Motivational interviewing in the reduction of risk factors for eating disorders: A pilot study

Eating disorder prevention programs are popular on college campuses, yet such programs have been infrequently evaluated (Mann et al., 1997) and the outcome of such studies has been equivocal. Motivational Interviewing (MI) offers a promising alternative because it has received support as a brief, secondary preventative intervention with alcohol use disorders among college students (e.g., Marlatt et al., 1998), and has been applied to a number of other health-related behaviors. This randomized, controlled study examined the feasibility, acceptability, and efficacy of MI in the reduction of risk factors for eating disorders. We also explored how MI exerted its effect, by examining the role of attitudes, norms, intentions, and self-efficacy. Fifty college women deemed 'at risk' for the development of an eating disorder were randomly assigned to a single MI session or a nutrition education session and re-assessed at posttreatment and six-week follow-up. Results demonstrated that MI is a highly acceptable intervention. All measures of eating disorder psychopathology (global eating pathology, body dissatisfaction, cognitive preoccupation, and dietary restraint) improved in both conditions from pretreatment to six-week follow-up, and participants in the MI condition improved more on two key symptoms, global eating pathology and body dissatisfaction. With regard to the putative mediators, we found that attitudes and self-efficacy improved from pretreatment to posttreatment in both conditions suggesting that these are modifiable with intervention. Norms did not change and intentions marginally worsened. Posttreatment attitudes, intentions, and self-efficacy were associated with eating disorder psychopathology at six-week follow-up, suggesting that these may be important targets in future investigations. None of the putative mediators were differentially influenced by treatment condition in this investigation. Thus, the social-cognitive variables we chose to examine do not appear to account for the small advantage of MI over nutrition education. This study provides initial support for motivational enhancement techniques with individuals 'at risk' for the development of eating disorders. Improved understanding of prospective risk factors will further refine our definition of 'at risk' thus allowing researchers to more effectively reach the target population. Moreover, future work is necessary to determine whether a higher dose of MI may be even more effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)