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Eating Disorders: A Trial of Prevention in a High Risk School Setting

Abstract

The study describes the long-term outcome of a program aimed at the prevention of eating disorders in a world-class, residential ballet school for female and male students, ages 10–18. The prevention program followed the paradigm of health promoting schools outlined by the World Health Organization and involved systemic changes as well as direct interventions with students. Three all-school surveys have been conducted, the baseline survey was conducted in 1987, within the first year of implementation of the program, and the second and third ones in 1991 and 1996, respectively. Measures included the Diagnostic Survey for Eating Disorders, the Eating Attitude Test, and the Eating Disorder Inventory. Comparisons between the baseline cohort and the two latter cohorts, revealed significant reductions in disordered eating patterns and disturbed attitudes about eating and body shape, as well as significant increases in healthy eating patterns. The study suggests the benefits of implementing multifaceted prevention programs for eating disorders in high risk settings.

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REFERENCES

  1. Button, E., & Whitehouse, A. (1981). Subclinical anorexia nervosa. Psychological Medicine, 11, 509–516.

    Google Scholar 

  2. Casteels-Reis, T., & Piran, N. (April 1992). The life adjustment of current subclinical bulimics. The Fifth International Conference on Eating Disorders, New York.

  3. Carreiro, D., & Verhaeghe, M. (1992). Dancers suffer for art. The Winnipeg Sun, April 4th and 5th Issues.

  4. Carter, J. C., Stewart, D. A., Dunn, V. J., & Fairburn, C. G. (1997). Primary prevention of eating disorders: Might it do more harm than good? International Journal of Eating Disorders, 22, 167–172.

    Google Scholar 

  5. Davis, C. (1990). Body image and weight preoccupation: A comparison between exercising and non-exercising women. Appetite, 15, 13–22.

    Google Scholar 

  6. Davis, C., Durnin, J. V. G. A., Gurevich, M., LeMaire, A., & Dionne, M. (1993). Body composition correlates of weight dissatisfaction and dietiery restraint in young women. Appetite, 20, 197–207.

    Google Scholar 

  7. European Network of Health-Promoting Schools. (1993). World Health Organization Regional Office for Europe, Copenhagen, Denmark.

  8. Faris, P. L., Hartment, B. K., Kim, S. W., Meller, W. H., Raymond, N. C., & Eckert, E. D. (1996). Vagal involvement in the pathophysiology of bulimia nervosa: Relationship of pain thresholds, disease symptoms and vagal activity. The Seventh International Conference on Eating Disorders, New York.

  9. Garfinkel, P. E., & Garner, D. M. (1982). Anorexia nervosa: A multidimensional perspective. New York: Brunner/Mazel.

    Google Scholar 

  10. Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitude Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273–279.

    Google Scholar 

  11. Garner, D. M., & Garfinkel, P. E. (1980). Socio-cultural factors in the development of anorexia nervosa. Psychological Medicine, 10, 647–656.

    Google Scholar 

  12. Halmi, K. A., Kleifield, E., & Wagner, S. (1996). Anoreixa nervosa: Prevention of relapse therapy. The Seventh International Conference on Eating Disorders, New York.

  13. Hench, T. (1997). A ballet dancer, so very thin, dies, and the questions begin (as cited by Terry, S.). New York Times, July 11th Issue.

  14. Johnson, C. (1985). Initial consultation for patinets with bulimia and anorexia nervosa. In D. M. Garner & P. E. Garfinkel (Eds.), Handbook of Psychotherapy for Anorexia Nervosa and Bulimia (pp. 19–51). New York: Guilford Press.

    Google Scholar 

  15. Kent, J., & Clopton. (1988). Bulimia: A comparison of psychological adjustment and familial characteristics in a nonclinical sample. Journal of Clinical Psychology, 44, 964–971.

    Google Scholar 

  16. Killen, J. D., Taylor, C. B., Hammer, L. D., Litt, I., Wilson, D. M., Rich, T., Hayward, D., Simmonds, B., Kraemer, H., & Varady, A. (1993). An attempt to modify unhealthful eating attitudes and weight regulation practices of young adolescent girls. International Journal of Eating Disorders, 13, 360–384.

    Google Scholar 

  17. Mann, T., Nolen-Hoeksema, S., Huang, K., Burgard, D., Wright, A., & Hanson, K. (1997). Are two interventions worse than none? Joint primary and secondary prevention of eating disorders in college females. Health Psychology, 16(3), 215–225.

    Google Scholar 

  18. McKinlay, J. B. (April 1997). Appropriate levels of intervention and analysis for community health interventions. One Hundred and Fifth Annual Convention of the American Psychological Association, Chicago.

  19. Moreno, A. B., & Thelen, H. H. (1993). A preliminary prevention program for eating disorders in a junior high school population. Journal of Youth and Adolescence, 22, 109–124.

    Google Scholar 

  20. Moriarty, D., Shore, R., & Maxim, N. (1990). Evaluation of an eating disorders curricululm. Evaluation and Program Planning, 13, 407–413.

    Google Scholar 

  21. Paxton, S. J. (1993). A prevention program for disturbed eating and body dissatisfaction in adolescent girls. A one year follow-up. Health Education Research, 8, 43–51.

    Google Scholar 

  22. Piran, N. (1995). Prevention: Can early lessons lead to a delineation of an alternative model? A critical look at prevention with school children. Eating Disorders: The Journal of Treatment and Prevention, 3, 28–36.

    Google Scholar 

  23. Piran, N. (1996). The reduction of preoccupation with body weight and shape in schools: A feminist approach. Eating Disorders: The Journal of Treatment and Prevention, 4(4), 323–330.

    Google Scholar 

  24. Piran, N. (1997a). Prevention of eating disorders: Directions for future research. Psychopharmacology Bulletin, 33(3), 419–423.

    Google Scholar 

  25. Piran, N. (1997b). The prevalence of eating disorders in an elite ballet school. Unpublished manuscript.

  26. Piran, N. (1998). A parcticipatory approach to the prevention of eating disorders. In G. Noordenbos & W. Vandereycken (Eds.), Prevention of Eating Disorders. London: Athelone Press.

    Google Scholar 

  27. Piran, N. (1999). On the move from tertiary to secondary and primary prevention: Working with an elite Dance school. In N. Piran, M. P. Levine, & C. Steiner-Adair (Eds.), Preventing Eating Disorders: A Handbook of Interventions and Special Challenges. Philadelphia: Brunner/Mazel (Taylor & Francis Group).

    Google Scholar 

  28. Powers, P. S., & Johnson, C. (1996). Small victories: Prevention of eating disorders among athletes. Eating Disorders: The Journal of Treatment and Prevention, 4(4), 364–377.

    Google Scholar 

  29. Rosen, J. C. (1989, April–June). Prevention of eating disorders. Newsletter of the National Anorexic Aid Society, 12, 1–3.

    Google Scholar 

  30. Ryan, J. (1996). Little Girls in Pretty Boxes: The Making and Breaking of Elite Gymnasts and Figure Skaters (p. 120). New York: Warner Books.

    Google Scholar 

  31. Shisslak, C. M., Crago, M., & Neal, M. E. (1990). Prevention of eating disorders among adolescents. American Journal of Health Promotion, 5, 100–106.

    Google Scholar 

  32. Smolak, L., & Levine, M. P. (1996). Eating Smart, Eating for Me: A pilot test of an elementary school eating curriculum. The Renfrew Perspective, 2(1), 9–10.

    Google Scholar 

  33. Staines, M. (1997). Personal communication.

  34. Steiner-Adair, C. (1986). The body politic: Normal female adolescent development and the development of eating disorders. Journal of the American Academy of Psychoanalysis, 14(1), 95–114.

    Google Scholar 

  35. Sundgot-Borgen, J. (1992). Eating disorders in female elite athletes. Oslo: The Norwegian University Press.

    Google Scholar 

  36. Taylor, C. B., & Altman, T. (1997). Priorities in prevention research for eating disorders. Psychopharmacology Bulletin, 33(3), 413–417.

    Google Scholar 

  37. Terry, S. (1997). A ballet dancer, so very thin, dies, and the questions begin. New York Times, July 11th Issue.

  38. Whitehouse, A., & Button, E. (1988). The prevalence of eating disorders in a U.K. college population. A reclassification of an earlier study. International Journal of Eating Disorders, 7, 393–397.

    Google Scholar 

  39. Zernicke, K. (1997). Dancer's death raises questions: Boston ballet had told women to lose weight. The Boston Globe, July 10th Issue.

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Correspondence to Niva Piran.

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Piran, N. Eating Disorders: A Trial of Prevention in a High Risk School Setting. The Journal of Primary Prevention 20, 75–90 (1999). https://doi.org/10.1023/A:1021358519832

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  • eating disorders
  • prevention