Dissonance‐based eating disorder prevention delivered in‐person after an online training: A randomized controlled trial for Brazilian men with body dissatisfaction

Abstract

Objective Few prevention programs have been developed and empirically evaluated to address eating disorder (ED) and muscle dysmorphia (MD) symptoms in men. Furthermore, new strategies for the broad implementation of available programs are needed. We investigated the acceptability and efficacy of a dissonance‐based (DB) intervention for Brazilian undergraduate men with body dissatisfaction to target risk and protective factors for ED and MD symptoms (the Body Project: More Than Muscles) after an online training for facilitators. Method Participants were randomized to a two‐session DB‐intervention (n = 89) or assessment‐only control (AOC) (n = 91), and completed validated measures assessing ED and MD risk and protective factors pre‐intervention, post‐intervention, and at 4‐ and 24‐week follow‐up post‐intervention. Results Acceptability ratings were highly favorable. Regarding efficacy, the DB condition demonstrated significantly greater decreases in ED and MD risk factors compared to AOC from pre‐intervention to 4‐week (p‐values <.05, between‐condition Cohen's d = 0.35–1.10) and 24‐week follow‐up (p‐values <.05, between‐condition Cohen's d = 0.33–0.78). Results at post‐intervention were not significant, with the exception that body appreciation showed significantly greater improvements in the DB condition (post‐intervention: p < .01, between‐condition Cohen's d = 0.40; 4‐week: p < .001, between‐condition Cohen's d = 0.80; and 24‐week follow‐up: p < .001, between‐condition Cohen's d = 0.58). Discussion Results support the acceptability and efficacy of a DB‐intervention delivered in‐person after an online training for facilitators up to 24‐week follow‐up in Brazilian men.

Reducing eating disorder risk among male athletes: A randomized controlled trial investigating the male athlete body project

“…The small-to-medium between-condition effect sizes found in the current study are comparable to previous BP studies with nonathlete men (Almeida et al, 2020;Brown et al, 2017;Jankowski et al, 2017). Between-condition baseline-to-post-assessment and baselineto-follow-up effect sizes (Table 2) also range from small-to-medium and are comparable to but somewhat smaller than previous BP studies which found small-to-large within-condition effect sizes in a sample of athletes (Brown & Keel, 2015) and nonathlete women (Becker et al, 2010).…”

“…This study also extends previous research regarding MD among nonathlete men (Almeida et al, 2020;Brown et al, 2017) to MAs by demonstrating that the MABP was successful at reducing one aspect of MD (i.e., supplement use) for the treatment group at follow-up.…”

“…Finally, adaptations of the BP for nonathlete men led to similar decreases in BD and eating psychopathology (e.g., Kilpela et al, 2016). Specifically, nonathlete men in the intervention groups reported reduced BII, DM, and MD (e.g., Brown, Forney, Pinner, & Keel, 2017), BD (e.g., Brown & Keel, 2015) and increased body appreciation (e.g., Almeida, Brown, Campos, Amaral, & de Carvalho, 2020), compared to controls. Thus, evidence of efficacy of the BP for female athletes and nonathlete men separately support investigation of a Male Athlete Body Project (MABP) intervention to target ED risk factors among MAs.…”

“…This pattern suggests that participants who begin are likely to complete the intervention, perhaps indicating satisfaction with the program. It is possible that the intervention was not long enough to produce other hypothesized changes (Almeida et al, 2020), including appearance-focused components of BD. Although some BP programs include only two sessions (e.g., Almeida et al, 2020), others use four sessions (Stice, Rohde, Gau, & Shaw, 2009).…”

“…It is possible that the intervention was not long enough to produce other hypothesized changes (Almeida et al, 2020), including appearance-focused components of BD. Although some BP programs include only two sessions (e.g., Almeida et al, 2020), others use four sessions (Stice, Rohde, Gau, & Shaw, 2009). Additionally, college women in the BP requested both a longer version of the program and follow-up booster meetings (Becker & Stice, 2017).…”