***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Because universal psychoeducational eating disorder prevention programs have had little success , we developed and evaluated two interventions for high-risk population s : a healthy weight control intervention and a dissonance-based intervention . METHOD Adolescent girls ( N = 148 ) with body image concerns were r and omized to one of these interventions or to a waitlist control group . Participants completed baseline , termination , and 1 , 3 , and 6-month follow-up surveys . RESULTS Participants in both interventions reported decreased thin-ideal internalization , negative affect , and bulimic symptoms at termination and follow-up relative to controls . However , no effects were observed for body dissatisfaction or dieting and effects diminished over time . DISCUSSION Results provide evidence that both interventions effectively reduce bulimic pathology and risk factors for eating disturbances This study evaluated a targeted intervention design ed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program . The program consisted of six , 90-minute weekly small group , synchronous on-line sessions and was facilitated by a therapist and manual . Participants were 73 girls ( mean age=14.4 years , SD=1.48 ) who self-identified as having body image or eating problems and were r and omly assigned to an intervention group ( n=36 ) ( assessed at baseline , post-intervention and at 2- and 6-months follow-up ) or a delayed treatment control group ( n=37 ) ( assessed at baseline and 6–7 weeks later ) . Clinical ly significant improvements in body dissatisfaction , disordered eating , and depression were observed at post-intervention and maintained at follow-up . Internet delivery was enthusiastically endorsed . The program offers a promising approach to improve body image and eating problems that also addresses geographic access problems Although it is widely accepted that dieting increases the risk for bulimic pathology , this hypothesis has not been tested in a r and omized experiment . Accordingly , the authors conducted an experimental test of the dietary restraint model by r and omly assigning nonobese women ( N = 82 ) to either a 6-week , low-calorie diet or a waitlist control condition . The diet intervention result ed in significant weight loss , confirming that dieting was successfully manipulated . Contrary to the restraint model , dieting result ed in significant decreases in bulimic symptoms relative to the control condition . Results converge with past findings from r and omized obesity prevention and treatment trials and provide evidence that dieting does not promote bulimic pathology ; rather , effective decreases in caloric intake appear to reduce bulimic symptoms Project GRAD ( Graduate Ready for Activity Daily ) was a r and omized controlled study to teach university seniors behavioral skills necessary for increasing and /or maintaining physical activity habits in preparation for the transition to working adult roles after graduation . This study examines the secondary effects of this intervention on body image concerns among college-aged men and women . Three hundred thirty-eight undergraduates ( 54 % female , M age = 24 years , SD = 1.95 ; M Body Mass Index = 24.26 , SD = 4.0 ) were studied . The sample was 61 % Anglo , 16 % Latino , 16 % Asian/Pacific Isl and er , 4 % African American , and 3 % Native American/Other .  Body image concerns were assessed at pre- and posttreatment using 2 subscales of the Eating Disorder Inventory : Drive for Thinness and Body Dissatisfaction . Because the latter concentrates on body parts typically associated with female concerns ( e.g. , thighs , hips , buttocks ) , a parallel scale was developed to target body parts that may be of more concern to men ( e.g. , legs , shoulders , arms , stomach ) . Results indicated that compared to the control group , women in the intervention showed a significant increase in drive for thinness without any changes in body dissatisfaction . For men , there were no significant changes in drive for thinness or body dissatisfaction . These results suggest that physical activity interventions may have some negative consequences of increasing concerns about thinness in women . This negative effect occurred despite intervention content design ed to prevent concern over eating , dieting , and the importance of weight . Health promotion studies should include assessment s of potential negative side effects BACKGROUND Body image dissatisfaction during adolescence is common but not benign . School-based interventions have the potential for wide reach , but scalability of previous programmes is limited by a reliance on external facilitators . AIMS To assess the acceptability , feasibility and efficacy of a teacher-delivered body image intervention . METHOD A pilot clustered r and omised controlled trial in which 16 classes of adolescent girls were allocated to a 6-session body image programme ( n = 261 ) ,  or usual curriculum control ( n = 187 ) ( registration : IS RCT N42594993 ) . RESULTS Students in the intervention group had significantly improved body esteem and self-esteem and reduced thin-ideal internalisation . Effects for body esteem and thin-ideal internalisation were maintained for 3 months . There were no group differences for eating pathology , peer factors or depression . Acceptability , feasibility and efficacy varied between schools . CONCLUSIONS Teacher-delivered body image lessons have promise but further work is needed to increase efficacy and make interventions suitable across a range of schools This study assessed the impact of a school-based program aim ed at preventing  disordered eating .  The program was based on the media-literacy approach and has interactive format . The program was assessed under strong method ological conditions . Seven schools with 263 Spanish adolescent girls in the area of Barcelona , were r and omly assigned to either the complete prevention program condition , the partial program condition or the non-treatment control condition , and assessed at pre , post and 6-month follow-up . The program was effective in generating positive changes at follow-up . The effects sizes ( ES(d ) = 0.29 to ES(d ) = 0.38 ) were greater , on average , than that obtained up to now in selective-universal programs , and similar or greater than that achieved by targeted prevention programs . The results indicate a greater and relevant effect size of the intervention in those participants who completed the inter-session interactive activities ( ES(d ) = 0.29 to ES(d ) = 0.45 ) although the differences were not significant . These results suggest the importance of monitoring adherence to the activities in all programs defined as " interactive " . The implication s and limitations of this study are discussed OBJECTIVE Although several prospect i ve studies have identified factors that increase risk for eating disorders , little is known about when these risk factors emerge and escalate , or when they begin to predict future eating disorder onset . The objective of this report was to address these key research gaps . METHOD Data were examined from a prospect i ve study of 496 community female adolescents ( M = 13.5 , SD = 0.7 at baseline ) who completed eight annual assessment s of potential risk factors and eating disorders from preadolescence to young adulthood . RESULTS Three variables exhibited positive linear increases : Perceived pressure to be thin , thin-ideal internalization , and body dissatisfaction ; three were best characterized as quadratic effects : dieting ( essentially little change ) ; negative affectivity ( overall decrease ) , and BMI ( overall increase ) . Elevated body dissatisfaction at ages 13 , 14 , 15 , and 16 predicted DSM-5 eating disorders onset in the 4-year period after each assessment , but the predictive effects of other risk factors were largely confined to age 14 ; BMI did not predict eating disorders at any age . DISCUSSION The results imply that these risk factors are present by early adolescence , although eating disorders tend to emerge in late adolescence and early adulthood . These findings emphasize the need for efficacious eating disorder prevention programs for early adolescent girls , perhaps targeting 14-year olds , when risk factors seem to be most predictive . In early adolescence , it might be fruitful to target girls with body dissatisfaction , as this was the most consistent predictor of early eating disorder onset in this study OBJECTIVE To assess the impact of an obesity prevention intervention on use of self-induced vomiting/laxatives ( purging ) and diet pills to control weight in girls in early adolescence . DESIGN We matched and r and omly assigned 10 middle schools to an  intervention  or a  control condition  in a r and omized controlled trial . Longitudinal multivariable analyses using generalized estimating equations were conducted with data from 480 girls to examine the effects of the intervention on the risk of reporting a new case of purging or diet pill use to control weight at follow-up 21 months later , while controlling for ethnicity and school matched pairs . Girls who reported purging or using diet pills at baseline were excluded from analyses . SETTING Middle schools . PARTICIPANTS Four hundred eighty girls in early adolescence aged 10 to 14 years ( mean age , 11.5 years ) . INTERVENTION The Planet Health obesity prevention program was implemented during 2 school years and was design ed to promote healthful nutrition and physical activity and to reduce television viewing . OUTCOME Reduced risk of using self-induced vomiting/laxatives or diet pills to control weight in the past 30 days . RESULTS After the intervention , we found 14 ( 6.2 % ) of 226 girls in control schools and 7 ( 2.8 % ) of 254 girls in intervention schools reported purging or using diet pills to control their weight ( P = .003 ) . In a multivariable generalized estimating equation model , girls in intervention schools were less than half as likely to report purging or using diet pills at follow-up compared with girls in control schools ( odds ratio , 0.41 ; 95 % confidence interval , 0.22 - 0.75 ) . CONCLUSION These findings provide promising evidence that school-based interventions may effectively integrate prevention of both obesity and disordered weight-control behaviors This two-group experimental study evaluated the effectiveness of a cognitive-behavioral body image intervention , adapted from an effective clinical intervention , with normal college females . Participants included non clinical , freshman college women who were assigned r and omly to either the  experimental intervention or the control group ( brief educational session ) . Participants were assessed prior to the intervention and again 1 month later on dieting behavior , body image , fear of fat , and anxiety concerning physical appearance . Although it was hypothesized that each of these variables would be lower in the experimental group , none of these results , except for a trend for decreased dieting , were found . Overall these results of slightly reduced dieting behavior are consistent with other research targeting primary and secondary prevention . This intervention 's failure to impact body image and eating behaviors of college students illustrates the continuing challenge of eating disorders prevention CONTEXT Eating disorders , an important health problem among college-age women , may be preventable , given that modifiable risk factors for eating disorders have been identified and interventions have been evaluated to reduce these risk factors . OBJECTIVE To determine if an Internet-based psychosocial intervention can prevent the onset of eating disorders ( EDs ) in young women at risk for developing EDs . SETTING San Diego and the San Francisco Bay Area in California . PARTICIPANTS College-age women with high weight and shape concerns were recruited via campus e-mails , posters , and mass media . Six hundred thirty-seven eligible participants were identified , of whom 157 were excluded , for a total sample of 480 . Recruitment occurred between November 13 , 2000 , and October 10 , 2003 . Intervention A r and omized controlled trial of an 8-week , Internet-based cognitive-behavioral intervention ( Student Bodies ) that included a moderated online discussion group . Participants were studied for up to 3 years . MAIN OUTCOME MEASURES The main outcome measure was time to onset of a sub clinical or clinical ED . Secondary measures included change in scores on the Weight Concerns Scale , Global Eating Disorder Examination Question naire , and Eating Disorder Inventory drive for thinness and bulimia subscales and depressed mood . Moderators of outcome were examined . RESULTS There was a significant reduction in Weight Concerns Scale scores in the Student Bodies intervention group compared with the control group at postintervention ( P < .001 ) , 1 year ( P < .001 ) , and 2 years ( P < .001 ) . The slope for reducing Weight Concerns Scale score was significantly greater in the treatment compared with the control group ( P = .02 ) . Over the course of follow-up , 43 participants developed sub clinical or clinical EDs . While there was no overall significant difference in onset of EDs between the intervention and control groups , the intervention significantly reduced the onset of EDs in 2 subgroups identified through moderator analyses : ( 1 ) participants with an elevated body mass index ( BMI ) ( > or = 25 , calculated as weight in kilograms divided by height in meters squared ) at baseline and ( 2 ) at 1 site , participants with baseline compensatory behaviors ( eg , self-induced vomiting , laxative use , diuretic use , diet pill use , driven exercise ) . No intervention participant with an elevated baseline BMI developed an ED , while the rates of onset of ED in the comparable BMI control group ( based on survival analysis ) were 4.7 % at 1 year and 11.9 % at 2 years . In the subgroup with a BMI of 25 or higher , the cumulative survival incidence was significantly lower at 2 years for the intervention compared with the control group ( 95 % confidence interval , 0 % for intervention group ; 2.7 % to 21.1 % for control group ) . For the San Francisco Bay Area site sample with baseline compensatory behaviors , 4 % of participants in the intervention group developed EDs at 1 year and 14.4 % , by 2 years . Rates for the comparable control group were 16 % and 3 
    Output:
    
Findings indicated small to moderate effect sizes on reduction of ED risk factors or symptoms which occurred up to three-year post-intervention .
Cognitive behavioural therapy ( CBT ) interventions had the largest effect size ( -0.40 , 95 % CI -0.55 to -0.26 ) on dieting outcome at 9-month follow-up while the healthy weight intervention reduced ED risk factors and body mass index .
No indicated prevention interventions were found to be effective in reducing ED risk factors .
CONCLUSIONS There are a number of promising preventive interventions for ED risk factors  including CD , CBT and ML .
Whether these actually lower ED incidence is , however , uncertain .