Intervenção preventiva em distúrbios de imagem corporal, transtorno alimentar e dismorfia corporal de jovens adultos: um ensaio clínico controlado randomizado em homens brasileiros

Abstract

Body image is a dynamic and multifaceted construct, consisting of two dimensions: attitudinal and perceptual. Among the attitudinal components, body dissatisfaction has gained prominence, mainly due to its relationship with the etiology of eating disorders (TAs) and muscle dysmorphia (DM). Given the complexity of the construct, the influence of mediating factors such as body-ideal internalization has been highlighted. Body image disturbances, TAs and DM are detrimental to people's health, quality of life and social relationships. However, few prevention programs have been developed and evaluated empirically to help men with these disorders. In addition, new strategies are needed to broadly implement the available programs. Thus, the objective of the present study was to evaluate the acceptance and efficacy of a dissonance-based intervention (Body Project: More Than Muscles), with online perleaders training, in reducing signs and symptoms of body image disturbances, TAs and DM in young adult men. A randomized controlled clinical trial was conducted with 180 young men, aged between 18 and 30 years old, enrolled in undergraduate courses at the Federal University of Juiz de Fora, Governador Valadares campus. Participants were randomized into two groups: intervention group (GI; n = 89) and control group (GC; n = 91). The GI received an intervention consisting of two sessions, one-week interval, with approximately 120 minutes each. The dependent variables were: body-ideal internalization, body dissatisfaction, drive for muscularity, body appreciation, as well as, disordered eating and DM symptoms. Self-report scales were applied at four times: pre-intervention, post-intervention, at four and 24 weeks of follow-up. The acceptance of the intervention among the GI was also evaluated. Our results showed high rates of adherence and acceptance. Regarding efficacy, the GI showed significant reductions in all dependent variables at the 4-weeks (p < .05; Cohen's d between groups: 0.16 – 1.10) and 24 weeks follow-up (p < .05; Cohen's d between groups: 0.11 – 0.78) compared to the GC, except for the Height subscale of the Male Body Attitudes ScaleRevised. Body appreciation showed a significant increase (GI compared to GC) at postintervention (p < .01; Cohen's d between groups: 0.40), 4-weeks (p < .001; Cohen's d between groups: 0.80) and at 24 weeks of follow-up (p < .001; Cohen's d between groups: 0.58). Changes in body-ideal internalization partially and completely mediated the effects of the intervention on the DM symptoms and disordered eating, respectively. The results support the acceptance and efficacy of the intervention “O Corpo em Questão: Mais do que Músculos” in reducing risk factors for TAs and DM in body dissatisfied men, as well as increasing protective factors (i.e. body appreciation). Lastly, a tool for the broad implementation of prevention programs (online training of per-leaders) was employed and presented initial evidence of efficacy.