Prevention of eating disorders: a review of outcome evaluation research

Prevention programs for eating disorders have been targeted both at primary prevention, through minimizing risk and enhancing protective factors, and secondary prevention, through the early identification of individuals displaying sub-clinical forms of eating disorders. Primary prevention programs with elementary school children have been found to change knowledge effectively, change attitudes in about half of students, and result in maintained behavioral change in about one-fifth of the students. Interactive primary prevention programs in elementary schools that intervened with students' social environment, such as peers and teachers, in addition to equipping students with resilience skills, seemed to be more effective. Secondary prevention at the university level revealed, in follow-up studies of about three months, the maintenance of attitudinal change in about two-thirds of the sample, and the maintenance of behavioral change in about two-fifths of the participants. In addition to including cognitive, critical and general resilience skills, these programs also engaged participants actively and invited their critical reflections. Apart from the implementation of "packaged" prevention programs, preventative interventions should be applied by all health, mental health and education professionals in their daily contact with children and their significant others.