Cited by 510Eating Disorders and BehaviorsNutrition, Health and Food BehaviorAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Eating disorder prevention programs: A meta-analytic review.

Stice, Eric, Shaw, Heather·2004·Psychological Bulletin

DOI 10.1037/0033-2909.130.2.206

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Abstract

This meta-analysis of eating disorder prevention programs found that intervention effects ranged from an absence of any effects to reductions in current and future eating pathology. Certain effects persisted as long as 2 years and were superior to minimal-intervention control conditions. Larger effects occurred for selected (vs. universal), interactive (vs. didactic), and multisession (vs. single session) programs; for programs offered solely to females and to participants over age 15; for programs without psychoeducational content; and for trials that used validated measures. The results identify promising prevention programs and delineate sample, format, and design features that are associated with larger effects, but they suggest the need for improved methodological rigor and statistical modeling of trials and enhanced theoretical rationale for interventions.

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“Considering that programs with a shorter duration tend to have larger effects and the reported frustration with replaying already completed content suggests that shorter duration play time with Dojomight be more effective [71,72].”
Background
The Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ-3): reliability and normative comparisons of eating disordered patients
Calogero, R. M., Davis, W. N., & Thompson, J. K. (2004) · Body Image · doi:10.1016/j.bodyim.2004.01.004 · Cited by 124
Eating Disorder Prevention Research: A Meta-Analysis
Fingeret, M. C., Warren, C. S., Antonio Cepeda-benito, A., & Gleaves, D. H. (2006) · Eating Disorders · doi:10.1080/10640260600638899 · Cited by 113
“Stice and Shaw (2004) recognized the importance of reviewing and analyzing data from eating disorder prevention studies with objective meta-analytic procedures.”
Background
The Impact of Western Beauty Ideals on the Lives of Women: A Sociocultural Perspective
Calogero, R. M., Boroughs, M., & Thompson, J. K. (2007) · Palgrave Macmillan UK eBooks · doi:10.1057/9780230596887_13 · Cited by 129
Effects of a Weight Maintenance Diet on Bulimic Symptoms in Adolescent Girls: An Experimental Test of the Dietary Restraint Theory.
Stice, E. M., Presnell, K. E., Groesz, L. M., & Shaw, H. E. (2005) · Health Psychology · doi:10.1037/0278-6133.24.4.402 · Cited by 114
Self-citation
Is BodyThink an efficacious body image and self-esteem program? A controlled evaluation with adolescents
Richardson, S. M., Paxton, S. J., & Thomson, J. S. (2009) · Body Image · doi:10.1016/j.bodyim.2008.11.001 · Cited by 110
Interventions aimed at reducing obesity in early childhood: a meta‐analysis of programs that involve parents
Yavuz, H. M., van IJzendoorn, M. H., Mesman, J., & van der Veek, S. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12330 · Cited by 118
The impact of thin models in music videos on adolescent girls’ body dissatisfaction
Bell, B. T., Lawton, R., & Dittmar, H. (2007) · Body Image · doi:10.1016/j.bodyim.2007.02.003 · Cited by 109
Interpersonal influences on late adolescent girls' and boys' disordered eating
Shomaker, L. B., & Furman, W. C. (2009) · Eating Behaviors · doi:10.1016/j.eatbeh.2009.02.003 · Cited by 107
Body Image Disturbance and The Social Norms Approach: An Integrative Review of the Literature
Bergstrom, R. L., & Neighbors, C. (2006) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2006.25.9.975 · Cited by 116
The Role of Teachers and Other Educators in the Prevention of Eating Disorders and Child Obesity: What Are the Issues?
Yager, Z., & Dea, J. A. O. (2005) · Eating Disorders · doi:10.1080/10640260590932878 · Cited by 105
“Although research into eating disorder programs confirms that planned interventions to date have not been iatrogenic ( Stice & Shaw, 2004 ), the potential for adverse effects from unplanned, unsupervised, and unproven programs is still a matter of concern.”
Background
A randomized controlled trial of a peer co-led dissonance-based eating disorder prevention program for gay men
Brown, T. A., & Keel, P. K. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.08.008 · Cited by 103
“…internalization among gay men, DB programs were developed from the dual-pathway model to target thin-ideal internalization for young women (Stice et al., 1996; Stice, 2001) and have become one of themore innovative and promising classes of eating disorder prevention programs (Stice & Shaw, 2004).”
Background
Empirically evaluated treatments for body image disturbance: a review
Farrell, C., Shafran, R., & Lee, M. (2006) · European Eating Disorders Review · doi:10.1002/erv.693 · Cited by 103
Eating Disorder Prevention: An Experimental Comparison of High Level Dissonance, Low Level Dissonance, and No-Treatment Control
Green, M., Scott, N. A., Diyankova, I. V., & Gasser, C. E. (2005) · Eating Disorders · doi:10.1080/10640260590918955 · Cited by 102
Effectiveness of a Computer-Based Interactive Eating Disorders Prevention Program at Long-Term Follow-Up
Graff Low, K., Charanasomboon, S., Lesser, J., Reinhalter, K., Martin, R., Jones, H., Winzelberg, A., Abascal, L., & Taylor, C. B. (2006) · Eating Disorders · doi:10.1080/10640260500403816 · Cited by 96
“…been identified, including internalization of the media-defined thin ideal (Thompson & Stice, 2001; Low, Charansomboon, Brown, Hiltunen, Long, & Reinhalter, 2003), weight concerns, poor body image (Stice & Shaw, 2004), and peer-induce pressure to diet (Leon, Fulkerson, Perry, & Early-Zald, 1995).”
Background
Exploring the integration of thin-ideal internalization and self-objectification in the prevention of eating disorders
Diest, A. M. K. V., & Pérez, M. (2012) · Body Image · doi:10.1016/j.bodyim.2012.10.004 · Cited by 96
A Preliminary Controlled Comparison of Programs Designed to Reduce Risk of Eating Disorders Targeting Perfectionism and Media Literacy
Wilksch, S. M., Durbridge, M., & Wade, T. D. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e3181799f4a · Cited by 96
Negative emotions and emotional eating: the mediating role of experiential avoidance
Litwin, R., Goldbacher, E. M., Cardaciotto, L., & Gambrel, L. E. (2017) · Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity · doi:10.1007/s40519-016-0301-9 · Cited by 94
Hypocrisy, dissonance and the self-regulation processes that improve health
Stone, J., & Focella, E. S. (2011) · Self and Identity · doi:10.1080/15298868.2010.538550 · Cited by 94
“In a recent meta-analytic review of 16 clinical trials, Stice and Shaw (2004) reported that, compared to other interventions and control conditions, the dissonance-based intervention showed stronger reduction of eating disorder risk factors and symptoms, lower risk for onset of the disorder, and…”
Background
Interpersonal and Self-regulation Determinants of Healthy and Unhealthy Eating Behavior in Adolescents
Kalavana, T. V., Maes, S., & Gucht, V. D. (2010) · Journal of Health Psychology · doi:10.1177/1359105309345168 · Cited by 105
Longitudinal Associations Among Bullying by Peers, Disordered Eating Behavior, and Symptoms of Depression During Adolescence
Lee, K. S., & Vaillancourt, T. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.0284 · Cited by 105
Dieting, overweight, and obesity: Self-regulation in a food-rich environment.
Stroebe, W. (2008) · American Psychological Association eBooks · doi:10.1037/11753-000 · Cited by 92
Identifying the eating disorder symptomatic in China: the role of sociocultural factors and culturally defined appearance concerns
Jackson, T., & Chen, H. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.09.010 · Cited by 89
A comparison of mindfulness, nonjudgmental, and cognitive dissonance-based approaches to mirror exposure
Luethcke, C. A., McDaniel, L., & Becker, C. B. (2011) · Body Image · doi:10.1016/j.bodyim.2011.03.006 · Cited by 84
“Eating disorder prevention programs overall have produced mixed findings for body image improvement and maintenance of the improvement at follow-up (Paxton, 2002; Stice & Shaw, 2004).”
Background
Do adherence variables predict outcome in an online program for the prevention of eating disorders?
Manwaring, J. L., Bryson, S. W., Goldschmidt, A. B., Winzelberg, A. J., Luce, K. H., Cunning, D., Wilfley, D. E., & Taylor, C. B. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.2.341 · Cited by 73
“…Clinical Psychology Copyright 2008 by the American Psychological Association 2008, Vol. 76, No. 2, 341–346 0022-006X/08/$12.00 DOI: 10.1037/0022-006X.76.2.341 341 undertaken, with results indicating modest success (Stice & Shaw, 2004; Taylor, Bryson, Luce, Cunning, Celio, Abascal, et al., 2006).”
Influential
The Construction of the Adolescent Male Body through Sport
Ricciardelli, L. A., McCabe, M. P., & Ridge, D. (2006) · Journal of Health Psychology · doi:10.1177/1359105306065018 · Cited by 81
Future Directions in Etiologic, Prevention, and Treatment Research for Eating Disorders
Stice, E. M., South, K., & Shaw, H. E. (2012) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.728156 · Cited by 81
“…individuals (vs. a universal population) with interactive exercises that focus on risk factors known to predict onset of eating pathology (e.g., body dissatisfaction), that are multisession (vs. single session), and that have used validated outcomes (Stice & Shaw, 2004; Stice, Shaw, & Marti, 2007).”
BackgroundSelf-citation
Evaluation of an intervention targeting both depressive and bulimic pathology: A randomized prevention trial
Bearman, S. K., Stice, E. M., & Chase, A. (2003) · Behavior Therapy · doi:10.1016/s0005-7894(03)80001-1 · Cited by 82
“Second, there is a general trend for selected prevention programs to produce larger intervention effects relative to universal prevention programs (Stice, 2003).”
BackgroundSelf-citation
An Examination of Psychosocial Correlates of Eating Disorders Among Female Collegiate Athletes
Petrie, T. A., Greenleaf, C. A., Reel, J. J., & Carter, J. E. (2009) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2009.10599601 · Cited by 80
“Body image groups that focus on decreasing internalization and the effects of societal pressures may be an effective intervention strategy (e.g., Stice & Shaw, 2004) with female athletes, as initial research indicates that they show promise (Smith & Petrie, 2008).”
Background

Authors: Stice, E., & Shaw, H.
Affiliations: The University of Texas at Austin (US)
ORCID: Stice, Eric
Shaw, Heather
Venue: Psychological Bulletin
Publisher: American Psychological Association (APA)
Published: 2004
Volume: 130
Issue: 2
Pages: 206-227
ISSN: 0033-2909 (ISSN-L)
1939-1455
DOI: 10.1037/0033-2909.130.2.206
OpenAlex: W2135258436
Cited by: 510
References: 110
Citations by year: 2026: 6 · 2025: 3 · 2024: 8 · 2023: 14 · 2022: 17 · 2021: 17 · 2020: 11 · 2019: 20 · 2018: 16 · 2017: 22 · 2016: 26 · 2015: 26 · 2014: 26 · 2013: 25 · 2012: 27
FWCI: 5.83
Type: journal article
Language: en
Open access: closed
Locations: Psychological Bulletin (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (MH 01708, MH64560, K01MH001708, MH/DK61957, R01MH064560)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: eating disorder prevention, prevention programs, eating pathology, psychoeducation, intervention effects, methodological quality, trial design, theoretical rationale
MeSH terms: Feeding and Eating Disorders, Female, Humans, Male, Mental Health Services, Program Evaluation

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Eating disorder prevention programs: A meta-analytic review.

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