Anorexia Prevention in Female College Students

Prevention of Anorexia Nervosa in Female College Students

This study evaluated whether an acceptance-based embodied movement program can reduce eating disorder risk and body shape concerns in female college students at elevated risk. A total of 135 female undergraduate and graduate students were randomly assigned to one of three groups: acceptance-based embodied movement, functional fitness control, or psychoeducation. The intervention lasted 8 weeks, and outcomes were assessed at baseline, week 4, week 8, and 3-month follow-up. The main outcomes were eating disorder risk and body shape concern. Secondary outcomes included depression, anxiety, body image flexibility, functionality appreciation, and body surveillance.

This was a single-blind, three-arm, parallel-group randomized controlled trial conducted among female college students at elevated risk of eating disorders or body shape concerns. Participants were recruited from Jinan University and randomly assigned in a 1:1:1 ratio to acceptance-based embodied movement, functional fitness control, or psychoeducation.

The acceptance-based embodied movement program used low-impact mindful movements derived from yoga and tai chi and incorporated acceptance and commitment therapy techniques. The program emphasized present-moment body sensations, acceptance of appearance-related thoughts and feelings, cognitive defusion, valued action, and appreciation of body functionality. The functional fitness control program matched the movement intervention in session duration, frequency, and contact time, but removed mindfulness and acceptance components. It included aerobic and core exercises with standard fitness instruction. The psychoeducation program provided cognitive and dissonance-based body image education without physical activity.

All three programs lasted 8 weeks and were delivered in groups by trained facilitators using written manuals. Outcomes were assessed at baseline, mid-intervention, post-intervention, and 3-month follow-up. The primary outcomes were eating disorder risk measured by the Eating Disorder Examination Questionnaire Short Form and body shape concern measured by the Body Shape Questionnaire-8C. Secondary outcomes included depression, anxiety, body image flexibility, functionality appreciation, and body surveillance. Attendance, intervention fidelity, and adverse events were monitored throughout the study.

Inclusion Criteria:

• Female undergraduate or graduate students.
• Aged 18 to 25 years.
• Elevated eating disorder risk or body shape concern based on the prespecified screening threshold.
• Physically able to participate in light-intensity physical activity.
• Provided written informed consent.

Exclusion Criteria:

• Current treatment for an eating disorder.
• Any physical condition contraindicating participation in exercise.
• Pregnancy.
• Concurrent participation in another structured body image or exercise program.