ED Prevention Programs

Nick Mazloum, Colin Gipson, and Jenny ChhoeupSan José State UniversityNUFS 124

Agenda

● What is Prevention?● What are the risk factors? Who

is most at risk?● Different levels and types of

prevention programs● Studies● Conclusion

What is Prevention?

● Any systematic effort to reduce risk factors that promote, initiate, prolongs, or increases issues, such as ED.

● Scientists believe that the key to preventing onset of ED, is to reduce the risk factors.

Risk Factors ● What are the risk factors?

○ Body dissatisfaction, depression, stress, basing self-esteem on appearance, lack of social support

● Who are most at risk?○ Adolescents (10-19 years old)○ Primarily young women

Risk Factors and Stages of Risk

● Predisposing Factors: Social Context, Individual Background

Social context, individual background

● Triggering Factors

Major life events

● Maintaining Factors

Biological and psychological

Adolescents and Statistics of Risk

● 13 % aged 12-14 and 16% aged 14-16 had elevated scores for disturbed eating behaviour (Jones et al. 2001)

● Various studies have shown that up to one quarter of boys and almost half of all girls try to lose weight by dieting (e.g. Aschenbrenner et al. 2004; Crowther et al. 2008; Ricciardelli et al. 2000; Warschburger 2009)

● Only one in three girls in 9th grade was satisfied with her figure

● One in three girls and one in six boys exhibited disordered eating patterns (KiGGS, Hölling and Schlack 2007) (Aschenbrenner et al. 2004; Buddeberg-Fischer and Reed 2001; Warschburger 2009)

Eating Disorders in Adulthood● Either early onset (which continues into adulthood) or late onset after adolescence

● late-life eating disorders ranges from 1.8% to 3.8% of population (PubMed)

● Binge Eating disorder most common among older adults

● Later life events such as divorce and marital conflicts are more likely to be risk factors than psychological and social factors which are major risk factors for adolescents

● Body dissatisfaction in middle aged women

Different Levels of Prevention

● Universal/Primary Prevention○ Goal: Prevent ED in the general population with varying degrees of risks.

■ ex.) Teaching about ED in a classroom.

● Selective Prevention○ Goal: Prevent ED through selecting individuals who do not have ED symptoms, but are at risk

for ED due to biological, psychological, or sociocultural risk factors.■ ex.) Educating adolescent girls who have a family history of ED.

● Indicated/Targeted Prevention○ Goal: Target individuals who are at high risk due to strong warning signs or risk factors (high

body dissatisfaction). Prevention is more individualized.■ Process is similar to a treatment plan.

https://www.nationaleatingdisorders.org/learn/general-information/prevention

Types of Prevention Interventions

● Mindfulness-Based Interventions ○ Involves “mental training”. Increase focus on

one’s feelings, thoughts, and bodily sensations.

○ Practice non-judgemental awareness and acceptance to reduce body dissatisfaction.

○ Increased levels of mindfulness has been shown to have positive correlation with body satisfaction (Liss & Erchull, 2015).

○ Examples: Yoga, meditation, Tai Chi, Breathing exercises, Raisin exercise

Types of Prevention Interventions● Cognitive-Dissonance-Based Interventions

○ Cognitive dissonance = going against a core belief

○ Incorporates verbal and behavioral exercises that encourage participants to challenge the thin-ideal ■ Ex. group discussions, critiquing

advertisements○ Have shown a 60% reduction in risk of

developing ED (Spice, Marti, Spoore, Presnell & Shaw, 2008).

○ Examples:■ The Body Project■ REbeL

“Pro-eating-disorder Websites and Subjective Well-Being”

● A Four-country study on young people ○ United States, Germany, the United Kingdom and Finland

What did this study examine?

● The association between exposure to pro-ED content online & subjective well-being (SWB) among adolescents and young adults.

● SWB = an individuals views about their psychological well-being, overall happiness, & appreciation for life.

Subjects:

● United States (n = 1,033) ● Finland (n = 555)● Germany (n = 978) ● United Kingdom (n = 999) ● Participants (n =3,557) were aged 15–30 (M = 22.80)● 50.15% were male.

Pro-ED Online Communities

● Encourage harmful weight-loss, weight-control practices, and disordered eating, such as anorexia nervosa (pro-ana) and bulimia nervosa (pro-mia)

● “Thinspiration”

● Offer a platform for openly & anonymously discussing issues related to ED’s, for gaining knowledge and support about losing weight.

● De-medicalizing ED’s & celebrating them as lifestyle choices is a practice often shared by pro-ED communities.

★ This study examines effects of pro-ED exposure among 4 countries, demonstrating varieties of social contexts.

Methods● Use of YouNet Surveys:

○ Online activity○ Online risks○ Harmful online material / victimization○ Offline interactions ○ Self-esteem○ Life satisfaction○ Social belonging

★ The totaled variable of SWB then formed a scoring scale of 2–20.

Findings and Conclusion

Exposure to Pro-ED content & weaker relations to primary social groups:

● Associated with lower well-being in adolescence and young adults● Can encourage harmful dieting among people with no history of eating disorders

★ It is important for health professionals and educators to stay aware of online communities that promote ED.

★ Intervention Strategy: promote positive peer support and the kind of online and offline discussions that aim for recovery. It may be necessary to regulate or restrict Internet and Social Media use.

Content Questions

1. What are the two types of prevention interventions? Describe them.

2. What kinds of exposure have you experienced to Pro-ED media, and what are other ways would you suggest to combat these influences?

3. Name one example from each of the major risk factor categories, and how do the risk factors for older adults differ from adolescents?

ReferencesAtkinson, M. J., & Wade, T. D. (2016). Does mindfulness have potential in eating disorders prevention? A preliminary controlled trial with young adult

women. Early Intervention in Psychiatry, 10(3), 234-245. 10.1111/eip.12160 Retrieved from http://libaccess.sjlibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=114189436&site=ehost-live&scope=site

Beccia, A. L., Dunlap, C., Hanes, D. A., Courneene, B. J., & Zwickey, H. L. (2018). Mindfulness-based eating disorder prevention programs: A systematic review and meta-analysishttps://doi.org/10.1016/j.mhp.2017.11.001

Breithaupt, L., Eickman, L., Byrne, C. E., & Fischer, S. (2017). REbeL peer education: A model of a voluntary, after-school program for eating disorder prevention. Eating Behaviors, 25, 32-37. 10.1016/j.eatbeh.2016.08.003 Retrieved from http://libaccess.sjlibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=123548124&site=ehost-live&scope=site

Stice, E., Marti, C. N., 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(2), 329–340. http://doi.org/10.1037/0022-006X.76.2.329

Liss, M., & Erchull, M. J. (2015). Not hating what you see: Self-compassion may protect against negative mental health variables connected to self-objectification in college womenhttps://doi.org/10.1016/j.bodyim.2015.02.006

Luca, A., Luca, M., & Calandra2, C. (2015). Eating Disorders in Late-life. Aging and Disease, 6(1), 48–55. http://doi.org/10.14336/AD.2014.0124

Neda Feeding Hope. (2018). Prevention. Retrieved from https://www.nationaleatingdisorders.org/learn/general-information/preventionWarschburger, P., Helfert, S., & Krentz, E. M. (2011). POPS: A school-based prevention programme for eating disorders. Journal

of Public Health, 19(4), 367-376. https://doi.org/10.1007/s10389-011-0425-3

Turja, T., Oksanen, A., Kaakinen, M., Sirola, A., Kaltiala-Heino, R., & Räsänen, P. (2017). Proeating disorder websites and subjective well-being: A four-country study on young people. International Journal Of Eating Disorders, 50(1), 50-57. doi:10.1002/eat.22589