Integrating eating disorder and weight gain prevention: a pilot and feasibility trial of INSPIRE
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The current study adapted evidence-based prevention programs to promote positive health behaviors among racially and ethnically diverse young adult women. Two successful programs (The Body Project and the Healthy Weight Intervention) were integrated to evaluate their feasibility, acceptability, and preliminary efficacy in reducing risk for both eating pathology and weight gain. Intervention features extended the previous prevention efforts by emphasizing broad appearance ideals to enhance relevancy for women of color and incorporating distress tolerance and emotion regulation skills training.
Individuals were excluded if they met criteria for an eating disorder diagnosis and/or obesity, as this was a prevention project. 27 young adult women participated (M age = 18.59; SD = 1.01). The following racial/ethnic groups were represented: 48.1% White, 25.9% Asian, 22.2% Black, and 3.7% Latina. After each meeting, participants completed satisfaction measures and therapists assessed intervention feasibility. Participants also completed comprehensive questionnaires at pretest (baseline), posttest (8 weeks), and 4-week follow-up.
Descriptive statistics and content analyses of open-ended questions indicated that the intervention was both acceptable and feasible. Hierarchical linear models evaluating within-subject change over time indicated reductions in several risk factors that were sustained at follow-up: eating pathology, appearance dissatisfaction, thin-ideal internalization, restrained eating, negative affect, emotion dysregulation, and fat intake. BMI did not change from pretest to posttest; however, BMI increased from posttest to follow-up (mean weight increase = 0.34 kg).
Results suggest that a prevention program designed to be more culturally sensitive is feasible and acceptable. Findings provide preliminary support for reducing the risk of eating pathology and promoting positive health behaviors.
Level of evidence
Time series with intervention, Level IV.
ClinicalTrails.gov ID: NCT03317587.
KeywordsPrevention Eating disorders Weight gain Body image Diversity
The authors would like to offer sincere thanks to the individuals who contributed to the implementation of this study, including Melissa Kwitowski, Rachel Boutté, Alex Davies, Neha Goel, and Ashley MacPherson.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to disclose.
Human and animal rights statement
All procedures performed in the study involving human participants were in accordance with the ethical standards of the host institutional.
Informed consent was obtained from all individual participants included in the study.
- 1.Fabricatore AN, Wadden TA (2006) Obesity. Annu Rev Clin Psychol 2:357–377. https://doi.org/10.1146/annurev.clinpsy.2.022305.095249 CrossRefGoogle Scholar
- 15.Neumark-Sztainer D (2003) Obesity and eating disorder prevention: An integrated approach? Adolesc Med 14:159–173Google Scholar
- 29.Stice E, Rohde P, Shaw H, Marti CN (2013) Efficacy trial of a selective prevention program targeting both eating disorder symptoms and unhealthy weight gain among female college students: 1- and 2-year follow-up effects. J Consult Clin Psychol 80:164–170. https://doi.org/10.1037/a0026484 CrossRefGoogle Scholar
- 34.Crago M, Shisslak CM, Estes LS (1996) Eating disturbances among American minority groups: a review. Int J Eat Disord 19:239–248. https://doi.org/10.1002/(SICI)1098-108X(199604)19:3%3c239:AID-EAT2%3e3.0.CO;2-N CrossRefGoogle Scholar
- 36.Horney AC, Stice E, Rohde P (2015) An examination of participants who develop an eating disorder despite completing an eating disorder prevention program: implications for improving the yield of prevention efforts. Prev Sci 16:518–526. https://doi.org/10.1007/s11121-014-0520-0 CrossRefGoogle Scholar
- 39.Hawkins RC, Clement PF (1984) Binge eating: measurement problems and a conceptual model. In: Hawkins RC, Fremous WJ, Clement PF (eds) The binge purge syndrome: diagnosis, treatment, and research. Springer, New YorkGoogle Scholar
- 44.Linehan MM (2014) DBT® skills training manual, 2nd edn. Guilford Press, New YorkGoogle Scholar
- 45.Sparling PB (2007) Obesity on campus. Prev Chronic Dis 4:A72Google Scholar
- 46.Campbell DT, Stanley JC (1963) Experimental and quasi-experimental designs for research. Rand McNally, ChicagoGoogle Scholar
- 49.Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16:363–370. https://doi.org/10.1002/1098-108X(199412)16:4%3c363:AID-EAT2260160405%3e3.0.CO;2-%23 Google Scholar
- 51.Cooper Z, Fairburn C (1987) The eating disorder examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders. Int J Eat Disord 6:1–8. https://doi.org/10.1002/1098-108X(198701)6:1%3c1:AID-EAT2260060102%3e3.0.CO;2-9 CrossRefGoogle Scholar
- 52.Luce KH, Crowther JH (1999) The reliability of the eating disorder examination self-report questionnaire version (EDE-Q). Int J Eat Disord 25:349–351. https://doi.org/10.1002/(SICI)1098-108X(199904)25:3%3c349:AID-EAT15%3e3.0.CO;2-M CrossRefGoogle Scholar
- 56.Van Strien T, Frijters JER, van Staveren WA et al (1986) The predictive validity of the Dutch restrained eating scale. Int J Eat Disord 5:747–755. https://doi.org/10.1002/1098-108X(198605)5:4%3c747:AID-EAT2260050413%3e3.0.CO;2-6 CrossRefGoogle Scholar
- 57.Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 26:41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94 CrossRefGoogle Scholar
- 61.Sallis JF, Haskell WL, Wood PD et al (1985) Physical activity assessment methodology in the Five-City project. Am J Epidemiol 121:91–106. https://doi.org/10.1093/oxfordjournals.aje.a113987 CrossRefGoogle Scholar
- 65.Meyers LS, Gamst G, Guarino AJ (2016) Applied multivariate research: design and interpretation, 3rd edn. Sage Publications Inc., Thousand OaksGoogle Scholar
- 66.Bryk AS, Raudenbush SW (1992) Hierarchical linear models: applications and data analysis methods. Sage Publications, Newbury ParkGoogle Scholar
- 76.Gardner CD, Trepanowski JF, Gobbo LCD et al (2018) Effect of low-fat VS low-carbohydrate diet on 12-month weight loss in overweight adults and the association with genotype pattern or insulin secretion the DIETFITS randomized clinical trial. JAMA 319:667–679. https://doi.org/10.1001/jama.2018.0245 CrossRefGoogle Scholar