Eating Disorders Prevention

Research estimates that 28.8 million Americans will have an eating disorder at some point in their lifetime. Of these, nearly two million cases will likely occur in children and adolescents younger than 20. The factors that contribute to developing an eating disorder tend to be complex. Research indicates that there are often biological, psychological, and societal risk factors involved. 

Studies show that prevention and early intervention programs can “significantly reduce some risk factors, promote early symptom recognition, and encourage help-seeking behavior for people with EDs (eating disorders)” in older adolescents and young adults. In this article, we look at various methods of eating disorder prevention and how to seek treatment, including therapy.

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Approaches to eating disorder prevention

According to the National Eating Disorders Association (NEDA), prevention scientists believe that reducing risk factors, strengthening resilience, and identifying and helping at-risk people are the keys to prevention. 

Reducing eating disorder risk factors

Some risk factors for developing eating disorders can be modifiable, and reducing them can help with prevention. For example, perfectionism, emotional dysregulation, and body image dissatisfaction can be seen as modifiable risk factors that may be addressed with psychotherapy and education.

Strengthening resilience against eating disorders

This approach generally involves strengthening protective factors, like high self-esteem, media literacy, coping and problem-solving skills, positive body image, and self-compassion. 

Identifying and helping those at risk

Identifying people who are at risk for developing eating disorders can help target those who could benefit from personalized intervention. To do this, it can be beneficial to understand the variety of risk factors that can contribute to developing an eating disorder, particularly those that are not modifiable. 

For example, some people who may be at risk include the following:

• Children of a parent with an eating disorder or another mental health condition
• People who have a personal history of mental health conditions
• Those with a history of substance misuse
• People with a personal history of trauma
• Those with limited social networks

Knowing the signs for which to look can identify those who may be helped through individualized interventions.

Levels of prevention

The above strategies for preventing eating disorders can be implemented in many ways. One proposed model for the prevention of mental health conditions that can apply to eating disorders focuses on universal, selective, and targeted prevention.

Universal prevention

Universal prevention typically focuses on preventative measures aimed at large populations. For eating disorders, this type of intervention may focus on the incoming freshman class at a large university or all teenagers in a specific city. The people in these groups usually have varying levels of risk, and prevention measures can be put in place through sweeping actions like changing policy and initiating education instead of focusing on specific risk factors. Universal prevention usually also involves advocating for changes in laws and cultural norms.

Selective prevention

Selective prevention is generally aimed at people who do not have eating disorders but are at risk of developing them. Selective prevention usually involves interactive, multisession education. It can take the form of presentations or classes for at-risk groups or education about the mental and physical implications of extreme dieting or disordered eating.

Targeted prevention

Targeted prevention is normally aimed specifically at people who are at high risk because they already have risk factors or some symptoms of eating disorders. This type of intervention can be aimed at individuals and small groups to improve coping skills, promote a balanced approach to eating habits and exercise, and improve self-esteem.

The Body Project

One intervention backed by several organizations and institutions is the Body Project, a group-based preventative intervention approach backed by 20 years of research. The Body Project was developed by researchers at the University of Texas at Austin, Stanford University, and the Oregon Research Institute and has been delivered to more than one million high school girls and college-aged women around the world. 

The Body Project generally provides a platform for girls and young women to talk about and address unrealistic beauty and body standards and develop self-esteem and a healthy body image. The program is primarily designed for girls and young women between ages 12 and 26 and can be implemented in various settings, including colleges, high schools, summer camps, scout troops, and community centers.

Although updated evidence may be needed, research has found that this type of intervention can be significantly more effective than others at preventing eating disorders. In Body Project sessions, a trained facilitator typically works with groups of at-risk girls and young women. 

During the first part of the program, groups may learn about and critique beauty and body standards idealizing thinness using activities like role-playing, discussions, and writing exercises. Group members may also focus on learning skills to strengthen resilience, like decreasing unhealthy efforts to lose weight, learning nutritious eating habits, and increasing body satisfaction.

The second part of the program usually helps girls and young women make lifestyle changes to achieve a healthy body weight, like learning how to make nutritious food choices and establishing safe exercise routines.

Body image, media, and literacy

Another aspect of eating disorder prevention is promoting media literacy. Comparison is often a factor in body dissatisfaction, and much of what is seen in the media promotes thinness as the ideal body standard. The celebrities and models commonly seen in magazines and movies do not usually accurately represent the average person, but projecting the idea that thin is the preferred body shape can make it difficult for people to accept their own bodies.

The internet has opened other opportunities for comparison as well. Photo editing can make it easy to manipulate images and eliminate flaws, while social media often gives us glimpses into curated representations of other people’s lives. Blogs and websites often perpetuate diet culture, with some promoting disordered eating as a lifestyle choice.

Being able to think critically about the accuracy of what is being presented in the media and online can help individuals protect against factors that contribute to eating disorders. Parents and older adults can help children look at images and societal body standards critically at a young age. Parents may influence their children to reject the pervasive standard of thinness in the media and online.

Is eating disorder prevention effective?

Getting professional support for eating disorders

Eating disorders can be preventable in some cases, but when prevention isn’t effective, recovery is possible. Treatment often varies depending on the specific eating disorder, its severity, and whether any other mental or physical health problems are present. Generally, treatment for eating disorders involves nutritional counseling, prescription medications for co-occurring mental health conditions, medical treatment for weight gain and to meet nutritional needs, and psychotherapy.

Psychotherapy can play a crucial role in the beginning of treatment and for long-term recovery. A licensed therapist can support someone with an eating disorder as they work to identify harmful thoughts and behaviors and manage the symptoms of comorbid mental health challenges, like anxiety and depression.

Consider online treatment

If you are recovering from an eating disorder or if you do not have a diagnosis but are concerned about your relationship with your body, food, and exercise, working with an online therapist can be an effective and convenient way to get support. 

With an online therapy platform like BetterHelp, you can work with a licensed mental health professional from the comfort of your home. Most people are matched with a provider within 48 hours of signing up, and you can change therapists at any time until you find one with whom you are comfortable. 

Research has found that online therapy can be an effective form of treatment for eating disorders. For example, a 2021 study found that online therapist-delivered cognitive behavioral therapy could have large effects on body dissatisfaction and eating disorder symptoms, and that these effects were sustained for at least one year post-treatment.