A randomized controlled feasibility trial of a single-session metacognitive training intervention for reducing eating disorder risk factors

This study investigates the feasibility and preliminary evidence for the efficacy of a single-session online metacognitive training (MCT-ED) among a population considered to be at-risk of developing an eating disorder. A total of N = 95 participants with high weight concerns were randomised to an MCT-ED condition (n = 43) or a waitlist control condition (n = 52). Participants completed measures of body image flexibility, perfectionism, weight and shape concerns and mood at baseline, post-treatment (one-week post-baseline), and 3-months post-treatment. The MCT-ED intervention consisted of content targeting cognitive flexibility and perfectionism. Treatment completion for MCT-ED was 93.62%, indicating that the intervention was feasible and acceptable. Participants also provided positive ratings on a feedback questionnaire indicating preliminary feasibility. At 1-week post-treatment, relative to the waitlist condition, the MCT-ED group had significantly lower personal standards (d = 0.64) and experienced a significantly greater decrease in concern over mistakes (d = 0.57). These improvements were not sustained at 3-month follow-up. Findings suggested that MCT-ED is a feasible brief intervention format for those with elevated weight concerns, but more research is required to produce longer, more meaningful effects that may impact weight and shape concerns.