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Prevention Across the Spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity

Published online by Cambridge University Press:  19 December 2014

S. M. Wilksch ,
S. J. Paxton ,
S. M. Byrne ,
S.B. Austin ,
S. A. McLean ,
K. M. Thompson ,
K. Dorairaj  and
T. D. Wade
S. M. Wilksch*
Affiliation:
School of Psychology, Flinders University, SA, Australia
S. J. Paxton
Affiliation:
School of Psychological Science, La Trobe University, VIC, Australia
S. M. Byrne
Affiliation:
School of Psychology, University of Western Australia, WA, Australia
S.B. Austin
Affiliation:
Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
S. A. McLean
Affiliation:
School of Psychological Science, La Trobe University, VIC, Australia
K. M. Thompson
Affiliation:
School of Psychology, University of Western Australia, WA, Australia
K. Dorairaj
Affiliation:
School of Psychology, University of Western Australia, WA, Australia
T. D. Wade
Affiliation:
School of Psychology, Flinders University, SA, Australia
*
* Address for correspondence: S. Wilksch, Ph.D., School of Psychology, Flinders University, GPO Box 2100, Adelaide, 5001 SA, Australia. (Email: [email protected])
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Abstract

Background

A randomized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors.

Method

A total of 1316 grade 7 and 8 girls and boys (mean age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; the Helping, Encouraging, Listening and Protecting Peers (HELPP) initiative; or control (usual school class). Risk factors were measured at baseline, post-program (5 weeks later), and at the 6- and 12-month follow-ups.

Results

Media Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at the 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up. Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys. A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up, while a main effect for group found Media Smart participants reported less screen time than controls.

Conclusions

Media Smart was the only program to show benefit on both disordered eating and obesity risk factors. Whilst further investigations are indicated, this study suggests that this program is a promising approach to reducing risk factors for both problems.

Keywords

Eating disordersobesitypreventionrisk factors
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 9 , July 2015 , pp. 1811 - 1823
Copyright
Copyright © Cambridge University Press 2014 

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References

Austin, SB (2011). The blind spot in the drive for childhood obesity prevention: bringing eating disorders prevention into focus as a public health priority. American Journal of Public Health 101, e1–e4.CrossRefGoogle ScholarPubMed
Austin, SB, Field, AE, Wiecha, J, Peterson, KE, Gortmaker, SL (2005). The impact of a school-based obesity prevention trial on disordered weight-control behaviors in early adolescent girls. Archives of Pediatrics and Adolescent Medicine 159, 225–230.CrossRefGoogle ScholarPubMed
Australian Curriculum, Assessment and Reporting Authority (2011). Guide to Understanding Index of Community Socio-Educational Advantage (ICSEA). Australian Curriculum Assessment and Reporting Authority: Sydney.Google Scholar
Becker, CB, Bull, S, Schaumberg, K, Cauble, A, Franco, A (2008). Effectiveness of peer-led eating disorders prevention: a replication trial. Journal of Consulting and Clinical Psychology 76, 347–354.CrossRefGoogle ScholarPubMed
Bird, EL, Halliwell, E, Diedrichs, PC, Harcourt, D (2013). Happy Being Me in the UK: a controlled evaluation of a school-based body image intervention with pre-adolescent children. Body Image 10, 326–334.CrossRefGoogle Scholar
Carter, FA, Bulik, CM (2008). Childhood obesity prevention programs: how do they affect eating pathology and other psychological measures. Psychosomatic Medicine 70, 363–371.CrossRefGoogle ScholarPubMed
Celio, AA, Bryson, S, Killen, JD, Taylor, C (2003). Are adolescents harmed when asked risky weight control behavior and attitude questions? Implications for consent procedures. International Journal of Eating Disorders 34, 251–254.CrossRefGoogle ScholarPubMed
Fairburn, CG, Beglin, SJ (1994). Assessment of eating disorders: interview or self-report questionnaire? International Journal of Eating Disorders 16, 363–370.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Field, AE, Austin, SB, Taylor, CB, Malspeis, S, Rosner, B, Rockett, HR, Gillman, MW, Colditz, GA (2003). Relation between dieting and weight change among preadolescents and adolescents. Pediatrics 112, 900–906.CrossRefGoogle ScholarPubMed
Field, AE, Camargo, CA, Taylor, CB, Berkey, CS, Colditz, GA (1999). Relation of peer and media influences to the development of purging behaviors among preadolescent and adolescent girls. Archives of Pediatrics and Adolescent Medicine 153, 1184–1189.CrossRefGoogle Scholar
Franko, DL, Striegel-Moore, RH, Thompson, D, Schreiber, GB, Daniels, SR (2005). Does adolescent depression predict obesity in black and white young adult women? Psychological Medicine 35, 1505–1513.CrossRefGoogle ScholarPubMed
Frost, RO, Marten, P, Lahart, C, Rosenblate, R (1990). The dimensions of perfectionism. Cognitive Therapy and Research 14, 449–468.CrossRefGoogle Scholar
Garner, DM, Olmstead, MP, Polivy, J (1983). Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders 2, 15–34.3.0.CO;2-6>CrossRefGoogle Scholar
González, M, Penelo, E, Gutiérrez, T, Raich, RM (2011). Disordered eating prevention programme in schools: a 30-month follow-up. European Eating Disorders Review 19, 349–356.CrossRefGoogle Scholar
Gortmaker, SLP, Peterson, KRDS, Wiecha, JP, Sobol, AMAM, Dixit, SP, Fox, MKMRD, Laird, NP (1999). Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Archives of Pediatrics and Adolescent Medicine 153, 409–418.CrossRefGoogle Scholar
Gowers, SG, Shore, A (2001). Development of weight and shape concerns in the aetiology of eating disorders. British Journal of Psychiatry 179, 236–242.CrossRefGoogle ScholarPubMed
Haines, J, Neumark-Sztainer, D, Eisenberg, ME, Hannan, PJ (2006). Weight teasing and disordered eating behaviors in adolescents: longitudinal findings from project EAT (Eating Among Teens). Pediatrics 117, e209–e215.CrossRefGoogle ScholarPubMed
Haines, J, Neumark-Sztainer, D, Wall, M, Story, M (2007). Personal, behavioral, and environmental risk and protective factors for adolescent overweight. Obesity 15, 2748–2760.CrossRefGoogle ScholarPubMed
Hallsworth, L, Wade, T, Tiggemann, M (2005). Individual differences in male body-image: an examination of self-objectification in recreational body builders. British Journal of Health Psychology 10, 453–465.CrossRefGoogle ScholarPubMed
Jacobi, C, Fittig, E (2010). Psychosocial risk factors for eating disorders. In The Oxford Handbook of Eating Disorders (ed. Agras, S.), pp. 123–136. Oxford University Press: New York.Google Scholar
Kovacs, M (1992). Children's Depression Inventory Manual. Multi-Health Systems: New York.Google Scholar
McKnight Investigators (2003). Risk factors for the onset of eating disorders in adolescent girls: results of the McKnight Longitudinal Risk Factor Study. American Journal of Psychiatry 160, 248–254.CrossRefGoogle Scholar
Neumark-Sztainer, D, Wall, MM, Haines, JI, Story, MT, Sherwood, NE, van den Berg, PA (2007). Shared risk and protective factors for overweight and disordered eating in adolescents. American Journal of Preventive Medicine 33, 359–369.CrossRefGoogle ScholarPubMed
Paxton, SJ, Eisenberg, ME, Neumark-Sztainer, D (2006). Prospective predictors of body dissatisfaction in adolescent girls and boys: a five-year longitudinal study. Developmental Psychology 42, 888.CrossRefGoogle Scholar
Pratt, BM, Woolfenden, SR (2002). Interventions for preventing eating disorders in children and adolescents. The Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD002891. doi:10.1002/14651858.CD002891.CrossRefGoogle Scholar
Richardson, SM, Paxton, SJ (2010). An evaluation of a body image intervention based on risk factors for body dissatisfaction: a controlled study with adolescent girls. International Journal of Eating Disorders 43, 112–122.CrossRefGoogle ScholarPubMed
Shisslak, CM, Renger, R, Sharpe, T, Crago, M, McKnight, KM, Gray, N, Bryson, S, Estes, LS, Parnaby, OG, Killen, J, Taylor, CB (1999). Development and evaluation of the McKnight Risk Factor Survey for assessing potential risk and protective factors for disordered eating in preadolescent and adolescent girls. International Journal of Eating Disorders 25, 195–214.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Stice, E (2001). A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology 110, 124–135.CrossRefGoogle ScholarPubMed
Stice, E, Marti, C, Spoor, S, Presnell, K, Shaw, H (2008). Dissonance and healthy weight eating disorder prevention programs: long-term effects from a randomized efficacy trial. Journal of Consulting and Clinical Psychology 76, 329–340.CrossRefGoogle ScholarPubMed
Stice, E, Presnell, K, Shaw, H, Rohde, P (2005). Psychological and behavioral risk factors for obesity onset in adolescent girls: a prospective study. Journal of Consulting and Clinical Psychology 73, 195–202.CrossRefGoogle ScholarPubMed
Stice, E, Shaw, H, Marti, CN (2007). A meta-analytic review of eating disorder prevention programs: encouraging findings. Annual Review of Clinical Psychology 3, 207–231.CrossRefGoogle ScholarPubMed
Stice, E, Ziemba, C, Margolis, J, Flick, P (1996). The dual pathway model differentiates bulimics, subclinical bulimics, and controls: testing the continuity hypothesis. Behavior Therapy 27, 531–549.CrossRefGoogle Scholar
Taylor, C, Bryson, S, Luce, KH, Cunning, D, Doyle, AC, Abascal, LB, Rockwell, R, Dev, P, Winzelberg, AJ, Wilfley, DE (2006). Prevention of eating disorders in at-risk college-age women. Archives of General Psychiatry 63, 881–888.CrossRefGoogle ScholarPubMed
Thompson, J, van den Berg, P, Roehrig, M, Guarda, AS, Heinberg, LJ (2004). The Sociocultural Attitudes Towards Appearance Scale-3: development and validation. International Journal of Eating Disorders 35, 293–304.CrossRefGoogle ScholarPubMed
Van Strien, T, Frijters, JE, Bergers, GP, Defares, PB (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders 5, 295–315.3.0.CO;2-T>CrossRefGoogle Scholar
Wilksch, SM (2010). Universal school-based eating disorder prevention: benefits to both high- and low-risk participants on the core cognitive feature of eating disorders. Clinical Psychologist 14, 62–69.CrossRefGoogle Scholar
Wilksch, SM (2013). School-based eating disorder prevention: a pilot effectiveness trial of teacher-delivered Media Smart. Early Intervention in Psychiatry. Published online 04 07 2013 . doi:10.1111/eip.12070. Google ScholarPubMed
Wilksch, SM, Durbridge, M, Wade, TD (2008). A preliminary controlled comparison of programs designed to reduce risk for eating disorders targeting perfectionism and media literacy. Journal of the American Academy of Child and Adolescent Psychiatry 47, 939–947.CrossRefGoogle ScholarPubMed
Wilksch, SM, Tiggemann, M, Wade, TD (2006). Impact of interactive school-based media literacy lessons for reducing internalization of media ideals in young adolescent girls and boys. International Journal of Eating Disorders 39, 385–393.CrossRefGoogle ScholarPubMed
Wilksch, SM, Wade, TD (2009 a). School-based eating disorder prevention. In Treatment Approaches for Body Dissatisfaction and Eating Disorders: Evidence and Practice (ed. Paxton, S. J. and Hay, P. J.), pp. 7–22. IP Communications: Melbourne.Google Scholar
Wilksch, SM, Wade, TD (2009 b). Reduction of shape and weight concern in young adolescents: a 30-month controlled evaluation of a media literacy program. Journal of the American Academy of Child and Adolescent Psychiatry 48, 652–661.CrossRefGoogle Scholar
Wilksch, SM, Wade, TD (2012). Examination of the Sociocultural Attitudes Towards Appearance Questionnaire-3 in a mixed-gender young-adolescent sample. Psychological Assessment 24, 352–364.CrossRefGoogle Scholar
Wilksch, SM, Wade, TD (2013). Life Smart: a pilot study of a school-based program to reduce the risk of both eating disorders and obesity in young adolescent girls and boys. Journal of Pediatric Psychology 38, 1021–1029.CrossRefGoogle Scholar
Wilksch, SM, Wade, TD (2014). Depression as a moderator of benefit from a school-based eating disorder prevention program. Behaviour Research and Therapy 52, 64–71.CrossRefGoogle ScholarPubMed