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Randomized Trial of a Dissonance-Based Group Treatment for Eating Disorders Versus a Supportive Mindfulness Group Treatment

Objective: This report evaluates a dissonance-based group eating disorder treatment designed to be a cost-effective front-line transdiagnostic treatment that could be more widely implemented than extant treatments that are more intensive and expensive relative to a supportive mindfulness group treatment typical of that offered at colleges. Method: Young women with eating disorders (N = 84) were randomized to 8-week dissonance-based Body Project treatment (BPT) or supportive mindfulness treatment, completing diagnostic interviews and questionnaires at pretest, posttest, and 6-month follow up. Results: Regarding primary outcomes, by 6-month follow up 77% of BPT participants no longer met diagnosis for an eating disorder versus 60% of supportive mindfulness participants (relative risk ratio = 2.22; 95% CI [1.01, 4.93]), though groups did not differ on eating disorder symptom change. Regarding secondary outcomes, BPT versus supportive mindfulness participants showed significantly lower dissonance about affirming the thin ideal at posttest and 6-month follow up (d = .38 and .32), body dissatisfaction at posttest and 6-month follow up (d = .62 and .62), negative affect at posttest and 6-month follow up (d = .49 and .48), and functional impairment (d = .36) at 6-month follow up; differences in thin-ideal internalization and abstinence from binge eating and compensatory behaviors were not significant. Conclusions: Whereas both treatments appeared effective, BPT produced larger effects and significantly greater remission of eating disorder diagnoses than a credible alternative treatment, which is very rare for trials that have compared active eating disorder treatments. Results suggest it would be useful to refine BPT and conduct target engagement research and efficacy trials.