Prevention of Eating Disorders
Prevention is a relatively new domain of research and discussion in the field of eating disorders. “Universal” or “primary prevention” refers to policies and programs that aim to lower the incidence of the disorder in a large population through reducing exposure to risk and enhancing exposure to protective or resilience factors. Both selective prevention, geared at groups at high risk of developing the disorder, and indicated prevention, geared at individuals already displaying low levels of symptoms, aim at reducing the rates of development of full-blown disorder through early identification and intervention (also termed “secondary prevention”).
Most of the systematic study of the prevention of eating disorders has been conducted since 1990. Despite limited allocation of resources, the field has seen considerable growth in output, leading to the emergence of a cumulative body of knowledge that can help guide further developments. This chapter discusses the impact of risk factors research on eating disorder prevention, reviews results and trends in prevention outcome research, and examines current challenges in the field of prevention. (Chapter 112 addresses the prevention of obesity.)
Prevention work relies on the development of etiological models. The study of risk and protective factors, in turn, is guided by prevailing views about the target disorder. Until the past decade, most research and knowledge about eating disorders was derived from clinical samples reflecting a dichotomous, illness-based view of eating disorders. Accordingly, clinic-based risk factor research tended to emphasize disrupted familial and personality processes. However, as cross-sectional risk factor research, comparing eating disorder samples to controls, has progressed to prospective community-based designs aiming to identify risk factors that predate the development of eating disorders, most intraindividual and familial structural variables have been found to have little predictive value.