Secondary effects of body dissatisfaction interventions on adolescent depressive symptoms: A meta-analysis

Secondary effects of body dissatisfaction interventions on adolescent depressive symptoms: A meta-analysis

Ahuvia, I. Jans, L. Schleider, J.
International Journal of Eating Disorders
OBJECTIVE Depression is a leading cause of disability among adolescents, yet existing treatments are variably effective, suggesting needs to identify novel intervention targets. Body dissatisfaction (BD) may be a promising, but understudied, target: BD is common among adolescents; prospectively associated with future depression; and modifiable through intervention. BD interventions are typically evaluated in terms of impacts on eating disorders, but many trials also measure depression-related secondary outcomes. However, BD intervention effects on depression have not been systematically examined. We, therefore, conducted a meta-analysis to estimate secondary effects of BD interventions on depression symptoms and related outcomes in adolescents (ages 12-19). METHOD Our systematic review included randomized controlled trials (RCTs) published between January 2006 and December 2020. Across-group effect sizes were analyzed using robust variance estimation. Preregistered methods, data, and analytic code are available at RESULTS: The meta-analysis included 13 RCTs, 50 effect sizes, and 6,962 participants. BD interventions led to significant postintervention reductions in depression-related outcomes versus control conditions (g = -0.19 at postintervention, 95% confidence interval: -0.07, -0.31, p = .005). No evidence emerged for moderators of this meta-analytic effect. DISCUSSION Overall, BD-focused interventions significantly reduced adolescent depression, with mean postintervention effect sizes comparable to those observed for interventions targeting depression explicitly. Results are bolstered by preregistered methods and robustness checks. Limitations include a lack of data on participants' sexual and gender identities and a significant risk of bias in the underlying literature. Future research on BD interventions should measure depression symptom severity as a secondary outcome.

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Type of intervention

Preventive- and Promotive Health Interventions

Early Intervention

Treatment and Child Welfare Interventions


Mental Health Problems and Disorders

Emotional Problems

Depression and Depressed Mood


The organization of interventions

Group Interventions

Age group

School Aged Children (6-12 years)

Adolescents (13-18 years)

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