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Eating disorder prevention programs: A meta-analytic review.
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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“although meta-analyses on other problems such as smoking and eating disorder suggested superior effects for longer interventions to very brief interventions”
From Meta-analytic review of online guided self-help interventions for depressive symptoms among college students (2021) · cites this paper as Stice and Shaw, 2004
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“Early intervention programs targeting depression and other mental health-related problems have reported a reduction in efficacy from post-intervention to follow-up [10, 59].”
From Acceptance and commitment therapy universal prevention program for adolescents: a feasibility study. (2017) · cites this paper as [59]
In the citing paper
“research suggests that compared to teacher-led programs, psychologist facilitated programs have better outcomes [59, 61].”
From Acceptance and commitment therapy universal prevention program for adolescents: a feasibility study. (2017) · cites this paper as [59]
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BackgroundHow can we improve dissemination of universal eating disorder risk reduction programs?
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“All intervention programs should be addressed to associoenvironmental (family functioning, weight-related behaviors of family and peers) as well as personal factors (34, 35).”
BackgroundHow Do Psychology Researchers Find Studies to Include in Meta-Analyses?
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“Stice and Shaw (2004) conduct a meta-analysis of 51 eating disorder intervention programs and conclude that combining proper message contents with the optimal delivery format and audience characteristics will produce the most effective eating disorder prevention programs.”
BackgroundInfluentialHeron, K. E. (2011) · Syracuse University Libraries (Syracuse University) · Cited by 8
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“For example, (Stice & Shaw, 2004) provided meta-analytic evidence on the use of a proximal approach called dissonance-based interventions (DBI) which encourages individuals to adopt a way of thinking which contradicts their current way of thinking (e.g. challenging social constructions of ‘beauty’…”
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“Meta-analytic studies report that selective ED prevention programs yield superior post-intervention effects when compared to universal prevention for the reduction of negative affect, eating pathology, and dieting (Fingeret et al., 2006; Stice & Shaw, 2004).”
BackgroundWick, K., Leipold-Haas, S., Dye, L., & Strauss, B. M. (2012) · Kindheit und Entwicklung · doi:10.1026/0942-5403/a000088 · Cited by 7
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“Furthermore, the design of the study integrated the suggestions set forth by Stice and Shaw (2004) that are summarized above.”
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“2021 Taylor & Francis Group, LLC mental health (Stice & Shaw, 2004).”
Lyles, A. A. (2014) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2014.07.004 · Cited by 6
“In addition, universal prevention programs have demonstrated favorable outcomes among girls but not boys (Goran & Reynolds, 2005; Mo-suwan, Pongprapai, Junjana, & Puetpaiboon, 1998; Plachta-Danielzik et al., 2007; Stice & Shaw, 2004).”
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“As for new research directions, moderator analyses (e.g. Stice & Shaw, 2004) have supported selective rather than universal strategies, and have related a probability of success to limiting the target group to female participants above 15 years of age, to the use of multisession approaches focusing…”
BackgroundAlman, J., Hoiles, K. J., Watson, H. J., Egan, S. J., Hamilton, M. P., McCormack, J., Potts, J., Forbes, D., & Shu, C. Y. (2014) · Journal of Eating Disorders · doi:10.1186/s40337-014-0032-0 · Cited by 6
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BackgroundExamining the link between weight suppression and non-suicidal self-injurious behaviors
Keel, P. K., Forney, K. J., Buchman‐Schmitt, J. M., Kennedy, G. A., & Joiner, T. E. (2018) · Eating Behaviors · doi:10.1016/j.eatbeh.2018.06.001 · Cited by 6
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“However, Stice and Shaw [13] suggested programs might be more effective with older participants and only females.”
BackgroundInfluentialRisikofaktoren und Präventionsmaßnahmen bei Essstörungen
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“Body dissatisfaction is probably the strongest predictor of unhealthy weight control practices and other disordered eating behaviors (23,24).”
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de León, M. D. C. E. P., Ruíz, E. J. C., Hernández, G., & Mejía-Castrejón, J. (2010) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.22201/fesi.20071523e.2010.2.11 · Cited by 3
“Es importante destacar que los programas de prevención interactivos vs didácticos pueden tener más efectos positivos en los participantes (Stice & Shaw, 2004).”
BackgroundKilpela, L. S., Hopkins, L. B., Alley, M. C., Presnell, K. E., McGinley, J., & Becker, C. B. (2014) · Advances in Eating Disorders · doi:10.1080/21662630.2014.957338 · Cited by 3
“CD interventions have demonstrated both efficacy and effectiveness across numerous trials, even across independent laboratories, and they have outperformed alternative interventions (Shaw et al., 2008; Stice, Becker, & Yokum, 2013; Stice & Shaw, 2004; Stice et al., 2007).”
BackgroundEvidence That Frame of Reference Effects Can Reduce Socially Prescribed Perfectionism
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“These prevention and early intervention strategies have opposing messages; ED prevention/intervention strategies reduce emphasis on weight (Stice and Shaw, 2004), but obesity prevention strategies often encourage daily weighing (Oude Luttikhuis et al.”
BackgroundFeminist Multicultural Perspectives on Body Image and Eating Disorders in Women
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“There is some experience that shows how this type of interventions can be useful in the preventive field [14], favoring the understanding of the disease, learning self-care skills, improving health status, reducing the use of health care and minimizing the general burden of the condition [15, 16].”
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“Body image concerns are associated with several negative outcomes for physical health [disordered eating/exercise [2, 3] and psychological wellbeing [low self-esteem, negative affect [3, 4] and are a primary modifiable risk and maintenance factor for eating disorders [5, 6].”
BackgroundA Meta-Analysis of School-Based Depression Prevention Programs for Children and Adolescents
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“E-mail: ldamour@laurelschool.org 76 the individual’s knowledge base, attitude, and/or behavior (Stice & Shaw, 2004).”
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“The moderate effect size (η = .11) is substantial compared to previous prevention programs for body dissatisfaction, which have generally produced small effects (Stice & Shaw, 2004).”
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“However, consistent with the discovery that older prevention programs were less effective when they stressed ED education 25,26,72 our data, contrary to prediction, showed no relationship between college history of ED education and EDR.”
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Бабчук, М. І., Бабчук, О. Г., Asieieva, Y., Вдовіченко, О., & Мельничук, І. Я. (2023) · Revista Amazonia Investiga · doi:10.34069/ai/2023.66.06.16 · Cited by 4
“The works of several authors have shown a positive correlation between body dissatisfaction and negative affect (Morey & Morey, 1987; Stice & Bearman, 2001; Stice & Shaw, 2004), as well as depressive symptoms (Morey & Morey, 1991; Stice, Hayward, Cameron, Killen & Taylor, 2000).”
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“Also, most dissonance based programs minimize the use of didactic techniques, as they are less effective than interactive techniques in changing thoughts and behaviors (Stice & Shaw, 2004; Stice, Shaw et al., 2007; Stice et al., 2003).”
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“…results with respect to knowledge acquisition, there is a need to further develop, improve, and evaluate such programs with respect to their impact on participants’ attitudes and behaviors (Cororve Fingeret,Warren, Cepeda-Benito, & Gleaves, 2006; Stice & Shaw, 2004; Stice, Shaw, &Marti, 2007).”
BackgroundAppearance Concerns, Dietary Restriction, and Disordered Eating
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“Despite the lack of robust data supporting the effectiveness of eating disorder prevention programs, several studies have shown that media literacy and cognitive dissonance-based intervention approaches are more effective than psycho-educational approaches (Stice & Shaw, 2004; Yager & O’Dea, 2008).”
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“In a meta-analysis of eating disorder prevention and intervention programs, Stice and Shaw (2004) found that 53% of the interventions resulted in significant reductions in 4 at least one established risk factor for eating pathology, such as body dissatisfaction.”
BackgroundInfluentialDavey, M. R. (2012) · UC Research Repository (University of Canterbury) · doi:10.26021/9309 · Cited by 2
Storying "Recovery": Exploring the Narratives of Young Women in Eating Disorder Recovery
LaMarre, A. (2014) · The Atrium (University of Guelph) · Cited by 2
Study of effectiveness of prevention programs
Mihić, J. (2013) · Cited by 2
Hernández, R. C. L., García, J. E. D. A., Gómez‐Peresmitré, G., Acevedo, S. P., & Saldaña, R. M. E. G. (2022) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.22201/fesi.20071523e.2022.2.646 · Cited by 1
“…la técnica de disonancia cognitiva muestra los mejores resultados en población con riesgo de desarrollar una TCA en comparación prevención universal e indicada (Stice et al., 2004; 2019; Taylor, 2005; Watson et al., 2016; Le et al., 2017), dato que concuerda con los resultados del presente trabajo.”
-, A. G., & Goel, P. (2024) · International Journal For Multidisciplinary Research · doi:10.36948/ijfmr.2024.v06i04.24778 · Cited by 1
“School counselors should provide individual and group counseling to support students with body image concerns [45].”
BackgroundKatsiferis, A., Joensen, A., Petersen, L. V., Ekstrøm, C. T., Olsen, E. M., Bhatt, S., Nguyen, T., & Strandberg‐Larsen, K. (2025) · npj Mental Health Research · doi:10.1038/s44184-025-00179-x · Cited by 2
“The deployment of such validated prediction models in a clinical setting could further enhance the quality of selective prevention programs, the latter known to be more ef fi cient than universal ones for reducing eating pathologies 33 .”
Resende, T. R. O., Alvarenga, M. D. S., & de Carvalho, P. H. B. (2026) · Body Image · doi:10.1016/j.bodyim.2026.102129 · Cited by 1
Children's understandings of mediated health campaigns for childhood obesity
Babooram, M., Mullan, B. A., & Sharpe, L. (2010) · Nutrition & Food Science · doi:10.1108/00346651011043989 · Cited by 1
“…around education which has been repeatedly shown to be ineffective in eliciting long term behavioural change (Helweg-Larsen & Collins, 1997., Stice & Shaw, 2004, Snyder, 2007., Noar, 2006) campaigns do need to incorporate some active strategies to improve the likelihood of behavioural…”
BackgroundTAKE ACTION: A Multidisciplinary Lifestyle Intervention for Families in a Rural Community
Wapner, A. W., Bianco, J. A., Long, M., Kushnick, M. R., Brannan, G. D., & Shubrook, J. H. (2010) · Childhood Obesity · doi:10.1089/chi.2010.0508 · Cited by 1
Effect of Animated Movie in Combating Child Sleep Health Problems
Surani, S., Rao, S. K., Khimani, A., Surani, S. S., & Subramanian, S. (2014) · CHEST Journal · doi:10.1378/chest.1799668 · Cited by 1
Metadata
- Authors
- Stice, E., & Shaw, H.
- Affiliations
- The University of Texas at Austin (US)
- Venue
- Psychological Bulletin
- Published
- 2004
- Volume
- 130
- Issue
- 2
- Pages
- 206-227
- ISSN
- 0033-2909 (ISSN-L)
- 1939-1455
- 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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