Traditional and new strategies in the primary prevention of eating disorders: a comparative study in Spanish adolescents

Ignacio Jáuregui Lobera¹, Pilar León Lozano², Patricia Bolaños Ríos³, Juan Romero Candau², Gregorio Sánchez del Villar y Lebreros⁴, M Teresa Morales Millán^1,5, M Teresa Montaña González^1,5, Lourdes Andrés Martín², Isabela Justo Villalobos², Nuria Vargas Sánchez<sup>2

1</sup>Área de Nutrición y Bromatología, Universidad Pablo de Olavide; ²Colegio Oficial de Farmacéuticos; ³Instituto de Ciencias de la Conducta; ⁴Instituto de Enseñanza Secundaria “Murillo”; ⁵Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain

Background: Research conducted to date into the primary prevention of eating disorders (ED) has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behavior in the target population.

Objective: This study describes an adaptation of the Girls’ Group model to the Spanish context, the main objective being to compare two types of intervention, ie, one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED.

Methods: On the basis of previous research on the primary prevention of ED, and taking into account recognized risk and protective factors, the following topics were addressed: nutritional aspects; self-esteem; coping strategies; the ideal image of what is attractive and role of the media; and body image. The total sample (174 girls and 197 boys) was divided into 12 work groups, six for the intervention group (one school) and six for the control group (two schools). School-based input (intervention group) was provided by a pharmacist, a psychologist, a qualified nutritionist/dietician, and specialist support staff (psychologists and/or educators) and teachers of the three schools.

Results: Participation in the intervention group reduced body dissatisfaction (F = 13.41; P < 0.01), the drive to thinness (F = 10.79; P < 0.01), and the influence of the media with respect to the esthetic body shape model (F = 13.90; P < 0.01), while self-esteem (F = 7.34; P < 0.01) and the use of coping strategies (F = 13.74; P < 0.01) both improved. There was also an improvement in the eating habits of participants, with better outcomes being achieved when intervening with females.

Conclusions: The present study shows that in the primary prevention of eating disorders, better outcomes are achieved by new models which target the attitudes and behavior of adolescents rather than focusing solely on the provision of risk information to raise awareness.

Keywords: coping strategies, adolescence, primary prevention, eating disorders, positive psychology