Dissonance-based eating disorder prevention improves intuitive eating: a randomized controlled trial for Brazilian women with body dissatisfaction.

Thainá Richelli Oliveira Resende, Maurício Almeida, Marle Dos Santos Alvarenga, Tiffany A Brown, Pedro Henrique Berbert de Carvalho

Journal: Eating and weight disorders : EWD 2022;27(3):1099-1112

PMID: 34143404

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Abstract

PURPOSE

Investigate the efficacy of a dissonance-based (DB) intervention (i.e., the Body Project), during which some examples of intuitive eating were provided by peer leaders, in improving intuitive eating and targeting risk and protective factors for eating disorders (ED) among Brazilian women with body dissatisfaction.

METHODS

Participants were randomized to a four-session DB intervention (n = 38) or assessment-only control (AOC) (n = 36), and completed validated measures assessing intuitive eating, body appreciation, self-esteem, body-ideal internalization, body dissatisfaction, negative affect, and disordered eating pre-intervention, post-intervention, and at 4- and 24-week follow-ups.

RESULTS

The DB condition demonstrated significantly greater increases in intuitive eating, body appreciation and self-esteem scores compared to AOC from pre-intervention to post-intervention (between-condition Cohen's d = 0.73-0.98), 4-week (between-condition Cohen's d = 1.25-1.87) and 24-week follow-up (between-condition Cohen's d = 0.82-1.38). Also, the DB condition showed significantly greater decreases in body-ideal internalization, body dissatisfaction and disordered eating scores from pre-intervention to post-intervention (between-condition Cohen's d = 0.76-1.04), 4-week (between-condition Cohen's d = 1.27-1.71) and 24-week follow-up (between-condition Cohen's d = 1.04-1.19). Regarding negative affect, DB condition showed significantly greater reduction only at 24-week follow-up (between-condition Cohen's d = 0.60).

CONCLUSION

Results reinforce the efficacy of DB interventions in reducing ED risk factors for young women and support the preliminary efficacy of these programs in improving intuitive eating, body appreciation, and self-esteem.

LEVEL OF EVIDENCE

Level I, randomized controlled trial. ReBEC (Brazilian Registry of Clinical Trials; available at http://www.ensaiosclinicos.gov.br/ ) number of registration: RBR-2f57cs. Date of registration: June 1, 2020.

Address: NICTA, Body Image and Eating Disorders Research Group, Federal University of Juiz de Fora, 745, São Paulo Street, City Center, Governador Valadares, Brazil.; School of Public Health, Nutrition in Public Health Post Graduation Program, University of São Paulo, São Paulo, Brazil.; Department of Psychiatry, University of California San Diego, San Diego, CA, USA.; San Diego State University Research Foundation, San Diego, CA, USA.; NICTA, Body Image and Eating Disorders Research Group, Federal University of Juiz de Fora, 745, São Paulo Street, City Center, Governador Valadares, Brazil. [email protected].; AMBULIM, Eating Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. [email protected].

DOI: 10.1007/s40519-021-01245-x