviours were assessed after each session. Their subjective discomfort, heart rate and skin conductance were assessed within the sessions. Both groups showed improvement in cognitive-affective and avoidance behaviour symptoms. Nevertheless, the pure exposure group showed faster habituation of subjective discomfort and a greater physiological response than the guided exposure group. These findings suggest that both procedures are effective interventions for improving body image disturbances, although psychophysiological changes observed within session suggest that each technique would act through different processes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review, 25(6) : 562-569
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Laramee, C., Drapeau, V., Valois, P., Goulet, C., Jacob, R., Provencher, V., Lamarche, B.
OBJECTIVE: To evaluate the effectiveness of a theory-based intervention to reduce the intention to use restrictive dietary behaviors for losing weight among adolescent female athletes involved in aesthetic sports.
DESIGN: Cluster-randomized controlled trial.
SETTING: Aesthetic sport teams of adolescent female athletes aged 12-17 years.
PARTICIPANTS: Two teams (n = 37 athletes) in the intervention group and 3 teams (n = 33) in the comparison group.
INTERVENTIONS: The 2 groups received nutrition education during 3 weekly 60-minute sessions. The intervention group was further exposed to a theory-based intervention targeting the specific determinant of intention to use restrictive dietary behaviors for losing weight, namely attitude.
MAIN OUTCOME MEASURES: Difference over time between groups in intention to use restrictive dietary behaviors for losing weight and in nutrition knowledge.
ANALYSIS: Mixed models for repeated measures.
RESULTS: The theory-based intervention contributed to maintaining a low intention of using restrictive dietary behaviors for losing weight over time in the intervention group compared with the comparison group (P < .03). Nutrition knowledge score increased equally in both groups.
CONCLUSION AND IMPLICATIONS: Complementing nutrition education with theory-based behavior change intervention may help maintain a low intention of using restrictive dietary behaviors for losing weight among female high school athletes involved in aesthetic sports.
Journal of Nutrition Education & Behavior, 49(6) : 497-504.e1
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Chithambo, T. P., Huey, S. J.
Objective: The current study evaluated two web-based programs for eating disorder prevention in high-risk, predominantly ethnic minority women. Method: Two hundred and seventy-one women with elevated weight concerns were randomized to Internet dissonance-based intervention (DBI-I), Internet cognitive-behavioral intervention (CBI-I), or no intervention (NI). Both interventions consisted of four weekly online sessions. Participants were assessed at pre- and post intervention. Outcome measures included eating pathology, body dissatisfaction, dieting, thin-ideal internalization, and depression. Results: At postintervention, DBI-I and CBI-I led to greater reductions in body dissatisfaction, thin-ideal internalization, and depression than NI. In addition, CBI-I was effective at reducing dieting and composite eating pathology relative to NI. No outcome differences were found between the active conditions. Moderation analyses suggested that both active conditions were more effective for ethnic minorities than Whites relative to NI. Discussion: Results suggest that both DBI-I and CBI-I are effective at reducing eating disorder risk factors in a high-risk, predominantly minority population relative to no intervention. Copyright © 2017 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 50(10) : 1142-1151
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Cognitive dissonance therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Brown, T. A., Forney, K. J., Pinner, D., Keel, P. K.
Objective: Pressures for men to conform to a lean, muscular ideal have, in part, contributed to eating disorder and muscle dysmorphia symptoms, yet few programs have been developed and empirically evaluated to help men. This study investigated the acceptability and efficacy of a cognitive dissonance-based (DB) intervention in reducing eating disorder and muscle dysmorphia risk factors in men with body dissatisfaction. Method: Men were randomized to a two-session DB intervention (n = 52) or a waitlist control condition (n = 60). Participants completed validated measures assessing eating disorder risk factors preintervention, postintervention, and at 1-month follow-up. Results: Program ratings indicated high acceptability. The DB condition demonstrated greater decreases in body-ideal internalization, dietary restraint, bulimic symptoms, drive for muscularity, and muscle dysmorphia symptoms compared with controls (p values <.02; between-condition Cohen's d =.30-1.11) from pre- to postintervention. At one-month follow-up, the DB condition demonstrated significantly lower scores for all variables (p values <.03; between-condition d =.29-1.16). Body-ideal internalization mediated intervention outcomes on bulimic and muscle dysmorphia symptoms. Discussion: Results support the acceptability and efficacy of The Body Project: More Than Muscles up to 1-month postintervention and should be examined against active control conditions. Copyright © 2017 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 50(8) : 873-883
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive dissonance therapy
Cook-Cottone, C., Talebkhah, K., Guyker, W., Keddie, E.
This study investigates outcomes of a revised version of a yoga-based, eating disorder prevention program, targeting eating disorder risk factors, among fifth grade girls (i.e., Girls Growing in Wellness and Balance: Yoga and Life Skills to Empower [GGWB]). The program is designed to decrease eating disorder risk factors and bolster self-care and includes revisions not yet studied that extend the program to 14 weeks and enhance content addressing self-care. Efficacy was assessed using a controlled, repeated measures design. Results indicate that participation in the GGWB program significantly decreases drive for thinness and body dissatisfaction while significantly increasing self-care when compared to a control group. As expected, the program did not have significant effects on eating disordered behaviour likely due to low baseline rates among participants. Implications of findings as well as directions for future research on prevention are discussed. Copyright © 2017 Taylor & Francis.
Eating Disorders, 25(5) : 392-405
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Other Psychological Interventions, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Relaxation
Depestele, L., Claes, L., Dierckx, E., Colman, R., Schoevaerts, K., Lemmens, G. M. D.
This study reports on a pilot study of a family group intervention with or without patient participation adjunctive to a specialized inpatient treatment for eating disorders (EDs). Participants were 112 female adolescent ED inpatients and one or both of their parents. The parents were invited to participate in an adjunctive multi-family group with patient (MFT) or in a similar multi-parent group without patient participation (MPT). Questionnaires assessing ED symptoms, family functioning and caregiving experiences were administered before and after intervention. Post-intervention results obtained from both patient and parent(s) indicated that improvement in ED symptoms and parental burden occurred after both types of interventions. Family functioning improved differently according to the informant: fathers reported an improvement of general family functioning, patients reported an improvement of problem solving and mothers reported a decrease in problem solving across both formats. This study emphasized the importance of including a multi-informant approach in family interventions. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders Review, 25(6) : 570-578
- Year: 2017
- Problem: Eating Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Family therapy