Primary prevention interventions aim to prevent the onset or development of an eating disorder and may be universal, selective or indicated.
While the aims of all these interventions can vary slightly, they do share common goals that are focused on enhancing the prevention of eating disorders in general.
These goals include:
- Improving general health, nutrition and psychological wellbeing, such as self-esteem, positive body image
- Enhancing media literacy, which provides education on the media’s promotion of unrealistic standards of ‘beauty’, so that people learn to critically analyse media messages and thus reduce the risk of developing eating disorders
- Reducing teasing and bullying, including weight-based teasing
Universal prevention for children and young people
Universal prevention efforts target whole communities (e.g. national, local, community, district, school classroom) and aim to promote general health and wellbeing, foster resilience and reduce the risk of eating disorders amongst non-symptomatic populations. For example, universal prevention can be achieved in schools by targeting the entire student body.
In the short-term, universal prevention programs may increase resilience and decrease risk factors. In the long-term, it is expected that those changes will lead to fewer eating problems and fewer cases of eating disorders in society.
Universal prevention approaches aim to:
- Help everyone. They may assist those who are at high risk and prevent the long-term onset of eating disorders, while also promoting the general health and wellbeing of those at minimal risk of eating disorders
- Help children learn how to manage the socio-cultural influences linked to the development of body image dissatisfaction
- Help middle school students (ages 12 – 15), as many personal and environmental risk factors that can trigger an eating disorder are known to develop during this stage of early adolescence
The risk factors associated with universal prevention often include, but are not limited to:
- Natural increases in body-fat and weight associated with puberty
- An increased desire for peer acceptance
- Onset of romantic interest
- Changes in academic expectations
Selective prevention for children and young people
Selective prevention programs are more discerning in their approach. Instead of targeting the whole population (as with universal prevention), they target those who may be at higher risk of developing disordered eating habits. This commonly includes females, but may also include populations such as athletes and dancers.
The aims of selective interventions can include:
- Helping the person identify the costs of pursuing the Western cultural body ideal of ‘thin’ (for girls) or ‘muscular/lean’ (for boys)
- Promoting the adoption of healthy, balanced attitudes on body image, eating and weight
- Reducing the importance placed on body shape and weight for defining personal success, happiness and self-worth
- Providing education on the unhelpful physical and psychological effects of dieting and extreme dietary restriction
- Providing psychoeducation on balanced nutrition and physical activity
Indicated prevention for children and young people
Indicated prevention programs are more targeted in their approach. They are designed to maximise early detection and treatment for people with symptoms of eating disorders, who do not meet threshold diagnostic criteria, but who are at high risk of developing an eating disorder.
The aims of indicated prevention are highly similar to those listed under ‘selective interventions’ above. However, indicated interventions can also work to teach someone with an eating disorder how to engage in healthy, non-disordered ways of eating and maintain a healthy weight.
At this stage, interventions seek to reduce the signs and symptoms related to eating disorders.