title: Interventions to reduce the stigma of eating disorders: A systematic review and meta-analysis.
abstract: Stigma is a problem for individuals with eating disorders (EDs), forming a barrier to disclosure and help-seeking. Interventions to reduce ED stigma may help remove these barriers; however, it is not known which strategies (e.g., explaining etiology to reduce blame, contact with a person with an ED, or educating about ED) are effective in reducing stigma and related outcomes. This review described effectiveness of intervention strategies, and identified gaps in the literature. A search of four databases was performed using the terms (eating disorder* OR bulimi* OR anorexi* OR binge-eating disorder) AND (stigma* OR stereotyp* OR beliefs OR negative attitudes) AND (program OR experiment OR intervention OR education), with additional texts sought through LISTSERVs. Two raters screened papers, extracted data, and assessed quality. Stigma reduction strategies and study characteristics were examined in critical narrative synthesis. Exploratory meta-analysis compared the effects of biological and sociocultural explanations of EDs on attitudinal stigma. Eighteen papers were eligible for narrative synthesis, with four also eligible for inclusion in a meta-analysis. Biological explanations reduced stigma relative to other explanations, including sociocultural explanations in meta-analysis (g = .47, p < .001). Combined education and contact interventions improved stigma relative to control groups or over time. Most studies examined Anorexia Nervosa (AN) stigma and had mostly female, undergraduate participants. Despite apparent effectiveness, research should verify that biological explanations do not cause unintentional harm. Future research should evaluate in vivo contact, directly compare education and contact strategies, and aim to generalize findings across community populations.
authors.affiliation: Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.
authors.forename: Joanna R
authors.identifier: 0000-0002-8193-1223
authors.initials: JR
authors.lastname: Doley
authors.affiliation: Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.|Melbourne School of Global and Population Health, University of Melbourne, Parkville, VIC, Australia.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Hart
authors.affiliation: Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Stukas
authors.affiliation: Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.
authors.forename: Katja
authors.initials: K
authors.lastname: Petrovic
authors.affiliation: School of Psychology, Deakin University, Burwood, VIC, Australia.
authors.forename: Ayoub
authors.initials: A
authors.lastname: Bouguettaya
authors.affiliation: Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Paxton
mesh_terms: D000856:Anorexia Nervosa / Q000523:psychology; D001294:Attitude to Health; D056912:Binge-Eating Disorder / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods; D006801:Humans; D008297:Male; D057545:Social Stigma; D013239:Stereotyped Behavior
keywords: eating disorders; interventions; meta-analysis; narrative review; stigma