The Body Project SMIL tests the effectiveness of a virtual, peer-led intervention aimed at reducing body dissatisfaction and preventing eating disorders in young women with psychiatric illnesses.
Eating disorders like anorexia, bulimia, and binge eating disorder have severe physical and mental health consequences. Young women with psychiatric disorders face a fourfold higher risk, yet no widely implemented prevention programs exist in Denmark. Body Project SMIL addresses this gap by testing whether a structured online intervention can prevent eating disorders before they develop.
The study is open to women aged 15-25 with body dissatisfaction and a verified psychiatric diagnosis (e.g., mood disorders, anxiety, ADHD, or personality disorders). Those with a clinical eating disorder diagnosis are not eligible. Participants must be comfortable engaging in online group discussions.
Participants are randomly assigned to one of two groups:
Body Project Group - A peer-led, virtual program with four one-hour sessions focusing on challenging beauty ideals through structured exercises.
Expressive Writing Group - A self-guided exercise where participants write about body image for four weeks.
Assessments take place before and after the intervention, with follow-ups at six months, one year, and two years tracking body dissatisfaction, eating disorder symptoms, and well-being.
The Body Project is a proven intervention that reduces body dissatisfaction, thin-ideal internalization, and eating disorder symptoms, with some studies showing a 77% reduction in eating disorder risk. While tested in various settings, this study is the first to evaluate its impact on young women with psychiatric illnesses.
Participation benefits may include improved body image, reduced eating disorder risk, and enhanced self-esteem. The group format provides a supportive environment for sharing experiences and fostering healthier attitudes toward body image.
Ethical approval has been granted, ensuring compliance with GDPR regulations. Since this is a preventive program, it does not replace clinical treatment. Participants showing signs of an active eating disorder will be referred for appropriate care.
Recruitment occurs through psychiatric departments, educational institutions, and social media. A research website (www.bodyproject.dk) provides study details and a secure registration form. Parental consent is required for participants under 18, and all participants may withdraw at any time without consequences.
Conducted by Aarhus University Hospital Psychiatry in collaboration with international experts, this research may inform scalable prevention programs for young people at risk of eating disorders.
self-reported body dissatisfaction and a medically verified psychiatric diagnosis (e.g., mood disorders, anxiety disorders, ADHD, and personality disorders)
ED symptoms equivalent to clinically significant ED corresponding to a diagnostic level according to DSM-5 criteria as evaluated via the Eating Disorder Diagnostic Interview.
Acute psychiatric instability or psychosis or suicide attempt within the last 12 months, or inability to cognitively understand the project or work in the online group setting either due to illness or severe substance abuse.
Not speaking and understanding Danish.
Parallel
Body Project
BehavioralDissonance-based, online, peed-led eating disorder prevention intervention, consisting of 4 x 1 hour with a week a part.
Expressive writing
BehavioralParticipants are encouraged to write about their body 40 min. per week
Eating Disorders
Prevalence of clinical eating disorders. The semi-structured Eating Disorder Diagnostic Interview (EDDI) assesses ED symptoms including binge eating and purging corresponding to DSM-5 ED diagnoses, and will be used to determine anorexia nervosa, bulimia nervosa, binge eating disorder, and purging disorder. EDDI is a structured diagnostic interview assessing DSM-5 eating disorder criteria, yielding presence/absence of diagnoses and symptom frequency/severity.
Eating Disorder symptoms
Prevalence of binge eating disorder symptoms according to Eating Disorder Examination Questionnaire (EDE-Q). EDE-Q is a self-report version of the Eating Disorder Examination, item 13-15, including frequency of behavior.
Eating Disorder symptoms
Prevalence of eating disorder symptoms and disordered eating behaviors according to Dutch Restraint Eating (DRES)Scale containing 10 items. Min. 11 - max. 50 ( lower scores indicate greater pathology)
Thin-idealization
The 8-item Ideal-Body Stereotype Scale-Revised assesses pursuit of the thin ideal (IBSSR). Min. 8- max. 40 (lower scores indicate greater body dissatisfaction)
Body Dissatisfaction and overevaulation of body and shape
The 10-item Body Dissatisfaction Scale assesses dissatisfaction with various body part. Min. 11 - max. 50 ( lower scores indicate greater dissatisfaction)
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Aarhus University Hospital
Lead sponsor
Aalborg Psychiatric Hospital
Collaborator
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