The Female Athlete Body project study: 18‐month outcomes in eating disorder symptoms and risk factors

Objective To evaluate the efficacy of the Female Athlete Body project (FAB) in reducing eating disorder (ED) symptoms and risk factors. Method This study was a community participatory three‐site, two‐arm, cluster randomized controlled trial (RCT). Female collegiate athletes (N = 481) were randomly assigned by team to the FAB intervention, a behavioral ED risk factor reduction program, or a waitlist control condition. Primary analyses examined 18‐month effects for ED pathology. Secondary analyses examined risk factors and correlates (e.g., thin‐ideal internalization, negative mood, Female Athlete Triad knowledge, and body mass index [BMI]). Results Linear mixed effects models with team as a cluster level variable and study condition as a between‐subjects variable revealed significantly reduced dietary restraint in FAB teams relative to control teams. FAB teams also reported significantly fewer objective and subjective binge episodes than control teams. Finally, FAB teams showed significantly lower thin‐ideal internalization and increased BMI at 18‐months. No other significant differences were found. Discussion This RCT examined the effects of a short intervention on ED pathology and risk factors in female collegiate athletes through 18‐month follow‐up. This trial is one of only three trials with female athletes that have shown long‐term reductions in any ED symptoms or produced positive effects on ED risk factors. The present study is the first to find such effects with athletes using a brief (i.e., 4 hr) intervention at 18‐month follow‐up. Although small effects were found, the current trial provides valuable lessons about future design and implementation of similar trials with athletes. Trial Registration Clinical trials NCT01735994.