Identifying Factors Which Influence Eating Disorder Risk during Behavioral Weight Management: A Consensus Study

This study aimed to understand clinician, researcher and consumer views regarding factors which influence eating disorder (ED) risk during behavioral weight management, including individual risk factors, intervention strategies and delivery features. Eighty-seven participants were recruited internationally through professional and consumer organizations and social media and completed an online survey. Individual characteristics, intervention strategies (5-point scale) and delivery features (important/unimportant/unsure) were rated. Participants were mostly women (n = 81), aged 35-49 y, from Australia or United States, were clinicians and/or reported lived experience of overweight/obesity and/or ED. There was agreement (64% to 99%) that individual characteristics were relevant to ED risk, with history of ED, weight-based teasing/stigma and weight bias internalization having the highest agreement. Intervention strategies most frequently rated as likely to increase ED risk included those with a focus on weight, prescription (structured diets, exercise plans) and monitoring strategies, e.g., calorie counting. Strategies most frequently rated as likely to decrease ED risk included having a health focus, flexibility and inclusion of psychosocial support. Delivery features considered most important were who delivered the intervention (profession, qualifications) and support (frequency, duration). Findings will inform future research to quantitatively assess which of these factors predict eating disorder risk, to inform screening and monitoring protocols.

Automated summary

This study aimed to understand the factors influencing eating disorder risk during behavioral weight management. Participants rated individual characteristics, intervention strategies, and delivery features. Findings showed that individual characteristics, such as a history of eating disorders and weight bias internalization, were considered relevant to eating disorder risk. Intervention strategies focusing on weight and monitoring were more likely to increase risk, while strategies with a health focus and psychosocial support were more likely to decrease risk. The delivery features considered most important were the qualifications and support provided by the intervention deliverers. These findings will help inform future research and screening protocols.