Prevention of eating disorders at universities: A systematic review and meta‐analysis

• Published in: The International journal of eating disorders 2020-06, Vol.53 (6), p.813-833
• Main Authors: Harrer, Mathias, Adam, Sophia H., Messner, Eva‐Maria, Baumeister, Harald, Cuijpers, Pim, Bruffaerts, Ronny, Auerbach, Randy P., Kessler, Ronald C., Jacobi, Corinna, Taylor, Craig Barr, Ebert, David D.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bulimia; college; College campuses; College students; Colleges & universities; Eating disorders; Feeding and Eating Disorders - prevention & control; Female; Humans; Male; Mental health; Meta-analysis; multilevel meta‐analysis; Prevention; psychotherapy; Risk Factors; students; Systematic review; Universities - standards; University students; Young Adult
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.23224

Background Eating problems are highly prevalent among young adults. Universities could be an optimal setting to prevent the onset of eating disorders through psychological intervention. As part of the World Mental Health‐International College Student initiative, this systematic review and meta‐analysis synthesizes data on the efficacy of eating disorder prevention programs targeting university students. Method A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, PsycINFO) for randomized trials comparing psychological preventive interventions for eating disorders targeting university students with psychoeducation or inactive controls was performed on October 22, 2019. Results Twenty‐seven studies were included. Thirteen (48.1%) were rated to have a low risk of bias. The relative risk of developing a subthreshold or full‐blown eating disorder was incidence rate ratio = 0.62 (95% CI [0.44, 0.87], n c = 8, numbers‐needed‐to‐treat [NNT] = 26.08; standardized clinical interviews only), indicating a 38% decrease in incidence in the intervention groups compared to controls. Small to moderate between‐group effects at posttest were found on eating disorder symptoms (g = 0.35, 95% CI [0.24, 0.46], NNT = 5.10, n c = 26), dieting (g = 0.43, 95% CI [0.29, 0.57], NNT = 4.17, n c = 21), body dissatisfaction (g = 0.40, 95% CI [0.27, 0.53], NNT = 4.48, n c = 25), drive for thinness (g = 0.43, 95% CI [0.27, 0.59], NNT = 4.23, n c = 12), weight concerns (g = 0.33, 95% CI [0.10, 0.57], NNT = 5.35, n c = 13), and affective symptoms (g = 0.27, 95% CI [0.15, 0.38], NNT = 6.70, n c = 18). The effects on bulimia nervosa symptoms were not significant. Heterogeneity was moderate across comparisons. Discussion Eating disorder prevention on campus can have significant, small‐to‐moderate effects on eating disorder symptoms and risk factors. Results also suggest that the prevention of subthreshold and full‐syndrome eating disorders is feasible using such interventions. More research is needed to identify ways to motivate students to use preventive eating disorder interventions. Antecedentes Los trastornos de la conducta alimentaria son altamente prevalentes entre los adultos jóvenes. Las universidades podrían ser un entorno óptimo para prevenir la aparición de trastornos alimentarios a través de la intervención psicológica. Como parte de la iniciativa World Mental Health‐International College Student, esta revisión sistemática y meta‐análisis sintetiza datos sob