School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review

Abstract

Background Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation.Aims This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health.Method We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023.Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies.Results After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853).Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes.Among these programmes, seven (41%) employed dissonance-based approaches.Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping.Ten (59%) of the programmes were effective in improving adolescent mental health.Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality.Conclusions The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students.Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.