Eating Disorder Prevention Programs: A Meta-Analytic Review

1. Eating Disorder Prevention Programs: A Meta-Analytic Review Eric Stice and Heather Shaw Presented by Lisa Hoekzema Radford University

2. Purpose • Better prevention programs need to be developed because: • Eating pathology is one of the most prevalent psychiatric problems for women and girls • Less than a third of individuals with eating disorders receive treatment • Treatment produces symptom remission in only 40% to 60% of patients

3. Issues to Consider • Will programs that are targeted at a high-risk group prove more successful than universal programs? • Are intervention effects stronger for female only groups verses male or mixed gender groups? • Do programs targeted at participants who are in the developmental period in which the pathology typically begins show better results?

4. Issues to Consider • Are interactive programs more effective than didactic programs? • Will stronger effects be seen in multiple session interventions relative to single session? • Do programs that focus on established risk factors rather than non-established factors have a larger effect?

5. Dependent Measures • Knowledge • Body Mass • Thin-ideal internalization • Body dissatisfaction • Dieting • Negative affect • Eating pathology

6. Literature Review • Computer search (1980-2003) • PsychINFO • MEDLINE • Dissertation Abstracts International • Cumulative index to nursing and Allied Health Literature • Key word: Eating disorder, eating pathology, anorexia, anorexic, bulimia, bulimic, binge eating, prevention, preventive, intervention

7. Literature Review • Table of contents from related journals • International Journal of Eating Disorders, Journal of Consulting and Clinical Psychology… • Reference sections of all identified articles, chapters and books • Researcher’s unpublished work • Found Studies that met criteria • 60 separate effect sizes

8. Inclusion/Exclusion Rules • Included both trials that tested for intervention effects on eating pathology and those that focused on intervention effects on risk factors that have been established as predictors of eating pathology • Must have random assignment to group and control group • Must know if experimental group effects were significantly different from the control group effects • Must include a minimum of 10 trials

9. Potential Moderators • Target audience • Method of presentation • Age of participants • Gender composition of group • Number of sessions • Program content • Validity of scales used

10. Results: Knowledge Average Effect Size at termination: .30* Χ2 (15, N= 16)= 190.52* Moderators: none Average Effect Size at Follow-Up: .29* Χ2 (12, N= 13)= 97.76* Moderators: none

11. Results: Body Mass Average Effect Size at termination: .12* Χ2 (10, N= 11)= 25.95* Average Effect Size at Follow-Up: .05 Χ2 (10, N= 11)= 18.26, ns

12. Results: Thin-Ideal Internalized Average Effect Size at termination: .30* Χ2 (15, N= 16)= 190.52* Average Effect Size at Follow-Up: .15 Χ2 (16, N= 17)= 25.88, ns

13. Results: Body Dissatisfaction Average Effect Size at termination: .13* Χ2 (45, N= 46)= 85.02* Average Effect Size at Follow-Up: .12* Χ2 (36, N= 37)= 76.11*

14. Results: Dieting Average effect size at termination= .11* Χ2 (32, N= 33)= 59.76* Average effect size at follow-up= .11* Χ2 (31, N= 32)= 66.58*

15. Results: Negative Affect Average effect size at termination= .14* Χ2 (33, N= 32)= 77.41* Average effect size at follow-up= .09* Χ2 (22, N= 23)= 27.04, ns

16. Results: Eating Pathology Average effect size at termination= .12* Χ2 (38, N= 39)= 83.11* Average effect size at follow-up= .12* Χ2 (27, N= 28)= 42.81*

17. Conclusions/Recommendations • There may be multiple approaches that prevent eating pathology • Better outcomes for: • High-risk participants • Interactive programs • Participants who were 15+ years old • Female only programs • Multiple sessions • Studies that used validated measures • If the best intervention was used, 60,157 cases of pathology could be prevented