Stice, E., Shaw, H., Burton, E., & Wade, E. (2006). Dissonance and healthy weight eating disorder prevention programs: A randomized efficacy trial. Journal of Consulting and Clinical Psychology, 74(2), 263–275. https://doi.org/10.1037/0022-006X.74.2.263

Type of Study: Randomized controlled trial
Number of Participants: 481

Population:

• Age — Mean=17 years
• Race/Ethnicity — 58% Caucasian, 19% Hispanic, 10% Asian/Pacific Islander, 7% Specified Other or Mixed Racial Heritage, and 6% African American
• Gender — 100% Female
• Status — Participants were adolescent girls with body dissatisfaction.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine the efficacy of a dissonance intervention [now called the Body Project] Participants were randomized to a dissonance intervention, healthy weight intervention, expressive writing control intervention, or assessment-only control condition. Measures utilized include the Ideal-Body Stereotype Scale—Revised, the Satisfaction and Dissatisfaction with Body Parts Scale, the Dutch Restrained Eating Scale (DRES), the Sadness, Guilt, and Fear/Anxiety subscales from the Positive Affect and Negative Affect Scale—Revised, the Social Adjustment Scale (SAS), and the Eating Disorder Diagnostic Interview. Results indicate that dissonance intervention participants showed significantly greater reductions in eating disorder risk factors and bulimic symptoms than healthy weight, expressive writing, and assessment-only intervention participants. Healthy weight intervention participants also showed significantly greater reductions in risk factors and symptoms than expressive writing intervention and assessment-only participants from pretest to posttest. Although these effects faded over 6-month and 12-month follow-ups, dissonance intervention and healthy weight intervention participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month follow-up, suggesting that both interventions have public health potential. Limitations include reliance on self-reported measures and lack of generalizability due to gender.

Length of controlled postintervention follow-up: 6 and 12 months.

Stice, E., Marti, C. N., Spoor, S., Presnell, K., & Shaw, H. (2008). Dissonance and healthy weight eating disorder prevention programs: long-term effects from a randomized efficacy trial. Journal of Consulting and Clinical Psychology, 76(2), 329–340. https://doi.org/10.1037/0022-006X.76.2.329

Type of Study: Randomized controlled trial
Number of Participants: 481

Population:

• Age — Mean=17 years
• Race/Ethnicity — 58% Caucasian, 19% Hispanic, 10% Asian/Pacific Islander, 7% Specified Other or Mixed Racial Heritage, and 6% African American
• Gender — 100% Female
• Status — Participants were adolescent girls with body image concerns.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Stice et al. (2006). The purpose of the study was to determine the efficacy of a dissonance intervention [now called the Body Project.] Participants were randomized to a dissonance intervention, healthy weight intervention, expressive writing control intervention, or assessment-only control condition. Measures utilized include the Ideal-Body Stereotype Scale—Revised, the Satisfaction and Dissatisfaction with Body Parts Scale, the Dutch Restrained Eating Scale (DRES), the Sadness, Guilt, and Fear/Anxiety subscales from the Positive Affect and Negative Affect Scale—Revised, the Social Adjustment Scale (SAS), and the Eating Disorder Diagnostic Interview. Results indicate that dissonance intervention participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment and lower risk for eating pathology onset through 2- to 3-year follow-up than did assessment-only controls. Participants in the dissonance intervention group showed greater decreases in thin-ideal internalization, body dissatisfaction, and psychosocial impairment than did expressive writing controls. Healthy weight participants showed greater decreases in thin-ideal internalization, body dissatisfaction, negative affect, eating disorder symptoms, and psychosocial impairment; less increases in weight; and lower risk for eating pathology and obesity onset through 2- to 3-year follow-up than did assessment-only controls. Healthy weight participants showed greater decreases in thin-ideal internalization and weight than did expressive writing controls. Intervention group participants showed a 60% reduction in risk for eating pathology onset, and healthy weight. Participants showed a 61% reduction in risk for eating pathology onset and a 55% reduction in risk for obesity onset relative to assessment-only controls through 3-year follow-up, implying that the effects are clinically important and enduring. Limitations include reliance on self-reported measures and lack of generalizability due to gender.

Length of controlled postintervention follow-up: 6 months, 1 year, 2 years, and 3 years.

Stice, E., Rohde, P., Gau, J., & Shaw, H. (2009). An effectiveness trial of a dissonance-based eating disorder prevention program for high-risk adolescent girls. Journal of Consulting and Clinical Psychology, 77(5), 825–834. https://doi.org/10.1037/a0016132

Type of Study: Randomized controlled trial
Number of Participants: 306

Population:

• Age — Mean=15.7 years
• Race/Ethnicity — 81% Caucasian, 9% Hispanic, 6% Other or Mixed Racial Heritage, 2% African American, and 2% Asian/Pacific Islander
• Gender — 100% Female
• Status — Participants were adolescent girls with body image concerns.

Location/Institution: Mid-sized city in the Northwest United States

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine whether a dissonance intervention [now called the Body Project] produced effects when school staff recruit participants and deliver the intervention. Participants were randomized to a dissonance intervention, or to a psychoeducational brochure control condition. Measures utilized include the Ideal-Body Stereotype Scale—Revised, the Satisfaction and Dissatisfaction with Body Parts Scale, the Dutch Restrained Eating Scale (DRES), the Center for Epidemiologic Studies Depression Scale (CESD), and the Eating Disorder Diagnostic Interview. Results indicate that the intervention group participants showed significantly greater decreases in thin-ideal internalization, body dissatisfaction, dieting attempts, and eating disorder symptoms from pretest to posttest than did those assigned to a psychoeducational brochure control condition. The effects for body dissatisfaction, dieting attempts, and eating disorder symptoms persisted through 1-year follow-up. Limitations include reliance on self-reported measures and the sample was relatively homogeneous with regard to ethnicity and socioeconomic status, suggesting that care should be taken in generalizing the results to other populations.

Length of controlled postintervention follow-up: 6 months and 1 year.

Stice, E., Rohde, P., Shaw, H., & Gau, J. (2011). An effectiveness trial of a selected dissonance-based eating disorder prevention program for female high school students: Long-term effects. Journal of Consulting and Clinical Psychology, 79(4), 500–508. https://doi.org/10.1037/a0024351

Type of Study: Randomized controlled trial
Number of Participants: 306

Population:

• Age — 14–19 years (Mean=15.7 years)
• Race/Ethnicity — 58% European American, 17% Asian, 13% Hispanic, 7% African American, 4% American Indian/Alaska Native, and 1% Native Hawaiian/Pacific Islander
• Gender — 100% Female
• Status — Participants were young women with body image concerns.

Location/Institution: 7 universities in Oregon, Texas, and Pennsylvania

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Stice, et al. (2009). The purpose of the study was to test whether the Body Project produces effects through long-term follow-up when high school clinicians recruit students and deliver the intervention under real-world conditions. Participants were randomized to the Body Project or to a psychoeducational brochure control condition. Measures utilized include the Ideal-Body Stereotype Scale—Revised, the Satisfaction and Dissatisfaction with Body Parts Scale, the Social Adjustment Scale (SAS), the Dutch Restrained Eating Scale (DRES), the Beck Depression Inventory (BDI), the Patterns of Help Seeking Behavior Scale, and the Eating Disorder Diagnostic Interview (EDDI). Results indicate that Body Project participants showed significantly greater decreases in body dissatisfaction at 2-year follow-up and eating disorder symptoms at 3-year follow-up than controls; effects on other risk factors, risk for eating disorder onset, and other outcomes (e.g., body mass) were marginal or nonsignificant. Limitations include reliance on self-reported measures and the sample was relatively homogeneous with regard to ethnicity and socioeconomic status, suggesting that care should be taken in generalizing the results to other populations.

Length of controlled postintervention follow-up: 6 months, 1 year, 2 years, and 3 years.

Stice, E., Yokum, S., & Waters, A. (2015). Dissonance-based eating disorder prevention program reduces reward region response to thin models: How actions shape valuation. PLoS ONE, 10(12), Article e0144530. https://doi.org/10.1371/journal.pone.0144530

Type of Study: Randomized controlled trial
Number of Participants: 38

Population:

• Age — Mean=19.8 years
• Race/Ethnicity — 68% European American, 13% Latino, 8% Asian/Pacific Islander, 5% Native Americans, 3% African Americans, and 3% Mixed Racial Heritage
• Gender — 100% Female
• Status — Participants were young women with body dissatisfaction.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine if the Body Project would reduce response of college students' brain regions implicated in reward valuation to thin models. Participants were randomized to the Body Project or an educational control condition. Measures utilized include the Schedule for Affective Disorders and Schizophrenia for School Age Children-Epidemiologic Version 5 (K-SADS-E5), the Ideal-Body Stereotype Scale-Revised, the Satisfaction and Dissatisfaction with Body Parts Scale, and the Eating Disorder Diagnostic Interview. Results indicate that compared to controls, Body Project participants showed greater reductions in caudate response to images of thin versus average-weight models, though participants in the two conditions showed pretest differences in responsivity of other brain regions that might have contributed to this effect. Greater pretest–posttest reductions in caudate and putamen response to thin models correlated with greater reductions in body dissatisfaction. Limitations include reliance on self-reported measures, small sample size, and lack of follow-up. Note: This article was not reviewed for rating Body Project since it studied college students which are outside the age range of the topic area..

Length of controlled postintervention follow-up: None.

Amaral, A., Stice, E., & Ferreira, M. (2019). A controlled trial of a dissonance-based eating disorder prevention program with Brazilian girls. Psicologia: Reflexao e Eritica, 32, Article 13. https://doi.org/10.1186/s41155-019-0126-3

Type of Study: Randomized controlled trial
Number of Participants: 141

Population:

• Age — Mean=16.25 years
• Race/Ethnicity — 100% Brazilian
• Gender — 100% Female
• Status — Participants were adolescents with body image concerns.

Location/Institution: Brazil

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of the Body Project with Brazilian girls, to determine if this intervention is culturally sensitive and efficacious with Latin-American adolescents. Participants were randomized to the Body Project or assessment-only condition. Measures utilized include the Body Shape Questionnaire (BSQ), the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ3), the Eating Attitudes Test (EAT-26), the Eating Disorder Diagnostic Scale (EDDS), the Children Depression Inventory (CDI), the Body Appreciation Scale (BAS), and the Positive Affect and Negative Affect Scale (PANAS). Results indicate that compared to assessment-only controls, Body Project participants showed a significantly greater reduction in body dissatisfaction, sociocultural influence of the media, depressive symptoms, negative affect, as well as significantly greater increases in body appreciation. There were no significant effects for disordered eating attitudes and eating disorder symptoms. Limitations include reliance on self-reported measures; large dropout rate; the assessment-only control condition was not a rigorous comparison condition because it did not control for demand characteristics inherent to randomized trials; and lack of follow-up.

Length of controlled postintervention follow-up: None.

The following studies were not included in rating Body Project on the Scientific Rating Scale...

Ghaderi, A., Stice, E., Andersson, G., Eno Persson, J., & Allzen, E. (2020). A randomised controlled trial of the effectiveness of virtually delivered body project (vBP) groups to prevent eating disorders. Journal of Consulting and Clinical Psychology, 88(7), 643–656. https://doi.org/10.1037/ccp0000506

The purpose of the study was to investigate the effectiveness of the Body Project delivered virtually (vBP) by peer educators for prevention of eating disorders. Participants were randomized to one of the following: vBP group, a placebo (expressive writing, EW) group, or to a waitlist control condition. The postintervention follow-up evaluations lasted for 24 months for the EW group and 6 months for the waitlist control condition. Measures utilized include the Eating Disorders Examination (EDE), the Eating Disorder Diagnostic Scale (EDDS), the Restraint Subscale of the Eating Disorders Examination Questionnaire (EDE-Q-r), the Positive Affect and Negative Affect Scale (PANAS), the Clinical Impairment Assessment (CIA), the Body Parts Dissatisfaction Scale (BPDS), the Body Shape Questionnaire-brief version (BSQ) and the Ideal Body Stereotype Scale-Revised (IBSS-R). Results indicate that the incidence of eating disorder onset over 24 months follow up were 3 in vBP and 13 in EW a significant difference. Incidence of eating disorder onset in vBP participants was less than in EW participants. The vBP participants generally showed significantly greater reduction in eating disorder symptoms, clinical impairment, body dissatisfaction, and internalization of thin ideal compared with the waitlist participants at postintervention and 6-month follow-up, and in eating disorder symptoms, restraint, body dissatisfaction, and internalization of thin ideal compared with the EW participants at postintervention, and 6-, 12-, 18-, or 24-months follow-up. EW participants reported significantly greater reduction in clinical impairment and body dissatisfaction at post intervention compared with the waitlist participants. Limitations include reliance on self-reported measures, drop-out was significant, and the EW intervention was not group-based to match the format of the vBP. Note: This article was not reviewed for rating Body Project since it is a study on vBody Project which is a modification of Body Project.