title: Reducing eating disorder onset in a very high risk sample with significant comorbid depression: A randomized controlled trial.
abstract: OBJECTIVE
  Eating disorders (EDs) are serious problems among college-age women and may be preventable. An indicated online eating disorder (ED) intervention, designed to reduce ED and comorbid pathology, was evaluated.
  
  
  METHODS
  206 women (M age = 20 ± 1.8 years; 51% White/Caucasian, 11% African American, 10% Hispanic, 21% Asian/Asian American, 7% other) at very high risk for ED onset (i.e., with high weight/shape concerns plus a history of being teased, current or lifetime depression, and/or nonclinical levels of compensatory behaviors) were randomized to a 10-week, Internet-based, cognitive-behavioral intervention or waitlist control. Assessments included the Eating Disorder Examination (EDE, to assess ED onset), EDE-Questionnaire, Structured Clinical Interview for DSM Disorders, and Beck Depression Inventory-II.
  
  
  RESULTS
  ED attitudes and behaviors improved more in the intervention than control group (p = .02, d = 0.31); although ED onset rate was 27% lower, this difference was not significant (p = .28, NNT = 15). In the subgroup with highest shape concerns, ED onset rate was significantly lower in the intervention than control group (20% vs. 42%, p = .025, NNT = 5). For the 27 individuals with depression at baseline, depressive symptomatology improved more in the intervention than control group (p = .016, d = 0.96); although ED onset rate was lower in the intervention than control group, this difference was not significant (25% vs. 57%, NNT = 4).
  
  
  CONCLUSIONS
  An inexpensive, easily disseminated intervention might reduce ED onset among those at highest risk. Low adoption rates need to be addressed in future research.
authors.affiliation: Department of Psychiatry, Stanford Medical Center.
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
authors.affiliation: Department of Psychology, Washington University in St. Louis.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Kass
authors.affiliation: Department of Psychiatry, Stanford Medical Center.
authors.forename: Mickey
authors.initials: M
authors.lastname: Trockel
authors.affiliation: Department of Psychiatry, Stanford Medical Center.
authors.forename: Darby
authors.initials: D
authors.lastname: Cunning
authors.affiliation: Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara.
authors.forename: Hannah
authors.initials: H
authors.lastname: Weisman
authors.affiliation: Department of Psychiatry, Stanford Medical Center.
authors.forename: Jakki
authors.initials: J
authors.lastname: Bailey
authors.affiliation: Department of Psychology, College of William & Mary.
authors.forename: Meghan
authors.initials: M
authors.lastname: Sinton
authors.affiliation: Department of Psychiatry, Stanford Medical Center.
authors.forename: Vandana
authors.initials: V
authors.lastname: Aspen
authors.affiliation: Department of Cardiology, Washington University School of Medicine.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Schecthman
authors.affiliation: Klinische Psychologie und Psychotherapie, Technische Universität Dresden.
authors.forename: Corinna
authors.initials: C
authors.lastname: Jacobi
authors.affiliation: Department of Psychology, Washington University in St. Louis.
authors.forename: Denise E
authors.initials: DE
authors.lastname: Wilfley
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003863:Depression / Q000150:complications* / Q000628:therapy; D003866:Depressive Disorder / Q000150:complications* / Q000628:therapy*; D001068:Feeding and Eating Disorders / Q000517:prevention & control*; D005260:Female; D006801:Humans; D020407:Internet; D008875:Middle Aged; D050177:Overweight / Q000209:etiology / Q000517:prevention & control; D011569:Psychiatric Status Rating Scales; D012306:Risk; D011795:Surveys and Questionnaires; D014850:Waiting Lists