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Cited by 171Eating Disorders and BehaviorsNutrition, Health and Food BehaviorBody Image and Dysmorphia Studies

Meta-analytic review of dissonance-based eating disorder prevention programs: Intervention, participant, and facilitator features that predict larger effects

Open access
Stice, Eric, Marti, C. Nathan, Shaw, Heather, Rohde, Paul·2019·Clinical Psychology Review
DOI 10.1016/j.cpr.2019.04.004PMC PMC6536334
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Abstract

Many trials have provided support for dissonance-based eating disorder prevention programs. This meta-analytic review characterized the average intervention effects and tested whether various intervention, participant, and facilitator features correlated with larger effects to guide implementation of optimally effective versions of this program. We identified 56 trials that evaluated 68 dissonance-based eating disorder prevention programs (7808 participants). Average intervention effect sizes (d) relative to minimal intervention control conditions and credible alternative interventions (respectively) were 0.57 and 0.31 for thin-ideal internalization, 0.42 and 0.18 for body dissatisfaction, 0.37 and 0.17 for dieting, 0.29 and 0.21 for negative affect, and 0.31 and 0.13 for eating disorder symptoms. As hypothesized, effects were larger for interventions with more dissonance-inducing activities, more group sessions, and larger group sizes, as well as when delivered in-person versus on-line, sessions were recorded, participation was voluntary, body dissatisfaction was required, participants were mid-adolescents or adults (versus older adolescence), there were more ethnic minority participants, groups were led by clinicians versus researchers and at least two facilitators, and when facilitators received more training and supervision. Unexpectedly from a dissonance-induction perspective, effects were larger when participants were compensated. Results offer directions for maximizing the benefits of implementation efforts with dissonance-based eating disorder prevention programs, and may hold lessons for preventing other public health problems with dissonance-based interventions.

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  • Programs focusing only on body image internalization are less effective than those also including media literacy, while dissonance-based prevention programs show more benefit.

    “Although programs focusing only on body image internalization are not as effective as those also including media literacy,321 more benefit has been found with dissonance-based prevention programs.322”

    From Digital Ecosystems, Children, and Adolescents: Technical Report (2026) · cites this paper as [322]

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Research works printed but not linked: 3

  1. Becker CB & Stice E (2008). Sorority Body Image Program: Group Leader Guide. New York: Oxford University Press.
  2. Krishna M (2011). The effectiveness of peer-led eating disorder prevention programs within the Dartmouth College sorority system. (Senior honors thesis). Dartmouth College.
  3. Wolfe JL (1992). Applying cognitive dissonance within a personal health curriculum to reduce risk factors associated with the development of eating disorders in a university population (Doctoral Dissertation). University of Georgia.

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Authors
Stice, E., Marti, C. N., Shaw, H., & Rohde, P.
Affiliations
Oregon Research Institute (US)
Corresponding author
Stice, Eric
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2019-06
Volume
70
Pages
91-107
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2019.04.004
PMC
PMC6536334
OpenAlex
W2938078844
Cited by
171
References
114
Citations by year
2026: 21 · 2025: 18 · 2024: 31 · 2023: 32 · 2022: 26 · 2021: 25 · 2020: 14 · 2019: 3 · 2018: 1
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
Keywords
dissonance-based intervention, eating disorder prevention, cognitive dissonance, thin-ideal internalization, body dissatisfaction, dieting, negative affect, eating disorder symptoms, intervention features, facilitator training, participant characteristics, participant compensation, adolescents
MeSH terms
Feeding and Eating Disorders, Cognitive Dissonance, Humans, Outcome and Process Assessment, Health Care

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