Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Burwood, VIC, 3125, Australia.
Eat Weight Disord. 2022 Dec;27(8):2989-3003. doi: 10.1007/s40519-022-01458-8. Epub 2022 Aug 27.
Eating disorders (EDs) and high body mass index (BMI) are two important public health issues with significant health and cost impacts. The aim of this systematic review and meta-analysis was to establish whether interventions are effective in preventing both issues.
Electronic databases were searched up to 10 May 2021. Studies were included if they were randomised or quasi-randomised controlled trials that evaluated a preventive intervention (regardless of its aim to prevent ED, high BMI or both) and reported both EDs and BMI-related outcomes. Both narrative synthesis and meta-analysis were used to synthesise the results. Publication bias was also investigated.
Fifty-four studies were included for analysis. The primary aim of the studies was ED prevention (n = 23), high BMI prevention (n = 21) and both ED and high BMI prevention (n = 10). Meta-analysis results indicated that preventive interventions had a significant effect on several ED outcomes including dieting, shape and weight concerns, body dissatisfaction, negative affect, eating disorder symptoms and internalization, with effect sizes ranging from - 0.16 (95% CI - 0.27, - 0.06) to - 0.61 (95% CI - 0.29, - 0.04). Despite several studies that demonstrated positive impacts on BMI, there was no significant effect on BMI-related measures in the meta-analysis. The risk of publication bias was low for the majority of the pooled effect results.
Preventive interventions were effective for either high BMI or EDs. However, there is limited evidence to show that current preventive interventions were effective in reducing both outcomes. Further research is necessary to explore the risk factors that are shared by these weight-related disorders as well as effective prevention interventions.
Level I: systematic review.
饮食失调（ED）和高身体质量指数（BMI）是两个重要的公共卫生问题，对健康和成本都有重大影响。本系统评价和荟萃分析的目的是确定干预措施在预防这两个问题方面是否有效。
电子数据库检索至 2021 年 5 月 10 日。如果研究是随机或准随机对照试验，评估预防干预措施（无论其预防 ED、高 BMI 或两者的目的是什么）并报告 ED 和 BMI 相关结果，则纳入研究。使用叙述性综合和荟萃分析来综合结果。还研究了发表偏倚。
纳入 54 项研究进行分析。研究的主要目的是预防 ED（n=23）、预防高 BMI（n=21）和预防 ED 和高 BMI（n=10）。荟萃分析结果表明，预防干预对几种 ED 结果有显著影响，包括节食、体型和体重担忧、身体不满、负性情绪、饮食障碍症状和内化，效应大小范围从-0.16（95% CI -0.27，-0.06）至-0.61（95% CI -0.29，-0.04）。尽管有几项研究表明对 BMI 有积极影响，但荟萃分析中 BMI 相关指标没有显著效果。大多数汇总效应结果的发表偏倚风险较低。
预防干预措施对高 BMI 或 ED 有效。然而，目前尚无证据表明预防干预措施能有效降低这两个结果。需要进一步研究探索这些与体重相关的疾病共同的危险因素以及有效的预防干预措施。
一级：系统评价。
