Mareille H.C.L. Hennekes Msc.*^1,2; Severina Haugvik Dipl.-troph., MPhil *, Maartje de Wit PhD, Elena Toschi MD, Christopher D. Desjardins PhD, Torild Skrivarhaug MD, PhD, Knut Dahl-Jørgensen MD, PhD, Eric Stice PhD, Line Wisting PhD^3,4

¹Amsterdam UMC, Location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, Netherlands

²Amsterdam Public Health, Mental Health, Amsterdam, Netherlands

³Oslo University Hospital, Division of Mental Health and Addiction, Regional Department for Eating Disorders, Norway

⁴Oslo New University College, Institute of Psychology, Norway

Objective: Young women with type 1 diabetes are at high risk for developing disordered eating behaviors and eating disorders, however effective prevention interventions are lacking. We evaluated pre-to post intervention effects of a novel dissonance-based eating disorder prevention program for young women with type 1 diabetes (Diabetes Body Project) in a multi-national randomized controlled trial.

Methods: Young women (14-35 years) with type 1 diabetes and body image concerns were randomized to either virtual Diabetes Body Project groups consisting of six weekly 1-hour sessions or an educational video control condition. Primary outcomes included eating disorder behaviors, risk factors and symptoms. Secondary outcomes included diabetes-specific psychological constructs and blood glucose time-in-range. Data was collected at pretest and posttest (~1-2 weeks after intervention and control condition).

Results: A total of 293 young women with type 1 diabetes were recruited. Compared to educational controls (n=146), participants in the Diabetes Body Project (n=147) showed significant improvements (all p<0.05) with medium effect sizes for diabetes-specific disordered eating behaviors, body dissatisfaction, and thin ideal internalization (Cohen’s d ranging from 0.56-0.70), and small effect sizes for eating disorder symptoms, dietary restraint, diabetes distress and quality of life (Cohen’s d ranging from 0.30-0.42). No significant effects were found for blood glucose time-in-range and negative affect.

Conclusions: The Diabetes Body Project produced significantly greater acute effects with overall small to medium effect sizes compared to educational video controls. As a brief low-cost virtual eating disorder prevention intervention, the Diabetes Body Project has potential for broad implementation.