Disorders - Eating Disorders
Atkinson, M.
Background: This effectiveness trial compared different
approaches to universal eating disorder prevention in a secondary school setting. We evaluated three different body image programmes, delivered by
trained teachers to classes of mixed-sex adolescent students. Method(s): Twenty schools (N = 2044, aged 13-15, 50.3% male) were randomised to receive
one of three 5-lesson interventions (mindfulness, n = 514; dissonance, n = 541; multifaceted, n = 489) or classes as usual (control, n = 503). Self-
report measures of key risk factors for eating disorders (including primary outcomes of body image and negative affect) were completed at baseline,
post-intervention, 6-month, and 12-month follow-up. Result(s): Multilevel models assessed effects of condition, time, gender, and their interactions,
over postintervention and follow-up while controlling for baseline. At 6-month follow-up there were no significant gender interactions, and no
significant differences between conditions on primary outcomes. Subsequent moderation analysis indicated that students with higher baseline negative
affect receiving the multifaceted programme reported greater body satisfaction and lower internalisation over follow-up, compared to control.
Additionally, students with lower baseline body esteem receiving the dissonance-based programme demonstrated lower internalisation over follow-up,
compared to control. Low to moderate acceptability was reported by students in all intervention conditions at post-intervention, highlighting future
work to increase engagement. Conclusion(s): These interim findings indicate some differential intervention benefits for certain groups of students
when delivered in a sustainable teacher-led format.
European Eating Disorders
Review, 29(6) : E14
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy, Cognitive dissonance
therapy
Almeida, M., Brown, T.
A., Campos, P. F., Amaral, A. C. S., deCarvalho, P. H. B.
Objective: Few prevention programs have been developed and empirically evaluated to address eating disorder (ED) and
muscle dysmorphia (MD) symptoms in men. Furthermore, new strategies for the broad implementation of available programs are needed. We investigated
the acceptability and efficacy of a dissonance-based (DB) intervention for Brazilian undergraduate men with body dissatisfaction to target risk and
protective factors for ED and MD symptoms (the Body Project: More Than Muscles) after an online training for facilitators. Method(s): Participants
were randomized to a two-session DB-intervention (n = 89) or assessment-only control (AOC) (n = 91), and completed validated measures assessing ED
and MD risk and protective factors pre-intervention, post-intervention, and at 4- and 24-week follow-up post-intervention. Result(s): Acceptability
ratings were highly favorable. Regarding efficacy, the DB condition demonstrated significantly greater decreases in ED and MD risk factors compared
to AOC from pre-intervention to 4-week (p-values <.05, between-condition Cohen's d = 0.35-1.10) and 24-week follow-up (p-values <.05, between-
condition Cohen's d = 0.33-0.78). Results at post-intervention were not significant, with the exception that body appreciation showed significantly
greater improvements in the DB condition (post-intervention: p <.01, between-condition Cohen's d = 0.40; 4-week: p <.001, between-condition Cohen's
d = 0.80; and 24-week follow-up: p <.001, between-condition Cohen's d = 0.58). Discussion(s): Results support the acceptability and efficacy of a
DB-intervention delivered in-person after an online training for facilitators up to 24-week follow-up in Brazilian men. Copyright © 2020 Wiley
Periodicals LLC.
International Journal of Eating
Disorders, 54(3) : 293-304
- Year: 2021
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Zhou, Y., Pennesi, J-L., Wade, T. D.
Objective: This study compared the effectiveness of two approaches to imagery rescripting (body versus general) among young women with
an elevated risk of developing an eating disorder. Method: University students (N = 130 females) were randomly assigned to one of the four
conditions: body or general imagery rescripting, psychoeducation, control. After initial brief laboratory training delivered online, participants in
the imagery rescripting conditions were asked to practice imagery rescripting for 5 min each day for a week. Primary (global eating psychopathology,
eating disorder behaviors, and body image acceptance) and secondary outcomes (self-compassion, fear of self-compassion, and dysfunctional attitudes)
were measured at baseline and one-week follow up. Results: Completer analyses showed both imagery rescripting conditions and psychoeducation had
significant impact on global eating psychopathology and body acceptance (d = 0.60-0.78). Psychoeducation did not impact secondary variables, whereas
body imagery rescripting improved self-compassion and fear of self-compassion (d = 0.61-0.80) and general imagery rescripting improved dysfunctional
attitudes (d = 0.82) compared to control. Intent to treat analyses had similar but slightly less robust results. Discussion: While three active
groups had significant impact on the primary variables, imagery rescripting approaches had impact on other variables that maintain disordered eating.
Future research should investigate the impact of combining psychoeducation and imagery rescripting in terms of impact on disordered eating. (PsycInfo
Database Record (c) 2021 APA, all rights reserved)
International Journal of Eating Disorders, 53(12) : 1906-
1917
- Year: 2020
- 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
Zeeck, Almut, Schlegel, Sabine, Jagau, Friederike, Lahmann,
Claas, Hartmann, Armin
Background: Unhealthy attitudes towards sport
and problematic exercise behavior in eating disorders (ED) are common and associated with poorer treatment outcome and higher relapse rates. There is
a need to develop and empirically test interventions that could complement standard treatment. The study aimed to assess the efficacy of the Freiburg
sport therapy program for eating disorders (FSTP).\rMethods: Outpatients with ED were randomized either to a 3 month sport therapy program (sport
therapy group: STG) or a waiting list control group (CG). Patients were assessed when starting the program and at the end of the intervention. The
intervention group (STG) was followed up after 6 month. Main outcome criterion was a reduction in unhealthy exercise (Commitment to Exercise Scale,
CES). Secondary outcomes encompassed eating pathology (Eating Disorder Examination, EDE), different dimensions of unhealthy exercise (Compulsive
Exercise Test, CET subscales) and exercise quantity (accelerometer).\rResults: Recruitment was challenging. Fifteen patients were randomized to the
STG and 11 were randomized to the CG condition. There was no statistically significant difference between groups according to the main outcome
criterion. However, the STG showed a significantly stronger reduction in avoidance and rule driven behavior (CET subscale) when compared to the CG.
Improvements (STG) were maintained at follow up.\rConclusions: There was no statistically significant difference in the reduction of unhealthy
attitudes towards sport and problematic exercise behavior between the intervention and the group, as measured with the Commitment to Exercise Scale.
Further findings may point to the effectiveness of the program, but have to be interpreted with caution and verified in further studies. A major
limitation is the small sample size.
Journal of Eating Disorders Vol 8 2020, ArtID 31, 8 :
- Year: 2020
- Problem: Eating Disorders
(any), Anorexia Nervosa, Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Physical activity, exercise, Other service delivery and improvement
interventions
Vanderkruik, R., Gist, D., Dimidjian, S.
Objectives: Young women are at increased risk for eating disorders during adolescence (age range =
16-19), and there is the need for effective, sustainable prevention programs delivered during this critical window of development. The Body Project
is a dissonance-based program that reduces key risk factors for disordered eating. Few studies have evaluated the program or the participant
experience when peer-delivered at the high school level. The objective of this study was to evaluate using mixed-methods the Body Project program
when peer-delivered among high school women. Method: Three studies were conducted among young women in high school in the United States: (a) an open
trial evaluation of a peer-delivered Body Project program (n = 112), (b) a pilot randomized controlled trial (RCT) comparing the Body Project with
assessment-only control (n = 74), and (c) a qualitative investigation of participants' experiences (n = 131). Results: Open trial participants
reported significant reductions in eating disorder risk factors and improvements in mood and self-attitude constructs over the intervention period
(ds = .32-.77, ps < .01). Intervention effects for Body Project participants in the RCT compared with control were significant for body
dissatisfaction, thin ideal internalization, dietary restraint, self-compassion, body surveillance, and loneliness (ds = .55-1.38, ps < .02).
Thematic analyses of qualitative data highlight considerations for program delivery and engagement, including insights about why women join the
program and perspectives on peer leaders. Conclusions: Findings support the effectiveness of the peer-delivered Body Project with high school-aged
women and highlight key recommendations for increasing engagement and strengthening prevention programs among young women. (PsycInfo Database Record
(c) 2020 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study
supports the potential of the peer-delivered Body Project program to reduce risk for disordered eating and improve social and self-constructs among
young women in high school, a critical developmental window when eating disorders are most likely to develop. Findings highlight key recommendations
for strengthening and expanding eating disorder prevention programs to enhance engagement and promote lasting positive outcomes. (PsycInfo Database
Record (c) 2020 APA, all rights reserved)
Journal of Consulting and Clinical Psychology, 88(12) : 1105-
1118
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive dissonance
therapy
Stewart, C., Goddard, E., Cakir, Z., Hall, R., Allen, G.
The research presented here evaluates the delivery of Happy Being Me (HBM; Dunstan, Paxton & McLean, 2017) with boys and girls in their
first year of secondary school in the UK (Year 7 and after comparisons aged 11-12). HBM is a manualised universal prevention programme which aims to
improve body dissatisfaction and associated risk factors. Risk factors studied here were internalization of the thin ideal, physical appearance
comparisons, appearance conversations. Secondary outcomes measured were self-esteem and eating disorder symptoms Study 1 tested the effectiveness of
HBM (n = 172) compared to a control group (n = 197) who received curriculum as usual. HBM resulted in significantly improved body satisfaction post-
intervention which was maintained at follow up. There were no significant changes in risk factors. Study 2 compared clinician (n = 172) and teacher
(n = 174) delivery. Students who received clinician-led, but not teacher-led, HBM had improved body satisfaction and this was maintained at follow
up. Internalization of the thin ideal and self-esteem, improved in both clinician and teacher-led groups with small to medium sized effects. HBM can
be delivered by clinicians independent of programme developers in a heterogeneous sample with positive effects on body satisfaction. Issues arising
for wider delivery are discussed. Copyright © 2020 Taylor & Francis.
Eating
Disorders., :
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Shimshoni, Y., Lebowitz, E. R.
Avoidant/Restrictive food intake disorder (ARFID) is characterized by dietary
restrictions that are not based on weight or shape concerns but that result in marked interference in feeding, growth, or psychosocial functioning
(American Psychiatric Association, 2013; Eddy et al., 2019). The aim of the current article was to review available reports of treatment for
childhood ARFID published since its inclusion in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), and to introduce
a novel parent-based treatment for child ARFID through a case presentation. Empirical support for psychosocial treatments for child ARFID currently
stems from two small-scale pilot randomized control trials, one pilot open trial, case reports, case series, and retrospective chart reviews.
Treatment approaches for outpatient care generally apply family-based therapy, child-centered cognitive behavioral therapy, or parent-based
behavioral approaches. SPACE-ARFID is a novel outpatient parent-based treatment that focuses on parental responses to child problematic eating
habits. SPACE-ARFID aims to promote flexibility and adjustment in food related situations. The treatment helps parents to systematically reduce
family accommodation, or changes that they make to their own behavior to help their child avoid or alleviate distress related to the disorder, while
increasing supportive responses to the child's symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Journal of Cognitive Psychotherapy, 34(3) : 200-
224
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any)
Savidaki, Maria, Demirtoka, Sezin, Rodriguez-Jimenez, Rosa-Maria
Background: Body
image disturbance and alexithymia are two core aspects of Eating Disorders (EDs). However, standard treatments for EDs do not include specific
techniques to approach these issues on a bodily level. This pilot study evaluated the effects of a Dance Movement Therapy (DMT) intervention on body
image and alexithymia in patients with EDs, and also explored their experience of the therapeutic process.\rMethod: 14 patients with EDs were
recruited from a private clinic. Seven were assigned via quasi-randomization to the DMT group and the others (n = 5) continued their treatment as
usual. The length of the intervention was 14 weeks. All participants completed the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the
Toronto Alexithymia Scale (TAS-20) at the beginning and at the end of the intervention. Additionally, the DMT group wrote reflective diaries about
their experience at the end of each session, which were analyzed using qualitative methods.\rResults: Between the pre- and post-intervention, the
participants of the DMT group significantly improved in Body Areas Satisfaction (effect size: 0.95) and Appearance Evaluation (effect size: 1.10),
and they decreased significantly in Appearance Orientation (effect size: 1.30). A decrease in Overweight Preoccupation was observed (effect size:
0.75), however this was not statistically significant. The control group did not show significant changes in any of the MBSRQ\rsubscales. Neither the
DMT group nor the control group improved significantly in the alexithymia scores. The qualitative analysis revealed valuable insights into the
participants' processes throughout the sessions. In general, participants received the DMT intervention positively. They reported improvements in
their mood states and an increase in their self-awareness. They also appreciated the relationship with the group and the therapist.\rConclusion:
These results indicate that DMT might be a complementary treatment option for EDs, as it may be able to address body image issues more effectively
than verbal therapies. More studies with larger samples are needed to confirm these promising preliminary results.
Journal of Eating Disorders Vol 8 2020, ArtID 22, 8 :
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Pilling, S., Fonagy, P., Allison, E., Barnett, P., Campbell, C., Constantinou,
M., Gardner, T., Lorenzini, N., Matthews, H., Ryan, A., Sacchetti, S., Truscott, A., Ventura, T., Watchorn, K., Whittington,
C., Kendall, T.
Background Over 600 RCTs have demonstrated the effectiveness of
psychosocial interventions for children and young people's mental health, but little is known about the long-term outcomes. This systematic review
sought to establish whether the effects of selective and indicated interventions were sustained at 12 months. Method We conducted a systematic review
and meta-analysis focusing on studies reporting medium term outcomes (12 months after end of intervention). Findings We identified 138 trials with
12-month follow-up data, yielding 165 comparisons, 99 of which also reported outcomes at end of intervention, yielding 117 comparisons. We found
evidence of effect relative to control at end of intervention (K = 115, g = 0.39; 95% CI: 0.30-0.47 I2 = 84.19%, N = 13,982) which was
maintained at 12 months (K = 165, g = 0.31, CI: 0.25-0.37, I2 = 77.35%, N = 25,652) across a range of diagnostic groups. We explored the
impact of potential moderators on outcome, including modality, format and intensity of intervention, selective or indicated intervention, site of
delivery, professional/para-professional and fidelity of delivery. We assessed both risk of study bias and publication bias. Conclusions Psychosocial
interventions provided in a range of settings by professionals and paraprofessionals can deliver lasting benefits. High levels of heterogeneity,
moderate to high risk of bias for most studies and evidence of publication bias require caution in interpreting the results. Lack of studies in
diagnostic groups such as ADHD and self-harm limit the conclusions that can be drawn. Programmes that increase such interventions' availability are
justified by the benefits to children and young people and the decreased likelihood of disorder in adulthood. Copyright © 2020 Pilling et al. This is
an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited.
PLoS ONE, 15(11 November) :
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Pacanowski, C. R., Diers, L., Crosby, R. D., Mackenzie, M., Neumark-Sztainer,
D.
Yoga has been proposed as a strategy for improving risk and protective factors for eating disorders,
but few prevention trials have been conducted. The purpose of this pilot study was to assess the feasibility and acceptability of a yoga series in
female college students (n = 52). Participants were randomized to a yoga intervention (three 50-minute yoga classes/week for 10 weeks conducted by
certified yoga teachers who received a 3-day intensive training) or a control group. Risk and protective factors, assessed at baseline, 5 and 10
weeks, included body dissatisfaction, negative affect, loneliness, self-compassion, positive affect, and mindfulness. Mixed models controlling for
baseline levels of outcome variables were run. On average, participants attended 20 out of 30 yoga classes, and the majority of participants reported
high levels of satisfaction with the yoga series. Appearance orientation decreased and positive affect increased in the yoga group relative to the
control group. After controlling for baseline levels, the yoga group had a significantly higher positive affect than the control group. Changes in
other outcomes were not statistically significant, as compared to the control condition. Future yoga research directions are discussed including
education about body image, measure and sample selection, and use of an implementation science framework.
Brunner-Mazel Eating Disorders Monograph Series, 28(4) : 513-541
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)
Monthuy-Blanc, Johana, Lemieux, Vincent, Theriault, Joanie, Rousseau, Michel
Disturbances in physical self-perceptions (PSP) can lead to inappropriate
attitudes and eating behaviours (IAEB) including eating disorders (ED) and obesity. This exploratory study assesses the effects of a blind integrated
prevention program-the SILENCE Program-with high school students. No significant effect of the SILENCE Program on the IAEB of the 61 adolescents was
observed between pre- and post-test, but a positive evolution of specific PSP components (global self-esteem, perceived physical appearance, etc.)
during 14 consecutive weeks was demonstrated compared to an ED-only program and the control condition. Promising avenues for integrated prevention
programs (like SILENCE Program) are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Abstract (French) Des perturbations des
perceptions du soi physique (PSP) peuvent mener a des attitudes et comportements alimentaires inappropries (ACAI) incluant les troubles du
comportement alimentaire et l'obesite. Cette etude exploratoire evalue les effets d'un programme de prevention voile (c.-a-d. que les eleves
ignorent l'objectif primaire du programme) et integre-le programme SILENCE-aupres d'elevesdu secondaire. Les resultats montrent aucun effet
significatif du programme sur les ACAI des 61 adolescents lors du test-retest bien qu'une evolution positive des composantes specifiques des PSP
(estime de soi globale, apparence physique percue, etc.) durant 14 semaines consecutives est note en comparaison au programme des ACAI et a la
condition controle. Des pistes prometteuses sur les programmes de preventions integres (comme le SILENCE Program) sont discutees. (PsycInfo Database
Record (c) 2023 APA, all rights reserved)
Canadian Journal of Community Mental Health, 39(4) : 61-
84
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Martinez-Avila, W. D., Sanchez-Delgado, G., Acosta, F. M., Jurado-Fasoli,
L., Oustric, P., Labayen, I., Blundell, J. E., Ruiz, J. R.
Regular physical activity
(PA) is an important part of the treatment of several medical conditions, including overweight and obesity, in which there may be a weakened appetite
control. Eating behaviour traits influence weight control and may be different in active and sedentary subjects. This paper reports the relationships
between the time spent in sedentary behaviour and physical activity (PA) of different intensity, and eating behaviour traits in young, healthy
adults. Additionally, it reports the results of a six-month-long, randomized, controlled trial to examine the effect of an exercise intervention on
eating behaviour traits. A total of 139 young (22.06 +/- 2.26 years) healthy adults (68.35% women) with a Body Mass Index (BMI) of 24.95 +/- 4.57
kg/m2 were enrolled. Baseline assessments of habitual PA were made using wrist-worn triaxial accelerometers; eating behaviour traits were
examined via the self-reported questionnaires: Binge Eating, Three-Factor Eating Questionnaire-R18 and Control of Eating Questionnaire. The subjects
were then randomly assigned to one of three groups: control (usual lifestyle), moderate-intensity exercise (aerobic and resistance training 3C4
days/week at a heart rate equivalent to 60% of the heart rate reserve (HRres) for the aerobic component, and at 50% of the 1 repetition maximum (RM)
for the resistance component), or vigorous-intensity exercise (the same training but at 80% HRres for half of the aerobic training, and 70% RM for
the resistance training). At baseline, sedentary behaviour was inversely associated with binge eating (r = -0.181, p < 0.05) and with uncontrolled
eating (r = -0.286, p = 0.001). Moderate PA (MPA) was inversely associated with craving control (r = -0.188, p <0.05). Moderate-to-vigorous PA (MVPA)
was directly associated with binge eating (r = 0.302, p < 0.001) and uncontrolled eating (r = 0.346, p < 0.001), and inversely associated with
craving control (r = -0.170, p < 0.015). Overall, PA was directly associated with binge eating (r = 0.275, p = 0.001), uncontrolled eating (r =
0.321, p < 0.001) and emotional eating (r = 0.204, p < 0.05). Additionally, only emotional eating was modified by the intervention, increasing in the
vigorous-intensity exercise group (p < 0.05). In summary, we observed that time spent in sedentary behaviour/PA of different intensity is associated
with eating behaviour traits, especially binge eating in young adults. In contrast, the six-month exercise intervention did not lead to appreciable
changes in eating behaviour traits. Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Nutrients, 12(12) : 1-
14
- Year: 2020
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise