Identifying Factors Which Influence Eating Disorder Risk during Behavioral Weight Management: A Consensus Study

Area of Science:

• Behavioral Medicine
• Psychiatry
• Public Health

Background:

• Behavioral weight management programs aim to improve health outcomes.
• However, certain aspects of these interventions may inadvertently increase eating disorder (ED) risk.
• Understanding these risks is crucial for developing safer interventions.

Purpose of the Study:

• To explore clinician, researcher, and consumer perspectives on factors influencing ED risk within behavioral weight management.
• To identify individual characteristics, intervention strategies, and delivery features associated with ED risk.

Main Methods:

• An international online survey was administered to 87 participants (clinicians, researchers, consumers).
• Participants rated the relevance of individual characteristics, intervention strategies, and delivery features to ED risk.
• Data were collected on demographics and lived experience with overweight/obesity and EDs.

Main Results:

• High agreement that individual factors like ED history, weight stigma, and bias internalization are relevant to ED risk.
• Intervention strategies focusing on weight, prescription (diets, exercise), and monitoring (calorie counting) were rated as potentially increasing risk.
• Strategies emphasizing health, flexibility, and psychosocial support were rated as potentially decreasing risk.
• Intervention delivery features, including provider qualifications and support characteristics (frequency, duration), were deemed important.

Conclusions:

• Behavioral weight management needs careful consideration of potential ED risks.
• Prioritizing a health-focused, flexible approach with integrated psychosocial support may be safer.
• Future research should quantify the predictive value of these factors for ED risk and inform screening protocols.