Objective: This systematic review evaluates and summarizes existing eating disorder (ED) prevention programs in Latin American countries.
Methods: A systematic literature search was conducted using the Cochrane Controlled Trial Register, PubMed, and Virtual Health Library databases up to and including July 31, 2022. All ED prevention studies published in English, Spanish or Portuguese were eligible, regardless of the study design, sample characteristics, and type of prevention programs. The Cochrane Collaboration Risk of Bias criteria were used to evaluate the quality of the included studies.
Results: Twenty-two studies were included. Most were pilot studies that were nonrandomized, had a high risk of bias, were from Mexico and Brazil, and employed selective interventions. Dissonance-based programs and social cognitive theory were the commonly used approaches in interventions, and most of them were tested in adolescent girls and women. Short follow-ups were used, varying from 1 to 6 months. Many found significant decreases after the intervention and/or at follow-up in ED/disordered eating risk behaviors/symptoms, negative affect, body-ideal internalization, and body image disturbances.
Conclusions: This review highlights promising efforts to prevent EDs among Latin American countries. Some barriers in conducting research include funding restrictions, laws that do not allow remuneration or compensation for participants, and high costs of training. Nonetheless, the outcomes of the programs developed and evaluated so far are positive enough to merit further work on ED prevention. Efforts for future researchers should recruit samples with diverse characteristics, use robust designs and data analysis techniques, and expand the accessibility of prevention programs.
Public significance statement: The development of effective eating disorder (ED) prevention programs that can be broadly implemented is a public health priority. Nevertheless, there is limited evidence regarding the characteristics of ED prevention programs and their efficacy among Latin American countries. In the present study, we reviewed existing ED prevention programs adopted in Latin America, described their characteristics and outcomes, noted the limitations of available programs, and discussed the implications of these findings for efforts to prevent the development of EDs in Latin America. The outcomes of the programs developed and evaluated so far are positive enough to merit the development and rigorous evaluation of future programs and their broad dissemination in Latin American countries. PROSPERO registration number CRD42021275245.
Objetivo: Esta revisión sistemática evalúa y resume los programas de prevención de trastornos de la conducta alimentaria (TCA) existentes en los países de América Latina. MÉTODOS: Se realizó una búsqueda bibliográfica sistemática utilizando las bases de datos del Registro Cochrane de Ensayos Controlados (Cochrane Controlled Trial Register), PubMed y Virtual Health Library hasta el 31 de julio de 2022 inclusive. Todos los estudios de prevención de TCA publicados en inglés, español o portugués fueron elegibles, independientemente del diseño del estudio, las características de la muestra y el tipo de programas de prevención. Se utilizaron los Criterios de Riesgo de Sesgo de la Colaboración Cochrane para evaluar la calidad de los estudios incluidos.
Resultados: Se incluyeron veintidós estudios. La mayoría eran estudios piloto no aleatorizados, tenían un alto riesgo de sesgo, eran de México y Brasil, y empleaban intervenciones selectivas. Los programas basados en la disonancia y la teoría cognitiva social fueron los enfoques comúnmente utilizados en las intervenciones, y la mayoría de ellos se probaron en niñas y mujeres adolescentes. Se utilizaron seguimientos cortos, que variaron de uno a 6 meses. Muchos encontraron disminuciones significativas después de la intervención y / o en el seguimiento en los síntomas de TCA/Conductas Alimentarias de Riesgo, afecto negativo, internalización de la figura ideal y trastornos de la imagen corporal.
Conclusiones: Esta revisión destaca los esfuerzos prometedores para prevenir los TCA entre los países de América Latina. Algunas barreras en la realización de investigaciones incluyen restricciones de financiamiento, leyes que no permiten la remuneración o compensación para los participantes y los altos costos de capacitación. No obstante, los resultados de los programas desarrollados y evaluados hasta ahora son lo suficientemente positivos como para merecer un mayor trabajo en la prevención de los TCA. Los esfuerzos para futuros investigadores deben reclutar muestras con características diversas, utilizar diseños robustos y técnicas de análisis de datos, y ampliar la accesibilidad de los programas de prevención.
Keywords: Latin America; dissonance-based; eating pathology; prevention programs.
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