title: A systematic review of interventions on body image and disordered eating outcomes among women in midlife.
abstract: OBJECTIVE
  Body dissatisfaction and disordered eating are widely recognized as issues that warrant attention among women in midlife, particularly the development and delivery of effective interventions. This article systematically reviews existing research on interventions among midlife women on body image and disordered eating outcomes, in order to inform intervention delivery and provide strategic directions for future research.
  
  
  METHODS
  Fourteen electronic databases were searched for articles published between 1992 and 2015 that evaluated interventions with nonclinical samples of women (M age 35-55 years) in controlled trials with at least one body image measure. Data were extracted and evaluated, and the methodological quality of studies was assessed using the Cochrane Collaboration tool for assessing risk of bias.
  
  
  RESULTS
  From 7,475 records identified, nine articles evaluating 11 interventions met the inclusion criteria. Seven interventions significantly improved body image at post-test (d's = 0.19-2.22), with significant improvements on disordered eating achieved by two of these interventions (d's = 0.90-1.72). Sustained improvements were achieved by three interventions that employed a multisession, therapeutically based, group intervention format; two with sustained body image and disordered eating improvements, and one with sustained body image improvements only (d's = 0.55-1.21; 2 weeks to 6 months). Methodological quality varied between studies.
  
  
  CONCLUSIONS
  To date, three interventions have demonstrated sustained improvements and are indicated for practitioners aiming to improve body image and disordered eating among women in midlife. Replication and more rigorous randomised controlled trials are required to enhance the methodological quality of intervention studies in this field.
authors.affiliation: Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
authors.forename: Helena
authors.initials: H
authors.lastname: Lewis-Smith
authors.affiliation: Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
authors.forename: Phillippa C
authors.initials: PC
authors.lastname: Diedrichs
authors.affiliation: Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
authors.forename: Nichola
authors.initials: N
authors.lastname: Rumsey
authors.affiliation: Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
authors.forename: Diana
authors.initials: D
authors.lastname: Harcourt
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged
keywords: body dissatisfaction; disordered eating; intervention; midlife; systematic review