Prevention of eating disorders: a systematic review and meta-analysis

Objective: To systematically reviewand quantify the effectiveness of Eating Disorder (ED) prevention interventions.
Methods: Electronic databases (including the Cochrane Controlled Trial Register,MEDLINE, PsychInfo, EMBASE, and
Scopus) were searched for published randomized controlled trials of ED prevention interventions from 2009 to
2015. Trials prior to 2009 were retrieved from prior reviews.
Results: One hundred and twelve articles were included. Fifty-eight percent of trials had high risk of bias. Findings
indicated small to moderate effect sizes on reduction of ED risk factors or symptoms which occurred up to threeyear
post-intervention. For universal prevention, media literacy (ML) interventions significantly reduced shape
and weight concerns for both females (−0.69, confidence interval (CI): −1.17 to −0.22) and males (−0.32, 95%
CI−0.57 to−0.07). For selective prevention, cognitive dissonance (CD) interventions were superior to control interventions
in reducing ED symptoms (−0.32, 95% CI−0.52 to−0.13). Cognitive behavioural therapy (CBT) interventions
had the largest effect size (−0.40, 95% CI−0.55 to−0.26) on dieting outcomeat 9-month follow-upwhile
the healthy weight intervention reduced EDrisk factors and body mass index.No indicated prevention interventions
were found to be effective in reducing ED risk factors.
Conclusions: There are a number of promising preventive interventions for ED risk factors including CD, CBT andML.
Whether these actually lower ED incidence is, however, uncertain. Combined ED and obesity prevention interventions
require further research.