Ecological and Activism
Approaches to the Prevention
of Body Image Problems
MICHAEL P. LEVINE
Social and cultural factors help create negative body image and disordered eating in females and males. Consequently, social learning theory (SLT) and cognitive-behavioral theory (CBT) have guided development of universal (primary) prevention programs for children and adolescents. These interventions, typically lasting 6–12 weeks, are implemented in schools by psychologists or teachers using direct instruction, symbolic modeling, role playing, and homework assignments. Our review of 42 published and unpublished outcome studies indicates that this approach is not consistently effective, and that when positive findings concerning body esteem and eating behaviors do emerge, they tend to be short-term effects. Given that prevention is the only viable solution to the widespread problems of negative body image and disordered eating in females, this chapter considers viable alternatives or supplements to psychoeducation.
SLT and CBT emphasize the role of reciprocal determinism among individual factors, behavior, and environment, including sociocultural influences in shaping negative body image and disordered eating. Given this perspective, it is perplexing that prevention programs have focused on students as individuals and not on changing the physical and social environments that frame negative body image. Changes in peer norms, school policies, teacher