A Systematic Review and Meta-analysis of Eating Disorder Preventative Interventions in Schools

Objective: Adolescents are particularly susceptible to developing an eating disorder (ED). Therefore, schools are in a unique position to assist in the prevention of EDs for this vulnerable group. To ascertain the current evidence-base for school-based ED prevention efforts, we conducted a systematic review and meta-analysis of randomised controlled trials that delivered a school-based ED prevention intervention and assessed the impact these interventions had on ED symptomatology.

Method: Electronic databases (PsycINFO, MEDLINE, EMBASE, Web of Science, Scopus and CENTRAL) were searched for published randomised controlled trials of school-based ED prevention interventions from inception to 2024. Twelve studies from 11 articles were identified with 7935 participants (mean ages ranging from 12 to 17). Of these studies, six were included in meta-analyses.

Results: Media literacy and dissonance-based interventions reported small to medium effects for ED symptomatology compared to controls at post-intervention. At three-to-six-month follow-up, intervention groups reported small negative to medium-sized positive effects compared to control groups on eating disorder symptomatology.

Conclusions: While school-based ED prevention interventions can effectively reduce ED symptomatology post-intervention, the programs analysed in this review do not reliably demonstrate effectiveness across groups and time. Future research should build upon current interventions to increase effectiveness and include long-term follow-ups.