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Psychol Med. 2018 Sep;48(12):2034-2044. doi: 10.1017/S0033291717003567. Epub 2017 Dec 13.

Online prevention of disordered eating in at-risk young-adult women: a two-country pragmatic randomized controlled trial.

Author information

School of Psychology,Flinders University,South Australia,Australia.
Department of Psychiatry,Stanford University Medical Center,Stanford,California,USA.
Department of Psychology,Washington University in St. Louis,St. Louis,Missouri,USA.
Institute of Clinical Psychology and Psychotherapy,Technische Universit├Ąt Dresden,Dresden,Germany.



Disordered eating (DE) is a widespread, serious problem. Efficacious prevention programs that can be delivered at-scale are needed.


A pragmatic randomized controlled trial of two online programs was conducted. Participants were young-adult women from Australia and New Zealand seeking to improve their body image. Media Smart-Targeted (MS-T) and Student Bodies (SB) were both 9-module interventions released weekly, whilst control participants received positive body image information. Primary [Eating Disorder Examination-Questionnaire (EDE-Q) Global], secondary (DE risk factors) and tertiary (DE) outcome measures were completed at baseline, post-program, 6- and 12-month follow-up.


Baseline was completed by 608 women (M age = 20.71 years); 33 were excluded leaving 575 randomized to: MS-T (N = 191); SB (N = 190) or control (N = 194). Only 66% of those randomized to MS-T or SB accessed the intervention and were included in analyses with controls; 78% of this sample completed measures subsequent to baseline. Primary intent-to-treat (ITT) analyses revealed no differences between groups, while measure completer analyses found MS-T had significantly lower EDE-Q Global than controls at 12-month follow-up. Secondary ITT analyses found MS-T participants reported significantly higher quality of life-mental relative to both SB and controls (6-month follow-up), while MS-T and controls had lower clinical impairment relative to SB (post-program). Amongst measure completers, MS-T scored significantly lower than controls and SB on 5 variables. Of those with baseline DE, MS-T participants were significantly less likely than controls to have DE at 12-month follow-up.


Given both programs were not therapist-moderated, MS-T has potential to achieve reductions in DE risk at low implementation costs.


Eating disorders; online; prevention; risk factors; targeted

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