Efficacy Trial of a Selective Prevention Program Targeting Both Eating Disorders and Obesity Among Female College Students: 1- and 2-Year Follow-Up Effects

Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 12/2012; 81(1). DOI: 10.1037/a0031235
Source: PubMed


Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1- and 2-year follow-ups.

Female college students at risk for these outcomes because of body image concerns (N = 398) were randomized to the Healthy Weight 2 group-based 4-hr prevention program, which promotes lasting healthy improvements to dietary intake and physical activity and nutrition science health behavior change principles, or an educational brochure control condition.

Intervention participants showed significantly less body dissatisfaction and eating disorder symptoms and lower eating disorder onset through 2-year follow-up versus controls, but the former 2 effects were small. There were no main effects for body mass index (BMI), depressive symptoms, dieting, caloric intake, physical activity, or obesity onset. Moderator analyses revealed stronger eating disorder symptom effects for youths with initially elevated symptoms and lower pressure to be thin, stronger BMI effects for youths with initially elevated symptoms and BMI scores, and weaker eating disorder symptom effects for youths with initially elevated pressure to be thin.

The 60% reduction in eating disorder onset over the 2-year follow-up was clinically significant and a novel effect for a prevention program, but the main effects on continuous outcomes were small, suggesting that adding nutrition science principles weakened the intervention efficacy. Effects on both eating disorder symptoms and BMI were greater for those with elevated eating disorder symptoms and BMI at pretest, implying that it might be useful to target these individuals in future trials.

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Available from: Paul Rohde, Dec 29, 2014
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    • "To our knowledge, risk and maintenance factors for LOC eating (as opposed to binge eating) have not been identified. Factors that previously have been associated with onset of binge eating include starting BMI, depressive symptoms, body dissatisfaction, and dietary restraint; BMI, depressive symptoms, and body dissatisfaction have shown relations with change in binge eating over time (Bearman, Stice, & Chase, 2003; Stice et al., 2013). Although these factors primarily have been examined with respect to bulimic symptoms, binge-eating disorder diagnosis, or objective binge eating only (vs. "
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    ABSTRACT: Objective: The subjective feeling of loss of control (LOC) over eating is common among eating-disordered individuals and has predicted weight gain in past research. Restrained eating and negative affect are risk factors for binge eating (which involves LOC), but intense feelings of pleasure derived from palatable foods might also predict the emergence or intensification of LOC eating. The Power of Food Scale (PFS) assesses preoccupation with the pleasure derived from palatable food. Method: The current sample (n = 294) comprised female college freshmen at risk for weight gain. LOC was assessed using an abbreviated version of the Eating Disorders Examination interview. LOC was assessed at baseline and at 6-week and 12- and 24-month follow-ups. Results: Among those exhibiting LOC eating at baseline (and controlling for baseline depression, restrained eating, and body image dissatisfaction), those scoring higher on the PFS at baseline showed a smaller reduction in LOC frequency over time relative to those scoring lower. Using the same covariates, the PFS predicted the first emergence of LOC over 2 years among those showing no LOC at baseline. Conclusions: These results suggest that powerful hedonic attraction to palatable foods may represent a risk factor for the maintenance of LOC in those initially experiencing it and the emergence of LOC eating in those who are not. An enhanced ability to identify individuals at increased risk of developing or maintaining LOC eating could be useful in prevention programs. (PsycINFO Database Record
    Full-text · Article · Dec 2015 · Health Psychology
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    • "The authors also found that reductions in body dissatisfaction were greater for young adults and older adolescents than for younger adolescents. These findings are compatible with the conclusions of the meta-analytic reviews reported previously[48],[49] and with many studies that report greater treatment effects in those with elevated symptoms at baseline.[52],[55],[56] Furthermore, programs that produce a higher level of cognitive dissonance (i.e., those that require increased effort to complete tasks, that expect public reporting of dissonant opinions, etc.) tend to produce greater reductions in eating disorder symptoms from pre-to-post-test than programs that have less intensive methods of generating cognitive dissonance,[57],[58] but these differences did not persist at the 3-month follow-up.[58] "
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    ABSTRACT: Eating disorders are common, life-threatening conditions in Western countries, but until relatively recently they were regarded as uncommon in non-Western cultures. However, the prevalence of eating disorders in many of the more affluent non-Western countries is rising rapidly as community members, particularly young women, internalize the 'thin ideal' that has been widely promoted by the international media. This review discusses the factors involved in the development of eating disorders in non-Western settings with a particular emphasis on the influences of urbanization, modernization, Westernization, and the resulting changes in women's roles. The cognitive dissonance programs developed in Western countries that have proven successful in countering the negative effects of the thin idea are described and their potential application to East Asia and other non-Western countries are discussed.
    Full-text · Article · Dec 2013 · Shanghai Archives of Psychiatry
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    • "Wilksch and Wade (2013) present a prevention model that is based on shared risk factors for obesity and eating disorders. Similar models have been examined in several studies of college students (e.g., Stice, Rohde, Shaw, & Marti, 2012), but rarely have been investigated in youth. In their study, five seventh-grade classrooms were randomized to either Life Smart or a classroom control. "

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