Background. Eating problems are highly prevalent among young adults. Universities could be an optimal setting to prevent eating disorders through psychological intervention. As part of the World Mental Health-International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of eating disorder prevention programs targeting university students.Method. A systematic literature search of bibliographical databases (CENTRAL, MEDLINE, PsycINFO) for randomized trials comparing psychological preventive interventions for eating disorders in university students to psychoeducation or inactive controls was performed through October 8th, 2018.Results. Twenty-two studies were included. Eight (36.4%) were rated to have a low risk of bias. The relative risk of developing a subthreshold or full-blown eating disorder was IRR=0.62 (95%CI: 0.44-0.87, n=8; standardized clinical interviews only), indicating a 38% decrease in incidence in the intervention groups compared to controls. Small to moderate between- group effects at post-test were found on self-reported global eating disorder symptoms (g=0.36, 95%CI: 0.25-0.47, n=20), dieting (g=0.47, 95%CI: 0.30- 0.64, n=18), body dissatisfaction (g=0.50, 95%CI: 0.33-0.67, n=14), drive for thinness (g=0.43, 95%CI: 0.27-0.59, n=12), weight concerns (g=0.33, 95%CI: 0.10-0.57, n=13) and affective symptoms (g=0.28, 95%CI: 0.16-0.40, n=14). Effects on bulimia were not significant. Heterogeneity was low to moderate across comparisons.Discussion. Eating disorder prevention on campus can have significant, small-to-moderate effects on eating disorder symptoms and risk factors. Results also suggest that the prevention of subthreshold and full-syndrome eating disorders is feasible using such interventions. More research is needed to identify effects on academic functioning, as well as ways to motivate students to use preventive eating disorder interventions.
Prevention of Eating Disorders at Universities: A Systematic Review and Meta-Analysis
