Training teachers to deliver body image lessons to teenagers in schools could help improve body esteem and reduce the risk of eating disorders, according to new research.

Researchers from King’s College London’s Institute of Psychiatry have found that an intervention called Me, You and Us, delivered by school teachers, is effective in improving body image in teenage girls.

Body dissatisfaction in adolescence is common – 17-33% of teenagers report body dissatisfaction, with the figure higher for girls than boys. It is associated with a range of problems, including depression, eating disorders, over- and under-exercising, obesity and unhealthy weight loss behaviours such as smoking, and cosmetic surgery use.

School-based interventions for body dissatisfaction have been recommended by the UK All Party Parliamentary Group on Body Image.

To test the effectiveness of the intervention, researchers recruited 16 classes of adolescent girls from three schools. Of these, 261 pupils were in the intervention group and received six, 50-minute body image lessons delivered by their school teachers. Lessons focused on:

• Media literacy: where ideals of beauty come from and critically analysing media images
• Peer interactions: concerning ‘fat talking’ – discussions about weight and shape, and activities on giving and receiving compliments
• Positive psychology principles: including boosting mood and self-esteem.

The other 187 pupils received their lessons as normal, acting as the control group.

Before the trial began, all pupils were asked about their age and ethnicity and screened for the presence of eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder. Their body esteem was assessed before the intervention began, after it had finished and at a three-month follow-up.

The researchers found that receiving the lessons had a significant positive effect on the girls’ body esteem, and this was maintained over the three months of follow-up.

At the start of the study, 17% of pupils in the intervention group and 19% of pupils in the control group were in the clinical range for body esteem. After the intervention, 32% of the pupils who were in the clinical range for body esteem showed reliable improvements after receiving the intervention, compared to 8% in the control group. In the intervention group, small but significant improvements were found in the pupil’s thin-ideal internalisation – the extent to which they endorsed social ideals associated with thinness – and in their self-esteem.

Importantly, there was no evidence of harm – i.e. decreases in body esteem – from receiving the programme. Three-quarters of pupils were either neutral or positive about how enjoyable the lessons were, and about two-thirds were neutral or positive about the usefulness of the lessons.

Lead researcher, Dr Helen Sharpe, said: “There is a need for safe and effective, evidence-based body image interventions that teachers can deliver in school. Our study suggests that a teacher-delivered programme for body image dissatisfaction is feasible, acceptable and effective.

“However, substantial further work is needed in refining the content of the lessons, increasing the effectiveness, improving the flexibility with which they may be used in different schools, and exploring the best ways of providing training for teachers so they are adequately prepared for this role.”

Reference: Sharpe H, Schober I, Treasure J and Schmidt U (2013) A cluster randomised controlled trial assessing the feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders. British Journal of Psychiatry, bjp.bp.113.128199, ePub ahead of print, 10 October 2013