Anorexia and bulimia prevention programs: the most effective intervention

In a literature review of the effectiveness of eating disorders prevention programs in reducing abnormal eating, only 6 of 38 programs examined reduced current or future symptoms that persisted over follow-up (1 to 24 months later)(1).  Given the high status of skinny high-fashion models, one does not expect wonders from eating disorders prevention programs with respect to girls or women inspired by the thinness of high-fashion models and at risk for developing anorexia or bulimia.

On the other hand, the intervention shown to be the most effective at reducing eating disorders symptomatology in girls with body image issues is a cognitive dissonance-based program(2-8), though its level of effectiveness is still not high.  Cognitive dissonace-inducing activities involve participants critiquing the thin fashion ideal in the form of written essays, discussions and behavioral exercises.  The participants critically think about the thin fashion ideal with respect to its origin, perpetuation, impact, costs related to its pursuit and who profits from it.  The bright idea behind the program is that activities that involve critiquing the thin ideal will counter the fashion world promoting the thin ideal, and the resulting psychological discomfort will motivate the participants to find the thin ideal less appealing in order to restore cognitive consistency, which will result in less disordered eating. 

Guess what?  It should be obvious that imparting knowledge of the influence of gay fashion designers will dovetail with dissonance-inducing activities, and fatally undermine the belief that given the high status and lofty portrayal of skinny high-fashion models in the media, surely people in general find them to be attractive or else they wouldn’t end up where they are.  In other words, this site has been on the right track from the beginning.

References

1. Stice, E., and Shaw, H., Eating disorder prevention programs: a meta-analytic review, Psychol Bull, 130, 206 (2004).
2. Becker, C. B., Smith, L., and Ciao, A. C., Reducing eating disorder risk factors in sorority members: A randomized trial, Behavior Therapy, 36, 245 (2005).
3. Matusek, J. A., Wendt, S. J., and Wiseman, C. V., Dissonance thin-ideal and didactic healthy behavior eating disorder prevention programs: Results from a controlled trial, International Journal of Eating Disorders, 36, 376 (2004).
4. Stice, E., Chase, A., Stormer, S., and Appel, A., A randomized trial of a dissonance-based eating disorder prevention program, Int J Eat Disord, 29, 247 (2001).
5. Stice, E., Mazotti, L., Weibel, D., and Agras, W. S., Dissonance prevention program decreases thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms: A preliminary experiment, Int J Eat Disord, 27, 206 (2000).
6. Stice, E., Presnell, K., Gau, J., and Shaw, H., Testing mediators of intervention effects in randomized controlled trials: An evaluation of two eating disorder prevention programs, J Consult Clin Psychol, 75, 20 (2007).
7. Stice, E., Shaw, H., Burton, E., and Wade, E., Dissonance and healthy weight eating disorder prevention programs: a randomized efficacy trial, J Consult Clin Psychol, 74, 263 (2006).
8. Stice, E., Trost, A., and Chase, A., Healthy weight control and dissonance-based eating disorder prevention programs: results from a controlled trial, Int J Eat Disord, 33, 10 (2003).