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 of ‘beauty’. 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, district, school classroom) and aim to promote general health and wellbeing, foster resilience and reduce the risk of eating disorders amongst non-symptomatic populations. For example, universal prevention can be achieved in schools by targeting the entire student body.
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 middle school students (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:
- Natural increases in body-fat and weight associated with puberty
- An increased desire for peer acceptance
- Onset of romantic interest
- 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 healthy, 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.
Preventing Eating Disorders
‘Prevention’ refers to specific programs or interventions designed to reduce risk factors, enhance protective factors and ultimately stop the increasing rate of eating disorders in our society. Early diagnosis, prevention programs and appropriate cost-effective treatments have proven to greatly reduce the impact of an eating disorder.
Secondary prevention interventions aim to lower the severity and duration of an eating disorder in a person who already has the illness. There is considerable overlap between indicated prevention and secondary prevention, with both methods sharing various aims and targeting similar groups.
In our society, a large percentage of young women and men engage in disordered eating behaviour. Disordered eating behaviours develop in response to negative body image and body dissatisfaction and can lead to serious physical, psychological, and functional problems.
Through communication platforms such as the media and social media, we are faced with manipulated, filtered and digitally enhanced images. Repeated exposure of such images can result in individuals feeling pressured to adhere to such ideals of appearance, increasing the risk of disordered eating and eating disorders.