23 - Primary prevention of eating disorders

Summary

Introduction

Given the serious physical, psychological, social and financial consequences of eating disorders (EDs) and the difficulties of treatment, successful prevention strategies would obviously be of paramount importance. Development of such strategies requires an understanding of risk factors and at-risk groups. Although there is growing evidence that EDs are increasing in African, Asian, Arab and Latin American women (Nasser et al., 2001), the majority of EDs occur in young Caucasian women living in highly industrialized societies. Particularly high-risk groups include dancers, sportswomen and those whose peak performance depends on being slim (Sundgott-Börgen & Bahr, 1998) or who are categorized by weight division (Dale & Landers, 1998). In terms of risk factors the most important are low self-esteem, negative body image, internalized slimness ideal, fear of fat and extreme dieting (Jacobi et al., 2004).

Optimum primary prevention strategies are those directed at the reduction of risk factors in higher risk groups. In this chapter several strategies for primary prevention interventions are described. The chapter will end with a discussion about the main results of primary prevention interventions and the implications for future initiatives.

Strategies for primary prevention

The slimming culture and the media

Because the slimming ideal can predispose women, especially those with low self-esteem and negative body image, to dieting behaviour, this idealization of the slim body has been a focus for ED prevention strategies. Media-activists have protested against the unhealthy ideals portrayed in advertisements and have advocated the use of models with more healthy body proportions (Levine et al., 1999).