Effect of a Dissonance-Based Prevention Program on Risk for Eating Disorder Onset in the Context of Eating Disorder Risk Factors

Test (a) whether a dissonance-based eating disorder prevention program that reduces thin-ideal internalization mitigates the
effects of risk factors for eating disorder onset and (b) whether the risk factors moderate the effects of this intervention
on risk for eating disorder onset, to place the effects of this intervention within the context of established risk factors.
Female adolescents (N = 481) with body image concerns were randomized to the dissonance-based program, healthy weight control program, expressive
writing control condition, or assessment-only control condition. Denial of costs of pursuing the thin-ideal was the most potent
risk factor for eating disorder onset during the 3-year follow-up (OR = 5.0). The dissonance program mitigated the effect
of this risk factor. For participants who did not deny costs of pursuing the thin-ideal, emotional eating and externalizing
symptoms increased risk for eating disorder onset. Negative affect attenuated the effects of each of the active interventions
in this trial. Results imply that this brief prevention program offsets the risk conveyed by the most potent risk factor for
eating disorder onset in this sample, implicate three vulnerability pathways to eating pathology involving thin-ideal pursuit,
emotional eating, and externalizing symptoms, and suggest that negative affect mitigates the effects of eating disorder prevention
programs.