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

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.