Research review: Effectiveness of universal eating disorder prevention interventions in improving body image among children: A systematic review and meta-analysis
Abstract
Background Increasingly, children are at risk of developing eating disorders. A systematic review and a meta‐analysis were conducted to examine the effectiveness of universal eating disorder prevention interventions in improving body image, internalization of appearance ideals, and self‐esteem among children aged 5–17 years old. Methods Nine electronic databases were systematically searched from each database’s point of inception to March 2019. The Cochrane Risk of Bias tool assessed each study’s risk of bias, while the GRADE approach judged the overall evidence for each review outcome. A meta‐analysis was conducted using the random‐effect model to obtain standardized mean differences with 95% confidence intervals under the inverse variance method. Heterogeneity was assessed using I 2 statistic and Cochran’s Q chi‐squared test. Publication bias was assessed using funnel plots. Results A total of 24 studies (22 trials) were included in this review. Universal interventions were found to be effective in improving children’s body esteem, self‐esteem, and internalization of appearance ideals at postintervention and at follow‐up timepoints. Subgroup analyses found that girls benefited more from these interventions than boys. Multisessional interventions with an optimal duration of approximately one month were found to be more effective. Conclusions The findings encourage the incorporation of universal preventive interventions into school curricula to benefit most children. Laypeople such as teachers can deliver these interventions, but content experts should address topics on body dissatisfaction. Due to the low quality of evidence, as accorded by the GRADE approach, current findings should be validated by future research.
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Eating disorder prevention interventions are more beneficial for girls than boys.
“In line with the present study, eating disorder prevention interventions are more beneficial for girls than boys [18].”
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- Authors
- Chua, J. Y. X., Tam, W., & Shorey, S.
- Affiliations
- KK Women's and Children's Hospital (SG)
- National University of Singapore (SG)
- Corresponding author
- Shorey, Shefaly
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2019-11-19
- Volume
- 61
- Issue
- 5
- Pages
- 522-535
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2991650875
- Cited by
- 69
- References
- 70
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 11 · 2023: 14 · 2022: 10 · 2021: 14 · 2020: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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
- eating disorder prevention, body image, body esteem, self-esteem, internalization of appearance ideals, body dissatisfaction, children, school-based intervention, sex differences, intervention duration
- MeSH terms
- Body Dissatisfaction, Feeding and Eating Disorders, Body Image, Child, Curriculum, Humans, Schools
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