Disorders - Eating Disorders
Kurz, M., Rosendahl, J., Rodeck, J., Muehleck, J., Berger, U.
Body ideals conveyed by the media and by body comparisons often result in
body dissatisfaction, which can cause risky health behaviours and eating disorders, especially in adolescents. We conducted a meta-analytic review of
existing school-based interventions designed to enhance media literacy in order to reduce body dissatisfaction and to promote a positive body image.
We included controlled trials examining children and adolescents from grade five to nine (age 10-15 years) after a manual search and a comprehensive
literature search using PsycINFO, Medline, Web of Science, and CENTRAL. We computed average weighted effect sizes (Hedges' g) with the help of a
random effects model and identified seventeen different programme evaluations with 7392 participants. We found a significantly larger effect on
positive body image and media literacy in the intervention compared to control groups. However, heterogeneity was substantial for both outcomes.
Results suggest that media literacy interventions have the potential to improve media literacy and reduce body dissatisfaction. Interventions that
worked with the principle of induction of cognitive dissonance were the most effective. Copyright © 2021. The Author(s).
Journal of prevention (2022), 43(1) : 5-23
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kristoffersen, M., Johnson, C., Atkinson, M. J.
Objective: Eating disorders (EDs) often emerge in late adolescence. Schools are ideal settings for prevention programs;
however, cost and time limit implementation. Microinterventions may overcome these challenges. This study adapted two microinterventions (cognitive
dissonance, self-compassion) and assessed feasibility and acceptability among mid-adolescents to provide proof-of-concept for further investigation.
Method(s): Feedback from staff (n = 5) and student (n = 15) focus groups contributed iteratively to the adaptation of intervention materials.
Students in Grade 10 and 11 (N = 101, Mage = 15.80, SD = 0.68) were then randomly allocated by class to a 20-min video-based cognitive-
dissonance or self-compassion intervention, accessed on their school devices. ED risk and protective factors were assessed at baseline, immediate
postintervention (state outcomes), and 1-week follow-up (trait outcomes). Acceptability items were included at both timepoints. Result(s):
Implementation was deemed feasible. Girls generally reported greater acceptability than boys. Among girls, the self-compassion intervention
demonstrated greater acceptability. Among boys, some aspects of acceptability (e.g., lesson endorsement, utilization of techniques) were rated higher
in the cognitive dissonance group whereas other aspects (e.g., understanding, interest) were greater in the self-compassion group. All groups
exhibited favorable changes in most state outcomes, however trait outcome change was varied. Discussion(s): Microinterventions provide a feasible way
of implementing prevention strategies in a time-poor educational context. Future large-scale evaluation is warranted to determine efficacy, following
modifications based on current findings. Public Significance: This study shows promising feasibility and acceptability of two brief, self-guided
video-based lessons (microinterventions) for adolescents in school classrooms, that use psychological techniques to target appearance pressures as a
key risk factor for eating disorders. Such interventions are easier to implement in school settings than longer, facilitator-led interventions, to
encourage greater uptake and ongoing use. Findings support further research to evaluate effectiveness, to ultimately provide accessible and gender-
inclusive tools for busy schools. Copyright © 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.
International Journal of Eating Disorders, 55(11) : 1496-
1505
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Cognitive dissonance
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Katcher, J. A., Suminski, R. R., Pacanowski, C.
R.
Dietary restraint and
low body appreciation are common among female-identifying undergraduates and are related to the development of disordered eating, which female-
identifying undergraduates engage in throughout college. Training students in intuitive eating, an approach that promotes eating by internal cues,
may be a way to ameliorate dietary restraint and low body appreciation, ultimately decreasing disordered eating. The purpose of this study was to
examine the impact of a five-week intuitive eating intervention on dietary restraint, body appreciation, and intuitive eating in female-identifying
undergraduates. A five-week intuitive eating intervention (NCT0394700) was facilitated by two Registered Dietitians. One treatment group (TG) (n = 7)
and one waitlist control group (WLCG) (n = 7) participated in the trial. From baseline to post-intervention, there was a significant decrease in
dietary restraint, t(12) = -2.88, p = 0.01, and a significant increase in intuitive eating, t(12) = 4.03, p = 0.002, in the TG compared to the WLCG.
The intervention had replicable effects on all outcome variables. Measurements at the five-week follow-up suggested the impact was sustained. This
study provides preliminary data suggesting an intuitive eating intervention may help improve disordered eating risk factors by decreasing dietary
restraint and increasing intuitive eating in female-identifying undergraduates.
International Journal of Environmental Research & Public Health [Electronic
Resource], 19(19) : 23
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Jacobi, C., Vollert, B., Hutter, K., Von-Bloh, P., Eiterich, N., Gorlich, D., Barr-Taylor, C.
Background: Although preventive interventions
for eating disorders in general have shown promise, interventions specifically targeting individuals at risk for anorexia nervosa (AN) are lacking.
Objective(s): The aim of this study was to determine the efficacy of a guided, indicated web-based prevention program for women at risk for AN.
Method(s): We conducted a randomized controlled efficacy trial for women at risk for AN. Assessments were carried out at baseline (before the
intervention), after the intervention (10 weeks after baseline), and at 6- and 12-month follow-ups (FUs). A total of 168 women with low body weight
(17.5 kg/m2<=BMI<=19 kg/m2) and high weight concerns or with normal body weight (19 kg/m2
Journal of Medical Internet Research, 24(6) (no pagination) :
- Year: 2022
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Galloway, R., Watson, H., Greene, D., Shafran, R., Egan, S. J.
Perfectionism is a transdiagnostic process across anxiety,
depression, and eating disorders. The aim of this systematic review was to examine the efficacy of self-help and face to face CBT for perfectionism
in reducing perfectionism and anxiety, depression, and eating disorders. A total of 15 randomised controlled trials of CBT for perfectionism were
identified (N = 912 participants; mean pooled age = 23 years) which met inclusion criteria. There were medium or large effect sizes found on
perfectionism measures; personal standards (g = 0.57, 95% CI = 0.43-0.72), concern over mistakes (g = 0.89, 95% CI = 0.71-1.08) and clinical
perfectionism (g = 0.87, 95% CI = 0.70-1.04). There were medium effects for symptoms of eating disorders (g = 0.61, 95% CI = 0.36-0.87) and
depression (g = 0.60, 95% CI = 0.28-0.91), and a small-medium effect on anxiety (g = 0.42, 95% CI = 0.21-0.62). There was no publication bias found.
Limitations included the small number of trials included and lack of active treatment comparisons. Results suggested that CBT for perfectionism is
efficacious in reducing perfectionism and symptoms of depression, anxiety and eating disorders. Future research should examine comparisons of CBT for
perfectionism with other psychological treatments. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
, 51(2) : 170-
184
- Year: 2022
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Fitzsimmons-Craft, E. E., Chan, W. W., Smith, A. C., Firebaugh, M. L., Fowler, L. A., Topooco, N., DePietro, B., Wilfley, D. E., Taylor, C. B., Jacobson, N. C.
Objective: Prevention of eating
disorders (EDs) is of high importance. However, digital programs with human moderation are unlikely to be disseminated widely. The aim of this study
was to test whether a chatbot (i.e., computer program simulating human conversation) would significantly reduce ED risk factors (i.e., weight/shape
concerns, thin-ideal internalization) in women at high risk for an ED, compared to waitlist control, as well as whether it would significantly reduce
overall ED psychopathology, depression, and anxiety and prevent ED onset. Method(s): Women who screened as high risk for an ED were randomized (N =
700) to (1) chatbot based on the StudentBodies© program; or (2) waitlist control. Participants were followed for 6 months. Result(s): For
weight/shape concerns, there was a significantly greater reduction in intervention versus control at 3- (d = -0.20; p =.03) and 6-m-follow-up (d = -
0.19; p =.04). There were no differences in change in thin-ideal internalization. The intervention was associated with significantly greater
reductions than control in overall ED psychopathology at 3- (d = -0.29; p =.003) but not 6-month follow-up. There were no differences in change in
depression or anxiety. The odds of remaining nonclinical for EDs were significantly higher in intervention versus control at both 3- (OR = 2.37, 95%
CI [1.37, 4.11]) and 6-month follow-ups (OR = 2.13, 95% CI [1.26, 3.59]). Discussion(s): Findings provide support for the use of a chatbot-based EDs
prevention program in reducing weight/shape concerns through 6-month follow-up, as well as in reducing overall ED psychopathology, at least in the
shorter-term. Results also suggest the intervention may reduce ED onset. Public Significance: We found that a chatbot, or a computer program
simulating human conversation, based on an established, cognitive-behavioral therapy-based eating disorders prevention program, was successful in
reducing women's concerns about weight and shape through 6-month follow-up and that it may actually reduce eating disorder onset. These findings are
important because this intervention, which uses a rather simple text-based approach, can easily be disseminated in order to prevent these deadly
illnesses. Trial registration: OSF Registries; https://osf.io/7zmbv. Copyright © 2021 Wiley Periodicals LLC.
International Journal of Eating
Disorders, 55(3) : 343-353
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Estey, E. E. E., Roff, C., Kozlowski, M. B., Rovig, S., Guyker, W. M., Cook-Cottone, C. P.
Evidence positions yoga as a promising intervention for enhancing positive embodiment and supporting the prevention of, and recovery
from, eating disorders (EDs) by reducing ED symptomatology and building skills that facilitate an ongoing, embodied sense of wellbeing. However,
yoga-based programs are few and rigorous literature on their efficacy is limited. This study examined the efficacy and feasibility of a yoga-based
program called Eat Breathe Thrive (EBT) which aims to prevent EDs and support embodiment. Participants (N = 168, 93.5 % women) from a community
sample in the United States and United Kingdom, ages 18-65, were randomly allocated to a 2-h, 7-week EBT program or waitlist-control condition.
Compared to controls, EBT participants experienced significant decreases in ED behaviors, depression, and difficulties regulating emotions. They
reported significantly greater use of mindfulness skills, such as interoceptive awareness, mindful self-care, and mindful eating. After a single
session, participants reported immediate improvement in their sense of well-being, indicating increased state positive embodiment. Most effects were
sustained at 6-month follow-up. The majority of individuals attended most sessions. Self-reported treatment integrity was excellent. Directions for
future research are proposed. Results support the efficacy and feasibility of an integrated yoga intervention that fosters positive ways of
inhabiting the body.
Body image, 42 : 427-439
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Mind-body exercises (e.g. yoga, tai chi, qigong)
de-Valle, M. K., Wade, T. D.
OBJECTIVE: Evaluate the feasibility, acceptability, and preliminary efficacy of a self-criticism
intervention addressing the link between appearance-motivated social media use and eating disorder risk. Another condition, designed to help users
curate their social media feed to reduce negative impacts on wellbeing, was also trialed as an active and credible comparison.\rMETHOD: University
students aged 17-25 (N = 170) were screened and randomized (n = 130) to the self-criticism intervention, social media curation, or waitlist control
group. The intervention comprised self-guided cognitive behavior therapy delivered in four modules over 1 week. Primary outcomes were feasibility and
acceptability. Secondary outcomes were appearance motivations for social media use, appearance comparison, self-criticism, body image flexibility,
and disordered eating (at baseline, one-week postrandomization, and two-weeks postrandomization).\rTrial registration: Actrn12621000353897.\rRESULTS:
Participants completed an average of 82% of the intervention modules and 77% of the homework exercises within the week allocated. The intervention
was well-accepted; participants reported a range of positive aspects, alongside suggested modifications to the intervention and study design to
improve acceptability. Group by time interactions suggested groups changed at a different rate on three secondary outcomes; between-groups effect
sizes suggested this was due to greater improvements in the self-criticism group than waitlist control.\rDISCUSSION: This was the first study to
evaluate an intervention for the link between appearance-related social media use and eating disorder risk for young adults. Positive findings
relating to feasibility, acceptability, and preliminary efficacy suggest a larger randomized controlled trial, with modifications to the intervention
and study design, is warranted.\rPUBLIC SIGNIFICANCE: Appearance-related social media use has been linked to poorer body image and disordered eating,
necessitating treatments that can disrupt this relationship. The self-criticism intervention evaluated in this study shows promise as a strategy to
address this need. It is the first intervention focused on appearance-related social media use to be designed for and tested in young adults, who are
at heightened risk of developing an eating disorder.
International Journal of Eating Disorders, 55(8) : 1066-
1078
- Year: 2022
- 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), Other Psychological Interventions
D'Adamo, L., Monterubio, G., Claire, A., Balantekin, K., Taylor, C., Fitzsimmons-Craft, E., Wilfley, D.
Background: Binge-type eating disorders (EDs; i.e., bulimia nervosa and binge eating disorder) are common among young adults with
overweight/ obesity, yet few interventions target both conditions. We tested an online guided self-help intervention that provided cognitive
behavioral therapy (CBT)-based tools for EDs and multicomponent behavioral weight loss (BWL) strategies to young adults with binge-type EDs and
overweight/obesity. Program engagement and change in weight and ED symptoms from baseline to post-intervention were compared between the combined
intervention (CBT+BWL) and an ED-only intervention. Method(s): 60 young adults with clinical/subclinical binge-type EDs and overweight/obesity (BMI M
= 34.4+/-7.4; global ED psychopathology M = 3.7+/-0.9, range = 0-6; binge episode frequency M over the last 28 days = 11.1+/-9.3) were randomized to
CBT+BWL or an EDonly condition. Participants received self-help session content for 8 weeks and self-reported ED symptoms and weight at baseline, 4-
weeks, and post-intervention (8-weeks). Linear mixed models, negative binomial models, Chi-squared tests, and t-tests compared changes in global ED
psychopathology, binge episode frequency, program completion, and session engagement. Result(s): No differences in weight change, ED symptom change,
program completion, or session engagement emerged between the conditions. Both groups achieved significant reductions in ED psychopathology (by 1.3
points in CBT+BWL and 1.4 points in EDonly) and binge frequency (by 4.9 episodes in CBT+BWL and 7.7 episodes in ED-only) from baseline to 8-weeks
(ps<.01). Neither condition achieved significant reductions in weight. 47% of participants completed all 8 sessions. Conclusion(s): CBT+BWL produced
similar improvements in ED symptoms versus CBT alone, suggesting that adding BWL content did not increase risk for EDs. Research should explore BWL
components that may promote weight change in young adults and evaluate their influence on ED risk, as well as for whom a CBT+BWL intervention may
impact ED risk.
Obesity, 30(Supplement
1) : 152
- Year: 2022
- Problem: Eating Disorders
(any), Binge Eating Disorders, Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Curzio, O., Billeci, L., Belmonti, V., Colantonio, S., Cotrozzi, L., De-Pasquale, C. F., Morales, M. A., Nali, C., Pascali, M. A., Venturi, F., Tonacci, A., Zannoni, N., Maestro, S.
Studies in psychiatric populations have found a positive effect of
Horticultural therapy (HCT) on reductions in stress levels. The main objective of the present pilot study was to evaluate the impact of the addition
of HCT to conventional clinical treatment (Treatment as Usual, TaU) in a sample of six female adolescents with anorexia nervosa restricting type
(AN-R), as compared to six AN-R patients, matched for sex and age, under TaU only. This is a prospective, non-profit, pilot study on patients with a
previous diagnosis of AN-R and BMI < 16, recruited in 2020 in clinical settings. At enrolment (T0) and after treatment completion (TF), psychiatric
assessment was performed. At T0, all the patients underwent: baseline electrocardiogram acquisition with a wearable chest strap for recording heart
rate and its variability; skin conductance registration and thermal mapping of the individual's face. An olfactory identification test was
administered both to evaluate the olfactory sensoriality and to assess the induced stress. One-way analyses of variance (ANOVAs) were performed to
analyze modifications in clinical and physiological variables, considering time (T0, TF) as a within-subjects factor and group (experimental vs.
control) as between-subjects factors. When the ANOVA was significant, post hoc analysis was performed by Paired Sample T-tests. Only in the HCT
group, stress response levels, as measured by the biological parameters, improved over time. The body uneasiness level and the affective problem
measures displayed a significant improvement in the HCT subjects. HCT seems to have a positive influence on stress levels in AN-R. Copyright © 2022
by the authors.
Nutrients, 14(24) (no pagination) :
- Year: 2022
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Cheng, Z., Gao, X., Yang, C., Brytek-Matera, A., He, J.
Body dissatisfaction and eating disorders have become major global concerns, including in
Asian populations. Few studies have examined intervention effects on body dissatisfaction and disordered eating in China, especially for
interventions with positive psychological perspectives (e.g., intuitive eating). In this pilot study, 66 women participated in an eight-module
intuitive eating intervention delivered online (n = 42; mean age, 30.74 years) and face-to-face (n = 24; mean age, 19.46 years) for 8 weeks. Measures
of body image and eating behaviors were used to assess the intervention's feasibility, acceptability, and initial efficacy. Linear mixed models were
used to analyze the data. The intervention had significant effects on both groups, promoting positive body image and intuitive eating and reducing
negative body image and disordered eating behaviors. The effects of the online and face-to-face interventions did not differ significantly. Thus,
whether delivered online or face-to-face, an intuitive eating intervention may effectively improve Chinese women's body image and eating behaviors.
However, the efficacy of the intuitive intervention in the Chinese context should be confirmed in future studies with designs in randomized control
trials.
Nutrients, 14(9) : 22
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Cerea, S., Doron, G., Manoli, T., Patania, F., Bottesi, G., Ghisi, M.
Body dissatisfaction has been related to Body Image
Disorders (BIDs) such as Eating Disorders (EDs) and Body Dysmorphic Disorder (BDD). This study investigates the efficacy of a mHealth app in reducing
body dissatisfaction, BDD/ED symptoms and related features. Ninety-five women who were identified as high-risk of developing BIDs (using the
Structured Clinical Interview for DSM-5) were randomized into: immediate-use App (iApp group; n = 47) and delayed-use App (dApp group; n = 48). The
iApp group started using the app at baseline for 16 days (T1). The dApp group started using the app at T1 for 16 days. Participants completed
questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Multivariate Analysis of Variance
(MANOVA) showed Group (iApp vs. dApp) x Time (T0 vs. T1) interactions indicating decrease in BDD symptoms and body dissatisfaction related to EDs in
the iApp group at T1. The Reliable Change Index indicated changes on extreme body dissatisfaction/BDD symptoms for 34.74% of participants. Although
preliminary, these findings highlight that a mHeatlh app might reduce BDD symptoms and body dissatisfaction related to EDs in women at high-risk for
BIDs. Effects on ED symptoms and associated features seem more limited. Copyright © 2022 Elsevier Ltd. All rights reserved.
Body image, 42 : 297-306
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)