Can Dissonance-Based Treatment Decrease Eating Issues?

In an effort to understand how to better treat women with eating and food issues, researchers conducted a study comparing the long-term effectiveness of a dissonance-based eating disorder program versus a traditional educational intervention. Eric Stice, Paul Rohde, Heather Shaw and Jeff Gau, all of the Oregon Research Institute, believe the study is vitally important. “Eating disorders, which afflict 10% of adolescent girls and young women, are marked by functional impairment, morbidity, mental health service utilization, and increased risk for future health and mental health problems,” they said.

The team enlisted 306 girls with eating issues and enrolled half into the dissonance based program. Over four one hour weekly sessions, the groups of girls were encouraged to critique thin ideal body types in exercises that elicited written, verbal and behavioral responses. “These activities theoretically produce cognitive dissonance that motivates participants to reduce their pursuit of the thin ideal, producing reductions in body dissatisfaction, unhealthy weight control behaviors, negative affect, and eating disorder symptoms,” said the team. The control group was enrolled in the educational brochure program, in which they were provided with a two page leaflet developed by the National Eating Disorders Association; that identified behaviors of positive and negative body image and eating issues.

Both groups were interviewed at the conclusion of the treatment, and again at six months, one, two and three years after. The results revealed that the dissonance based group had less body dissatisfaction at the end of the treatment through the third year follow-up. The team said, “It is encouraging that this brief 4-hour dissonance-based eating disorder prevention program produced intervention effects that persisted through 2- and 3-year follow-up, particularly in light of the fact that most eating disorder prevention programs have not been shown to reduce eating disorder symptoms.  The present study is the first to find evidence that a prevention intervention significantly reduced eating disorder symptoms through 3-year follow-up.”

Stice, Eric, Paul Rohde, Jeff Gau, and Heather Shaw. “An Effectiveness Trial of a Selected Dissonance-Based Eating Disorder Prevention Program for Female High School Students: Long-Term Effects.” Journal of Consulting and Clinical Psychology 79.4 (2011): 500-08. Print.

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • T Foster

    T Foster

    August 15th, 2011 at 11:36 PM

    Nice idea! Showing these thin-obsessed girls how its not really great being what they are targeting to be sounds like a good way to get them off that mental block. I wouldn’t mind doing the same to my teenage daughter who thinks a normal-sized meal for her age would make her fat!

  • Beth


    August 16th, 2011 at 4:13 AM

    Changing the way that young girls think about their bodies can be so difficult.
    They are so in tune with what Hollywood is and that is what they would like to emulate.
    Sometimes it is hard to help them get past the fact that for most of us that is not reality.

  • archie


    August 16th, 2011 at 1:05 PM

    now where exactly are we going to find these thin women’s pictures that are not attractive and elusive for young women?getting that would be a hard thing to do!

  • Sally Q

    Sally Q

    August 17th, 2011 at 11:44 AM

    This is a great idea! Unless we show youngsters how harmful things can get in the pursuit of that perfection of your body,they will not stop.It would be even better if they are shown examples and also explained what exactly happens if you are obsessed with something like that!

  • Harper


    August 17th, 2011 at 1:50 PM

    I agree with Archie. We have been so programmed to think that to be thin is to be beautiful that it is often very hard to undo these ways of thinking. I have struggled with an eating disorder for a long time now and you will never show me a picture of a thin girl and make me believe that her shpe is not idea. That is what I strive for and what so many other girls want too.

  • H.T.


    August 22nd, 2011 at 7:01 PM

    Yeah. Women, no men. A friend of my son’s died because of his anorexia, and why did he die? Because nobody in his family believed he could be anorexic. He died because they didn’t pay attention soon enough to see it for what it was, thinking only women become anorexic.

    Why is so much attention given to women who have eating disorders while men are completely ignored? It’s ignorance and dare I say sexist!

  • Wayne Baker

    Wayne Baker

    August 23rd, 2011 at 12:02 AM

    I’m not an expert, although I do enjoy reading articles about therapy and psychology. I would love to have understood this one. Unfortunately I didn’t. I really wish such articles would explain any terminology briefly a layman won’t understand, like what dissonance-based treatment means, if it’s not already clarified in the article itself.

    A glossary of terms the articles could link to would be stupendous but I’m not greedy. :) A footnote with the definition would fine too. Thanks for listening.

  • Linda Jame. ACSW

    Linda Jame. ACSW

    September 29th, 2011 at 10:55 AM

    Dissonance-based treatment for eating disorders is an attempt to create conflict or confusion as it relates to our socially accepted idealization of thinness. Definition notwithstanding, Wayne’s question is a good one. This synopsis of cited research (while suggesting potential positive prevention outcomes) offers little specificity, and, of course, we’re all interested in what works in the treatment and prevention of those suffering from eating disorders.

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