Primary Prevention

Primary prevention interventions aim to prevent the onset or development of an eating disorder and may be universal, selective or indicated.

While the aims of all these interventions can vary slightly, they do share common goals that are focused on enhancing the prevention of eating disorders in general.

These goals include:

• Improving general health, nutrition and psychological wellbeing, such as self-esteem and positive body image
• Enhancing media literacy, which provides education on the media’s promotion of unrealistic standards. This enables people to critically analyse media messages, thus reducing the risk of developing an eating disorder
• Reducing teasing and bullying, including weight-based teasing

Universal prevention for children and young people

Universal prevention efforts target whole communities (e.g. national, local, community, school classroom) and aim to promote general health and wellbeing, foster resilience and reduce the risk of eating disorders among non-symptomatic populations. For example, universal prevention can be achieved in schools by targeting the entire school community.

In the short-term, universal prevention programs may increase resilience and decrease risk factors for the development of eating disorders. In the long-term, it is expected that those changes will lead to fewer eating problems and fewer cases of eating disorders in society.

Universal prevention approaches aim to:

• Help everyone. They may assist those who are at high risk and prevent the long-term onset of eating disorders, while also promoting the general health and wellbeing of those at minimal risk of eating disorders
• Help children learn how to manage the socio-cultural influences linked to the development of negative body image and body dissatisfaction
• Help young adolescents (ages 12-15), recognising this particular developmental period as a time in which many personal and environmental risk factors that can trigger an eating disorder are known to develop

The risk factors associated with universal prevention often include, but are not limited to:

• Changes associated with puberty
• An increased desire for peer acceptance
• Changes in academic expectations

Selective prevention for children and young people

Selective prevention programs are more discerning in their approach. Instead of targeting the whole population (as with universal prevention), they target those who may be at higher risk of developing disordered eating habits. Such high risk groups may include females, athletes, and dancers.

The aims of selective interventions can include:

• Helping the person identify the costs of pursuing the Western cultural body ideal of ‘thin’ (for girls) or ‘muscular/lean’ (for boys)
• Promoting the adoption of healthy, balanced attitudes towards eating, body, weight, and shape
• Reducing the importance placed on body shape and weight for defining personal success, happiness and self-worth
• Providing education on the unhelpful physical and psychological effects of dieting and extreme dietary restriction
• Providing psychoeducation on balanced nutrition and physical activity

Indicated prevention for children and young people

Indicated prevention programs are more targeted in their approach. They are designed to maximise early detection and treatment for people with symptoms of eating disorders, who do not meet threshold diagnostic criteria, but who are at high risk of developing an eating disorder.

The aims of indicated prevention are highly similar to those listed under ‘selective interventions’ above. However, indicated interventions can also work to teach someone with an eating disorder how to engage in non-disordered ways of eating and maintain a healthy weight.

At this stage, interventions seek to reduce the signs and symptoms related to eating disorders.