(PS10-55) Effectiveness of a dissonance-based body image group during virtual treatment for an eating disorder

Abstract Text:

Background: Thirty million people will have an eating disorder in their lifetime. Eating disorders are associated with a myriad of medical, physical, and psychosocial consequences yet only 50% of those receiving treatment recover. Body dissatisfaction is a potent risk factor for an eating disorder. It is often the last eating disorder symptom to improve and significantly predicts treatment relapse. Thus, it is critical that eating disorder treatment targets body dissatisfaction.
Research consistently shows that dissonance-based body image groups reduce body dissatisfaction across a variety of populations. This study evaluated the effectiveness of an dissonance-based body image group as an adjunct to outpatient treatment for an eating disorder

Methods: Participants were patients receiving evidence-based treatment for an eating disorder who also attended a 4-week dissonance-based body image group based on The Body Project and EVERYbody Project. Modifications were made to the group protocols to be gender inclusive, directly address healthism, and to heightened dissonance during group activities. Participants completed the Sociocultural Attitudes Toward Appearance Questionnaire to evaluate internalization of thin ideal and athletic ideal and pressures from family, friends, and media to change their body; two items from the Eating Disorder Examination Questionnaire to evaluate dietary restraint; and the Body Parts Scale to evaluate body satisfaction. Measures were completed, on average, within 4 weeks before the first group and during the final group.

Results: N=214 patients had pre- and post- group outcomes measures available for analysis. Patients had a mean age of 19.26 (9.58) and were primarily white (69.4%) with a diagnosis of anorexia nervosa, restricting type (66.2%). There was a significant reduction from baseline to post-intervention in internalization of the thin ideal, t(194) = 9.93, p<.001, d=.63; internalization of the athletic ideal, t(138)=8.48, p<.001, d=.61; pressures from the media, t(199)=4.35, p<.001, d=.33; pressures from family, t(198)=3.51, p<.001, d=.18; pressures from peers, t(195)=5.43, p<.001, d=.33; dietary restraint t(166)=4.50, p<.001, d=.26; and an improvement in body satisfaction, t(186)=-10.51, p<.001, d= -.68. A majority of changes were of a moderate effect.

Conclusion: A dissonance-based body image group significantly reduced aspects of body dissatisfaction in patients receiving virtual outpatient care for an eating disorder. Future research is needed to evaluate the overall treatment outcome of patients who completed the group versus those who did not. Directly addressing body dissatisfaction is a critical component of eating disorder treatment.