Skip to main content
SpringerLink
Log in

Feasibility and acceptability of a prevention program for eating disorders (Me, You and Us) adapted for young adolescents in Korea

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the adaptability and acceptability of a prevention program.

Methods

A total of 169 Korean students (83 boys and 86 girls) with a mean age of 12.3 years from a 6th grade class at an elementary school participated in the study. Mental health social workers delivered Me, You and Us, a school-based body image intervention program originally developed in the UK, through a set of six sessions. The participants were assessed in terms of their body satisfaction and self-esteem before the program, after the program, and at 1-month follow-up. They were also surveyed about their satisfaction and acceptability levels after the program.

Results

At baseline, girls had lower body satisfaction and self-esteem than boys, and their body satisfaction and self-esteem improved after the program. The improved body satisfaction was maintained at the 1-month follow-up. The efficacy of the program on body satisfaction was positively correlated with the frequency of their baseline level of “fat talk.” The program was more effective in girls with possible symptoms of an eating disorder at baseline. 93.7% of boys and 77.4% of girls responded that they enjoyed the program.

Conclusions

The program Me, You and Us was well-accepted by early adolescents in Korea and it can play a role in increasing body satisfaction and self-esteem by reducing “fat talk” in 6th grade students.

Level of evidence

Level III, cohort study with intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Currin L, Schmidt U, Treasure J, Jick H (2005) Time trends in eating disorder incidence. Br J Psychiatry 186:132–135. doi:10.1192/bjp.186.2.132

    Article  PubMed  Google Scholar 

  2. Hudson JI, Hiripi E, Pope HG, Kessler RC (2007) The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biol Psychiatry 61:348–358. doi:10.1016/j.biopsych.2006.03.040

    Article  PubMed  Google Scholar 

  3. Keski-Rahkonen A, Hoek HW, Susser ES, Linna MS, Sihvola E, Raevuori A, Bulik CM, Kaprio J, Rissanen A (2007) Epidemiology and course of anorexia nervosa in the community. Am J Psychiatry 164:1259–1265. doi:10.1176/appi.ajp.2007.06081388

    Article  PubMed  Google Scholar 

  4. Micali N, De Stavola B, Ploubidis G, Simonoff E, Treasure J, Field AE (2015) Adolescent eating disorder behaviours and cognitions: gender-specific effects of child, maternal and family risk factors. Br J Psychiatry 207:320–327. doi:10.1192/bjp.bp.114.152371

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Stice E (2002) Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull 128:825–848. doi:10.1037//0033-2909.128.5.825

    Article  PubMed  Google Scholar 

  6. Taylor CB, Bryson SW, Altman TM, Abascal L, Celio A, Cunning D, Killen JD, Shisslak CM, Crago M, Ranger-Moore J, Cook P, Ruble A, Olmsted ME, Kraemer HC, Smolak L, McKnight I (2003) Risk factors for the onset of eating disorders in adolescent girls: results of the McKnight longitudinal risk factor study. Am J Psychiatry 160:248–254. doi:10.1176/ajp.160.2.248

    Article  Google Scholar 

  7. Stice E, Becker CB, Yokum S (2013) Eating disorder prevention: current evidence-base and future directions. Int J Eat Disord 46:478–485. doi:10.1002/eat.22105

    Article  PubMed  PubMed Central  Google Scholar 

  8. Austin SB (2016) Accelerating progress in eating disorders prevention: a call for policy translation research and training. Eat Disord 24:6–19. doi:10.1080/10640266.2015.1034056

    Article  PubMed  Google Scholar 

  9. Neumark-Sztainer D, Levine M, Paxton S, Smolak L, Piran N, Wertheim E (2006) Prevention of body dissatisfaction and disordered eating: What’s next? Eat Disord 14:265–285. doi:10.1080/10640260600796184

    Article  PubMed  Google Scholar 

  10. O’Dea J, Maloney D (2000) Preventing eating and body image problems in children and adolescents using the health promoting schools framework. J Sch Health 70:18–21

    Article  PubMed  Google Scholar 

  11. Smolak L, Levine MP, Schermer F (1998) A controlled evaluation of an elementary school primary prevention program for eating problems. J Psychosom Res 44:339–353. doi:10.1016/s0022-3999(97)00259-6

    Article  CAS  PubMed  Google Scholar 

  12. Neumark-Sztainer DR, Friend SE, Flattum CF, Hannan PJ, Story MT, Bauer KW, Feldman SB, Petrich CA (2010) New moves-preventing weight-related problems in adolescent girls a group-randomized study. Am J Prev Med 39:421–432. doi:10.1016/j.amepre.2010.07.017

    Article  PubMed  PubMed Central  Google Scholar 

  13. Stice E, Rohde P, Shaw H, Gau J (2011) An effectiveness trial of a selected dissonance-based eating disorder prevention program for female high school students: long-term effects. J Consult Clin Psychol 79:500–508. doi:10.1037/a0024351

    Article  PubMed  PubMed Central  Google Scholar 

  14. Wilksch SM, Paxton SJ, Byrne SM, Austin SB, McLean SA, Thompson KM, Dorairaj K, Wade TD (2015) Prevention across the spectrum: a randomized controlled trial of three programs to reduce risk factors for both eating disorders and obesity. Psychol Med 45:1811–1823. doi:10.1017/s003329171400289x

    Article  CAS  PubMed  Google Scholar 

  15. O’Dea JA, Abraham S (2000) Improving the body image, eating attitudes, and behaviors of young male and female adolescents: a new educational approach that focuses on self-esteem. Int J Eat Disord 28:43–57

    Article  PubMed  Google Scholar 

  16. Richardson SM, Paxton SJ (2010) An evaluation of a body image intervention based on risk factors for body dissatisfaction: a controlled study with adolescent girls. Int J Eat Disord 43:112–122. doi:10.1002/eat.20682

    Article  PubMed  Google Scholar 

  17. Richardson SM, Paxton SJ, Thomson JS (2009) Is body think an efficacious body image and self-esteem program? A controlled evaluation with adolescents. Body Image 6:75–82. doi:10.1016/j.bodyim.2008.11.001

    Article  PubMed  Google Scholar 

  18. Stanford J, McCabe MP (2005) Sociocultural influences on adolescent boys’ body image and body change strategies. Body Image 2:105–113. doi:10.1016/j.bodyim.2005.03.002

    Article  PubMed  Google Scholar 

  19. Stewart DA, Carter JC, Drinkwater J, Hainsworth J, Fairburn CG (2001) Modification of eating attitudes and behavior in adolescent girls: a controlled study. Int J Eat Disord 29:107–118

    Article  CAS  PubMed  Google Scholar 

  20. Wade TD, Davidson S, O’Dea JA (2003) A preliminary controlled evaluation of a school-based media literacy program and self-esteem program for reducing eating disorder risk factors. Int J Eat Disord 33:371–383. doi:10.1002/eat.10136

    Article  PubMed  Google Scholar 

  21. Wilksch SM, Wade TD (2009) Reduction of shape and weight concern in young adolescents: a 30-month controlled evaluation of a media literacy program. J Am Acad Child Adolesc Psychiatry 48:652–661. doi:10.1097/CHI.0b013e3181a1f559

    Article  PubMed  Google Scholar 

  22. Yager Z, Diedrichs PC, Ricciardelli LA, Halliwell E (2013) What works in secondary schools? A systematic review of classroom-based body image programs. Body Image 10:271–281. doi:10.1016/j.bodyim.2013.04.001

    Article  PubMed  Google Scholar 

  23. Nichter M (2001) Fat talk: what girls and their parents say about dieting. Harvard University, Cambridge

    Google Scholar 

  24. Cruwys T, Leverington CT, Sheldon AM (2016) An experimental investigation of the consequences and social functions of fat talk in friendship groups. Int J Eat Disord 49:84–91. doi:10.1002/eat.22446

    Article  PubMed  Google Scholar 

  25. Stice E, Maxfield J, Wells T (2003) Adverse effects of social pressure to be thin on young women: an experimental investigation of the effects of “fat talk”. Int J Eat Disord 34:108–117. doi:10.1002/eat.10171

    Article  PubMed  Google Scholar 

  26. Sharpe H, Schober I, Treasure J, Schmidt U (2013) Feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders: cluster randomised controlled trial. Br J Psychiatry 203:428–435. doi:10.1192/bjp.bp.113.128199

    Article  PubMed  Google Scholar 

  27. McCabe MP, Ricciardelli LA (2004) Body image dissatisfaction among males across the lifespan—a review of past literature. J Psychosom Res 56:675–685. doi:10.1016/s0022-3999(03)00129-6

    Article  PubMed  Google Scholar 

  28. Levine MP, Smolak L (2006) The prevention of eating problems and eating disorders: theory, research, and practice. Lawrence Erlbaum, Mahwah

    Book  Google Scholar 

  29. Neumark-Sztainer D, Paxton SJ, Hannan PJ, Haines J, Story M (2006) Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. J Adolesc Health 39:244–251. doi:10.1016/j.jadohealth.2005.12.001

    Article  PubMed  Google Scholar 

  30. O’Dea JA (2004) Evidence for a self-esteem approach in the prevention of body image and eating problems among children and adolescents. Eat Disord 12:225–239. doi:10.1080/10640260490481438

    Article  PubMed  Google Scholar 

  31. Thomas JJ, Lee S, Becker AE (2016) Updates in the epidemiology of eating disorders in Asia and the Pacific. Curr Opin Psychiatry 29:354–362. doi:10.1097/yco.0000000000000288

    Article  PubMed  Google Scholar 

  32. Jung J, Forbes GB (2007) Body dissatisfaction and disordered eating among college women in China, South Korea, and the United States: contrasting predictions from sociocultural and feminist theories. Psychol Women Q 31:381–393. doi:10.1111/j.1471-6402.2007.00387.x

    Article  Google Scholar 

  33. Cho JH, Han SN, Kim JH, Lee HM (2012) Body image distortion in fifth and sixth grade students may lead to stress, depression, and undesirable dieting behavior. Nutr Res Pract 6:175–181. doi:10.4162/nrp.2012.6.2.175

    Article  PubMed  PubMed Central  Google Scholar 

  34. Korea Center for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey. http://www.knhanes.cdc.go.kr. Accessed May 2017

  35. Kim KA (2003) A relationship among appearance satisfaction, body cathexis and psychological characteristics during childhood and adolescence. Thesis of Master’s Degree in Graduate School of Sungshin Women’s University, Seoul, pp 31–41

  36. Park JH, Choi TS (2008) The effect of body image on self-esteem in adolescents. Korean J Play Ther 11:117–129

    Google Scholar 

  37. Kim YR, Heo SY, Kang H, Song KJ, Treasure J (2010) Childhood risk factors in Korean Women with anorexia nervosa: two sets of case-control studies with retrospective comparisons. Int J Eat Disord 43:589–595. doi:10.1002/eat.20752

    Article  PubMed  Google Scholar 

  38. Chisuwa N, O’Dea JA (2010) Body image and eating disorders amongst Japanese adolescents. A review of the literature. Appetite 54:5–15. doi:10.1016/j.appet.2009.11.008

    Article  PubMed  Google Scholar 

  39. Morgan JF, Reid F, Lacey JH (1999) The SCOFF questionnaire: assessment of a new screening tool for eating disorders. Br Med J 319:1467–1468

    Article  CAS  Google Scholar 

  40. Mendelson BK, White DR (1985) Development of self-body-esteem in overweight youngters. Dev Psychol 21:90–96

    Article  Google Scholar 

  41. Harter S (1981) The perceived competence scale for children. Child Dev Psychol 53:87–97

    Article  Google Scholar 

  42. Solmi F, Hatch SL, Hotopf M, Treasure J, Micali N (2015) Validation of the SCOFF questionnaire for eating disorders in a multiethnic general population sample. Int J Eat Disord 48:312–316. doi:10.1002/eat.22373

    Article  PubMed  Google Scholar 

  43. Luck AJ, Morgan JF, Reid F, O’Brien A, Brunton J, Price C, Perry L, Lacey JH (2002) The SCOFF questionnaire and clinical interview for eating disorders in general practice: comparative study. Br Med J 325:755–756. doi:10.1136/bmj.325.7367.755

    Article  Google Scholar 

  44. Parker SC, Lyons J, Bonner J (2005) Eating disorders in graduate students: exploring the SCOFF questionnaire as a simple screening tool. J Am Coll Health 54:103–107. doi:10.3200/jach.54.2.103-107

    Article  PubMed  Google Scholar 

  45. Lee JS (2001) Correlation among adolescents gender, obesity, others appraisal of their bodies and the adolescents body-esteem. Korea National University of Education, Cheongju

    Google Scholar 

  46. Lee HY (2004) Correlation between their body image and self-esteem dependent on the degree of obesity of obese children. Univ. of Kong Ju, Gongju

    Google Scholar 

  47. Dion J, Hains J, Vachon P, Plouffe J, Laberge L, Perron M, McDuff P, Kalinova E, Leone M (2016) Correlates of body dissatisfaction in children. J Pediatr Psychol 171:202–207. doi:10.1016/j.jpeds.2015.12.045

    Article  Google Scholar 

  48. Nelson TD, Jensen CD, Steele RG (2011) Weight-related criticism and self-perceptions among preadolescents. J Pediatr Psychol 36:106–115. doi:10.1093/jpepsy/jsq047

    Article  PubMed  Google Scholar 

  49. Xanthopoulos MS, Borradaile KE, Hayes S, Sherman S, Vander Veur S, Grundy KM et al (2011) The impact of weight, sex, and race/ethnicity on body dissatisfaction among urban children. Body Image 8:385–389. doi:10.1016/j.bodyim.2011.04.011

    Article  PubMed  Google Scholar 

  50. Querol SE, Alvira JMF, Graffe MIM, Rebato EN, Sanchez AM, Aznar LAM (2016) Nutrient intake in Spanish adolescents SCOFF high-scorers: the AVENA study. Eat Weight Disord 21:589–596. doi:10.1007/s40519-016-0282-8

    Article  Google Scholar 

  51. Holling H, Schlack R (2007) Eating disorders in children and adolescents. First results of the German health interview and examination survey for children and adolescents (KiGGS). Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 50:794–799. doi:10.1007/s00103-007-0242-6

    Article  CAS  PubMed  Google Scholar 

  52. McCabe MP, Ricciardelli LA, Karantzas G (2010) Impact of a healthy body image program among adolescent boys on body image, negative affect, and body change strategies. Body Image 7:117–123. doi:10.1016/j.bodyim.2009.10.007

    Article  PubMed  Google Scholar 

  53. Weiss K, Wertheim E (2005) An evaluation of a prevention program for disordered eating in adolescent girls: examining responses of high and low risk girls. Eat Disord 13:143–156. doi:10.1080/10640260590918946

    Article  PubMed  Google Scholar 

  54. Becker CB, Bull S, Schaumberg K, Cauble A, Franco A (2008) Effectiveness of peer-led eating disorders prevention: a replication trial. J Consult Clin Psychol 76:347–354. doi:10.1037/0022-006x.76.2.347

    Article  PubMed  Google Scholar 

  55. Flay BR, Biglan A, Boruch RF, Castro FG, Gottfredson D, Kellam S, Moscicki EK, Schinke S, Valentine JC, Ji P (2005) Standards of evidence: criteria for efficacy, effectiveness and dissemination. Prev Sci 6:151–175. doi:10.1007/s11121-005-5553-y

    Article  PubMed  Google Scholar 

  56. Marchand E, Stice E, Rohde P, Becker CB (2011) Moving from efficacy to effectiveness trials in prevention research. Behav Res Ther 49:32–41. doi:10.1016/j.brat.2010.10.008

    Article  PubMed  Google Scholar 

  57. Ricciardelli LA, McCabe MP (2001) Children’s body image concerns and eating disturbance: a review of the literature. Clin Psychol Rev 21:325–344

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Dr. Helen Sharpe for offering the materials of Me, You and Us.

Author information

Author notes

  1. Jin Hong Park

    Present address: Department of Neuroscience, Scripps Graduate Program, The Scripps Research Institute, Jupiter, FL, USA

Authors and Affiliations

  1. Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea

    Gi Young Lee, Youl-Ri Kim, Jin Hong Park & So Hyun An

  2. Department of Psychiatry, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea

    Eun Jin Park

  3. Goyang Child and Adolescent Community Mental Health Center, Goyang, Republic of Korea

    Eun Jin Park, Ji Hyun Lee & Jeong Hun Sim

  4. Department of Neuropsychiatry, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea

    Youl-Ri Kim

  5. Institute of Human, Environment and Future, Inje University, Kimhae, Republic of Korea

    Kyung Hwa Kwag

  6. Section of Eating Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, London, UK

    Janet Treasure

Authors
  1. Gi Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eun Jin Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Youl-Ri Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyung Hwa Kwag
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jin Hong Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. So Hyun An
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ji Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jeong Hun Sim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Janet Treasure
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Youl-Ri Kim.

Ethics declarations

Funding sources

Financial support for this study was provided by the National Research Foundation of Korea (NRF) with a Grant funded by the Korean government (MSIP) (Grant #. NRF-2014S1A5B8063466). The funding sources had no involvement in the study design, collection, analysis, or interpretation of the data, writing the manuscript or the decision to submit the paper for publication.

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical measure.

Informed consent

Informed consents were received from a parent or a guardian for each of the participants.

Additional information

Gi Young Lee and Eun Jin Park are co-first authors.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (XLSX 32 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, G.Y., Park, E.J., Kim, YR. et al. Feasibility and acceptability of a prevention program for eating disorders (Me, You and Us) adapted for young adolescents in Korea. Eat Weight Disord 23, 673–683 (2018). https://doi.org/10.1007/s40519-017-0436-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-017-0436-3

Keywords

Search

Navigation