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Peer program targets eating disorders in athletes.

SEATTLE -- A peer-led program appeared to be successful in decreasing the risk of eating disorders among female college athletes, according to early results involving 64 participants.

The risk of eating disorders among female college women generally, said Carolyn B. Becker, Ph.D., of the department of psychology at Trinity University, San Antonio. Female athletes are a unique group with unique issues, she pointed out. "There is certainly a pervasive belief among many athletes and many coaches that weight loss is going to enhance performance," she said at an international conference sponsored by the Academy for Eating Disorders.

The Female Athlete Body Project was derived in part from a parent program at the university, the Sorority Body Image Program, which found that a peer-led, cognitive dissonance-based intervention reduced risk factors for eating disorders among sorority members, Dr. Becker said (J. Consult. Clin. Psychol. 2008;76:347-54).

The new program uses two interventions--a cognitive dissonance-based intervention and a healthy-weight intervention--that have been modified specifically for female athletes to cover topics such as sport-related body ideals and the female athlete triad. The former intervention focuses on rejecting thin ideals, whereas the latter focuses on embracing the healthy ideal, Dr. Becker explained at the conference, which was cosponsored by the University of New Mexico.

Attendance in the program is mandatory for all women participating in varsity sports and cheerleading at the university. The interventions are delivered in small, interactive group sessions that are conducted within teams, both to facilitate team building and to best address the differences in body image by sport. In the first year, half of the team receives the cognitive dissonance intervention and the other half receives the healthy-weight intervention; in the second year, the groups switch. The interventions are delivered over three sessions lasting for 1 hour and 15 minutes, each led by peers.

Participants are assessed at baseline, at the end of each intervention, and at the 6-week and 1-year follow-ups, according to Dr. Becker. In all, 112 athletes have participated in the program in its first year. She described results for the first 64 participants, who were from the basketball, softball, tennis, swimming/diving, and cross-country teams. Results for the remaining athletes are still being analyzed.

Regardless of the type of intervention received (cognitive dissonance or healthy weight), the athletes significantly improved from baseline in terms of thin-ideal internalization, as measured with the Ideal Body Stereotype Scale-Revised (IBSS-R); negative affect, as measured with the Positive and Negative Affect Schedule-Expanded Form (PANAS-X); eating pathology, as measured with the Eating Disorder Examination Questionnaire-Bulimia Nervosa scale (EDEQ-BN); and body dissatisfaction, as measured with the EDEQ scales for shape concern (EDEQ-SC) and weight concern (EDEQ-WC). With the exception of thin-ideal internalization, all measures were significantly improved from baseline at the 6-week follow-up.

Four athletes approached the head athletic trainer with concerns that they might have the female athlete triad--something that had never happened before during his tenure, Dr. Becker said.

"To us, in fact, that was the most exciting outcome that we had," she commented. Future goals, according to Dr. Becker, include taking the program through its second year to determine if there are additive benefits of the two interventions, and exploring options for making the program sustainable.

Dr. Becker reported that the study was supported by a grant from the National Institute of Mental Health. She did not have any conflicts of interest to disclose.

BY SUSAN LONDON Contributing Writer
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Title Annotation:Psychosomatic Medicine
Author:London, Susan
Publication:Clinical Psychiatry News
Date:Sep 1, 2008
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