Prevention of eating disorders: A systematic review of randomized, controlled trials.

PREVENTION of eating disorders; ANALYSIS of variance; EATING disorders; HEALTH; INFORMATION storage & retrieval systems; MEDICAL databases; MEDICAL information storage & retrieval systems; PSYCHOLOGY information storage & retrieval systems; MEDLINE; CLASSIFICATION of mental disorders; META-analysis; PROBABILITY theory; REGRESSION analysis; SYSTEMATIC reviews; BIBLIOGRAPHIC databases; EFFECT sizes (Statistics); NARRATIVES; RANDOMIZED controlled trials; DATA analysis software; MEDICAL coding; DESCRIPTIVE statistics; ODDS ratio; DISEASE risk factors

ABSTRACT Objective This systematic review evaluated the efficacy of universal, selective, and indicated eating disorder prevention. Method A systematic literature search was conducted in Medline, PsycINFO, Embase, Scopus, and the Cochrane Collaboration Library databases to January 2016. Studies were included if they were randomized, controlled trials (RCT) and tested an eating disorder prevention program. We retrieved 13 RCTs of universal prevention ( N = 3,989 participants, 55% female, M age = 13.0 years), 85 RCTs of selective prevention ( N = 11,949 participants, 99% female, M age = 17.6 years), and 8 RCTs of indicated prevention ( N = 510 participants, 100% female, M age = 20.1 years). Meta-analysis was performed with selective prevention trials. As there were a limited number of universal and indicated trials, narrative synthesis was conducted. Results Media literacy had the most support for universal prevention. Most universal approaches showed significant modest effects on risk factors. Dissonance-based was the best supported approach for selective prevention. Cognitive-behavior therapy (CBT), a healthy weight program, media literacy, and psychoeducation, were also effective for selective prevention and effects were maintained at follow-up. CBT was supported for indicated prevention and effects were maintained at follow-up. Discussion The modest effects for universal prevention were likely due to floor effects. The evidence for selective prevention suggests that empirically supported approaches should be disseminated on a wider basis. Our findings suggest CBT should be offered for indicated populations. Overall, results suggest efficacy of several prevention programs for reducing risk for eating disorders, and that wider dissemination is required. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

RESUMEN Prevención de Trastornos de la Conducta Alimentaria Una revisión sistemática de Ensayos Controlados Aleatorizados Objectivo Esta revisión sistemática evaluó la eficacia de la prevención universal, selectiva e indicada para trastornos de la conducta alimentaria. Método Se realizó una búsqueda sistemática de la literatura en las bases de datos Medline, PsycINFO, Embase, Scopus y Cochrane Collaboration Library hasta enero de 2016. Los estudios fueron incluidos si eran ensayos controlados aleatorizados (ECA) y evaluaban un programa de prevención para trastornos alimentarios. Se recuperaron 13 ECAs de prevención universal (N = 3,989 participantes, 55% mujeres, M edad = 13.0 años), 85 ECAs de prevención selectiva (N = 11,949 participantes, 99% mujeres, M edad = 17.6 años) y 8 ECAs de prevención indicada (N = 510 participantes, 100% mujeres, M edad = 20.1 años). El meta-análisis se realizó con ensayos de prevención selectiva. Debido al número limitado de ensayos universales e indicados, se realizó la síntesis narrativa. Resultados La alfabetización de los medios tuvo el mayor apoyo para la prevención universal. La mayoría de las aproximaciones universales mostraron efectos modestos significativos sobre los factores de riesgo. Los programas basados en disonancia fueron los que mejor apoyaron la prevención selectiva. La Terapia Cognitivo Conductual (TCC), un programa de peso saludable, la alfabetización de los medios y la psicoeducación, también fueron efectivos para la prevención selectiva y sus efectos se mantuvieron en el seguimiento. La TCC apoyó la prevención indicada y sus efectos se mantuvieron en el seguimiento. Discusión Los efectos modestos para la prevención universal se debieron probablemente a los efectos de piso. La evidencia para la prevención selectiva sugiere que las aproximaciones apoyadas empíricamente deben difundirse sobre una base más amplia. Nuestros hallazgos sugieren que la TCC debe ofrecerse a poblaciones indicadas. En general, los resultados sugieren que diversos programas de prevención son eficaces para reducir el riesgo de trastornos de la conducta alimentaria y que se requiere una mayor difusión. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:833-862) [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Eating Disorders is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)