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Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns

Third-wave behavioural interventions are becoming increasingly popular in treating and preventing various mental health problems, and scholars are beginning to test whether these interventions can effectively target eating disorder (ED) risk factors (e.g., disordered eating, body image concerns). While several studies have examined the effects of third-wave interventions on ED risk factors, no meta-analysis has synthesized and quantified these data. Consequently, to demonstrate whether third-wave behavioural interventions show potential as ED prevention programs, we examined whether these interventions can effectively modify ED risk factors in samples of individuals without an eating disorder.

A meta-analysis was conducted on twenty-four studies (13 randomized controlled trials). Most studies delivered selective prevention programs (i.e., targeting those who reported elevated risk factors), with few delivering universal (e.g., whole populations) or indicated (subthreshold cases) programs. We found third-wave interventions to produce significant and modest improvements in disordered eating and body image concerns from pre-treatment to follow-up, with some evidence that dialectical behaviour interventions produced the largest effects. Third-wave interventions were significantly more efficacious than inactive (but not active) control conditions in reducing disordered eating behaviours in available RCTs. These findings mostly applied to selective prevention programs, so the evidence base for universal and indicated prevention programs was weak.

Overall, we conclude by arguing that third-wave behavioural interventions show potential as effective ED prevention programs. We highlight the need for researchers to not only conduct more large-scale RCTs examining the efficacy of these interventions on ED risk factors, but also for researchers to consider examining whether these interventions actually prevent ED onset in “at risk” cases.

Text: Jake Linardon
Photo: Per Carlbring

Read the full paper:
Jake Linardon, John Gleeson, Keong Yap, Kylie Murphy & Leah Brennan (2018) Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: implications for eating disorder prevention, Cognitive Behaviour Therapy, DOI: 10.1080/16506073.2018.1517389

Jake Linardon – one of the authors

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