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Prevention of Eating-Related Disorders: Speaker’s Abstracts

Gail McVey

Moving from Individual to Ecological Models of Prevention: Linking School-Based Research with Community Action and Policy Change

This presentation will provide a brief overview of research findings related to school-based interventions designed to promote positive body image and help prevent disordered eating among school-age children. A description of how the model of prevention evolved from classroom curriculum and nurse-facilitated peer support groups (McVey,Davis,Tweed, & Shaw, 2004; McVey, Lieberman, Voorberg, Wardrope, & Blackmore, Tweed, 2003a,b) to the development of a longer and more intensive comprehensive program within an ecological approach (McVey, Tweed, & Blackmore, 2007) will be provided. The prevention strategies have subsequently been translated to teachers and local public health practitioners through web-based training and curriculum material (McVey, Gusella, Tweed, & Ferrari, 2007; www.aboutkidshealth.ca/thestudentbody), and face-to-face community-based workshops (McVey, Davis, Kaplan, Katzman, Geist, Pinhas, Heinmaa, & Forsyth, 2005; www.ocoped.ca). Partnership development and networking activities across health and education sectors with researchers, clinicians, members of government, national government organizations, community-based coalitions, and parent representatives will be described to showcase how collaborative community research, using a systems approach, can help change practice.

Michael Levine
Theoretical Issues and lessons learned from other fields of prevention

What can people committed to prevention of the spectrum of problems with body image, eating, and weight/shape concerns learn about effective and ethical prevention from theory, research, and evaluation methodology in other fields of prevention? This presentation begins by briefly summarizing the key features of the more effective eating disorder universal and selective prevention programs for children and adolescents. These features are then compared to the implications of effective programming for prevention of other health-related problems such as cigarette-smoking and alcohol use. The ATHENA program for female high school athletes, cheerleaders, and dancers (http://www.ohsu.edu/hpsm/athena.cfm) is an extension of very successful ATLAS program for prevention of steroid and supplement use by male high school athletes (http://www.ohsu.edu/hpsm/atlas.cfm). The ATHENA program, which integrates substance abuse and eating disorder prevention, will be discussed in some detail. The presentation concludes with specific suggestions for feasible improvements to current eating disorder prevention projects will be offered.

Anthony Biglan
Reflective on the morning presentations

Linda Smolak
Gender and Ethnicity as Cultural Contexts for Disordered Eating

Body image problems, disordered eating, and eating disorders develop within cultural contexts. Messages from parents, peers, media, textbooks, and school personnel all contribute to the onset and maintenance of body image and eating problems. Messages about gender and ethnicity are a crucial component of this socialization. From an early age, girls learn the value of appearance and sexuality for their social and financial success while simultaneously understanding that their skills and achievements are relatively devalued. The experiences involved in developing these beliefs and attitudes differ by ethnicity and social class. The purpose of this presentation is to explore the “lived experiences” of being female that contribute to these patterns of development. Objectification and sexism, including sexual harassment, sexual violence, and media images, focus girls on their bodies contributing to the development of depression, negative body image, and disordered eating. Similarly, ethnic based harassment and discrimination may contribute to emphasis on an attractive body as a means to success within the majority culture. Thus, this presentation explores the aspects of being female and being a member of an ethnic minority group that may contribute to the gender and ethnic group differences in rates and types of body image and eating problems. Protective factors, including feminist and ethnic identities, will also be discussed.

Niva Pira
Linking the Social Context to Prevention Work: Facilitating Positive Body Image and Body Care

This presentation will address key dimensions in the task of linking social context to prevention work towards the goal of facilitating positive body image and body care. First, the presentation will address social critical theory and related research that examines the complex impact of structures of power and privilege, associated with gender and other social variables, on self and body experiences. Second, the presentation will address the implications of this knowledge to prevention work, in particular: the incorporation of public health, systemic, participatory, protective, and context-specific perspectives to prevention work.

Leora Pinhas
The Link between Weight and Health: What are the Controversies?

Illness prevention and health promotion programs by their very nature must rely on particular assumptions about their topic of focus. This presentation will briefly review the basic assumptions underlying the link between weight and health and explore the evidence base that supports our current understanding about illness prevention and obesity in children and adolescents. How weight is determined and interpreted, the treatment recommendations for children who are classified as having a unhealthy weight and current data on outcomes will be reviewed.

Lindsay McLaren
Understanding the Social Determinants of Obesity and Eating Disorders: A Population Health Approach

The population health approach aims to understand and improve the health of whole populations (i.e., not just those who are sick) and to reduce health inequities among population groups. In this brief presentation I will outline some implications of this approach for research on obesity and eating disorders. First, population health highlights a distinction between individuals and populations when considering the causes of an illness, and this distinction provides insight into upstream determinants of obesity and eating disorders. Second, attention to health inequities draws attention to the complex socioeconomic patterning of these weight-related issues, for which multidimensional models of social class are informative.

Joe Kelly
Advocacy: Parent and Community Involvement

Since 1999, Dads & Daughters has been working to make the world safe and fair for our daughters. The international NGO, based in Minnesota and New York, participates in coalitions addressing gender equity in education, marketing to children, mental health parity, mental illness prevention and responsible fathering. This talk will describe a “net-roots” campaign strategy Dads & Daughters employed for several years, based on challenging corporate marketers and US federal policymakers to “put your daughter’s face in the picture” when engaging in marketing and/or policy harmful to girls and/or women. Since most CEOs of large North American corporations are men (and most of those are fathers, stepfathers, and/or grandfathers), this strategy frequently proved to be effective. It also provided openings to talk with media about how sexist marketing to girls and sexist policies affecting girls undermine family stability, positive father-daughter relationships, and the healthy development of boys. I will discuss some examples of campaigns, and the underlying processes that made them successful. The goal is to help participants draw lessons that they can apply to their own advocacy and activism efforts on behalf of girls’ and women’s well-being.

Susan Paxton
Advocacy: Public Health and Government Involvement

In light of the high prevalence of body image and eating problems it is essential that effective public health interventions are not only developed but also widely disseminated. Whole community interventions require a public health approach with strong government backing. In Australia, the Victorian State Government has been a leader in public health intervention in this field. This talk will describe influences that have been important in raising government awareness and that have assisted in mainstreaming concerns about body image and eating disorders. Advocacy of organizations and individuals has been essential. I will describe government responses to the Parliamentary Inquiry into Body Image and Eating Disorders, with an emphasis on the public health advertising campaigns and the roll-out of teacher training for Dove’s BodyThink prevention intervention. This talk will also discuss ongoing issues in public health intervention including: the difficulties of maintaining a focus on prevention when need for treatment facilities is still high; how best to facilitate integration with obesity interventions; the difficulty of maintaining focus, energy and expenditure in this area; and the need for stronger evidence to support public health interventions. Governments need our support in moving forward public health interventions.

Alison Colavecchia
Physician Development: Promoting Comfort and Confidence in the Early Identification and Medical Management of Patients with Eating Disorders

Physicians and administrators have often expressed a reluctance to provide care for or admit to hospital, those patients who present with an eating disorder. There is general discomfort around the complex nature of the illnesses and with the intractable recovery often associated with these disorders. In response to these and other concerns raised by parents, clinical eating disorder team staff, clients and physicians themselves, physician development became a priority for the CWEDP approximately two years ago. A variety of initiatives have been undertaken including completion of a comprehensive needs assessment, delivery of workshops and mentoring sessions and the creation of a physician resource binder. These have been developed to promote improved comfort and confidence among physicians and clinical nurse practitioners particularly around early identification and ongoing medical monitoring and management. Through the distribution of a practical resource binder, physicians have also been provided with an opportunity to dialogue with a specialist practitioner from the outpatient program in their area. This opportunity has been very positively received as has the binder. This brief presentation will highlight findings from the needs assessment as well as provide an overview of the feedback received from the physicians around the educational efforts delivered to date including the resource binder.