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Effective Prevention Programs in College and University Settings

Deanne Zotter and Justine Reel

Although eating disorders (EDs) and disordered eating can occur at any age (Reel, SooHoo, Summerhays, & Gill, 2008), college students tend to be more vulnerable than their older counterparts. Estimates are that 10% to 30% of college women appear to be at risk for developing an ED over the course of their college years (Franko et al., 2005). EDs are associated with significant impairment in functioning. Furthermore, disordered eating can increase the risk for depressive and anxiety disorders, substance abuse, health problems, and obesity (Johnson, Cohen, Kasen, & Brook, 2002; Stice, Cameron, Killen, Hayward, & Taylor, 1999). Given the poor to modest treatment outcomes, prevention of EDs has become a well-recognized public health goal.

Targeting college students for prevention efforts makes sense for many reasons. College students have been identified as an at-risk group, and specific groups of college students (e.g., sorority women, athletes, health and physical education [H&PE] majors) are believed to be at higher risk than college students in general. Effective prevention programs may not only help the students themselves, but the positive effects of such programs (i.e., producing healthier attitudes and behaviors in the college participants) have the potential to benefit students, and those they come in contact with, well beyond their college years. If healthy body attitudes and weight management behaviors can be instilled in these individuals through effective prevention programs during their career preparation years, they will be in a position to be positive role models for their future communities, students, patients, consumers, and, perhaps most important, their future children.

In this chapter, we review the prevalence of EDs, disordered eating behaviors, and body image concerns in college and university populations. Attention is given to groups believed to be at higher risk, including sorority women, college athletes, and those majoring in health and physical education. Prevention programs developed and administered on college campuses are then discussed. Given that even well-intentioned efforts can have negative outcomes such as normalizing eating-disordered behaviors (Mann et al., 1997), we focus on prevention efforts in university settings that have received research support for their effectiveness. First, we review the findings from literature reviews of prevention programs across all settings and then examine findings specific to university settings. Next, we provide information on an Internet-based prevention program, two programs aimed at preventing EDs among sorority women, and suggestions for the prevention of disordered eating in college athletes. A summary of a recent study examining prevention among H&PE students is also provided. Finally, we discuss important considerations for prevention efforts with university students, including directions for further research.

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