Research projects

Body image, eating disorders and depressive symptom outcomes following a school-based body image prevention intervention: a one year follow-up study

Principal researcher

Professor Susan J Paxton
Professor Eleanor Wertheim


La Trobe University



Award type

beyondblue Victorian Centre of Excellence Grant

Project completion year



The primary aim of this research was to examine the impact on body image, eating disorder and depressive symptoms of a body image intervention program, Happy Being Me, for year 7 girls, over a one year period. It was hypothesised that: 
1) Girls who receive the intervention compared with a control group of girls who do not, will show significantly lower levels of depressive symptoms, body dissatisfaction, unhealthy dietary restraint, bulimic symptoms, internalisation of the thin ideal, body comparison, appearance conversations, expectancies of thinness, and higher media literacy and self-esteem;
2) Girls with higher depressive symptoms at baseline who receive the program compared to those who do not will have lower depressive symptoms.


Year 7 girls (n=488) were allocated to either an intervention or no intervention control condition. The intervention group received the Happy Being Me program that focused on addressing media and peer influences on body image in 6 interactive class-room sessions. Participants completed assessments of body image concerns, negative affect, disordered eating, and sociocultural peer and media influences at baseline, post-program, six-month follow-up and one year follow-up.


Supporting the first hypothesis, at post-test the intervention group had significant improvements in depressive symptoms, body dissatisfaction, weight and shape concern, dietary restraint, internalisation of the thin ideal, media literacy and expectancies of thinness. At follow-up there were improvements in depressive symptoms, internalisation of the thin ideal, appearance comparisons, appearance conversations, media literacy and expectancies of thinness.
Supporting the second hypothesis, girls with higher depressive symptoms at baseline who received the program compared to those who did not had lower depressive symptoms at post-test.


Supplementary studies were conducted on baseline data to examine relationships between variables to shed light on the contribution of risk factors to body dissatisfaction and disordered eating. 
The first study found that high levels of media literacy, which is defined as critical analysis and understanding of media images and messages, was associated with low levels of body dissatisfaction. The relationship between these variables was mediated by internalisation of the thin ideal and by appearance comparisons. These cross-sectional findings can be interpreted as indicating that higher media literacy acts on the internalisation and comparison processes to reduce the persuasive impact of external influences such as media, which may thus be protective against the development of body dissatisfaction.
The second study found that a biopsychosocial model accounted for high proportions of variance in body dissatisfaction and disordered eating. The analysis of the model showed that negative affect, which comprised depressive symptoms and self-esteem, body mass index, and sociocultural influences were related to body dissatisfaction and disordered eating, via the mediating processes of internalisation of the thin ideal and appearance comparisons. Notably, the study also found a strong direct relationship between negative affect and bulimic symptoms, indicating that negative affect may be particularly important in the development of disordered eating.


The findings from this study showed that the Happy Being Me program is a valuable prevention intervention that achieved promising results in reducing risk factors for body dissatisfaction and improving psychological well-being. In addition, the program was very favourably received by early adolescent girls.

Peer reviewed publications

McLean, S.A., Paxton, S.J., & Wertheim, E.H. (2013). Relationships between media literacy and eating disorder risk factors in early adolescent girls: Implications for prevention. Body Image 10, 283-289. Impact Factor 1.90.
Rodgers, R.F., Paxton, S.J. & McLean, S.A. A Biopsychosocial Model of Body Image Concerns and Disordered Eating in Early Adolescent Girls. (Submitted to Journal of Youth and Adolescence (Impact Factor 2.717) 21 June 2013)

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