Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta-analysis

Hiba Jebeile, Sol Libesman, Hannah Melville, Timothy Low-wah, Genevieve Dammery, Anna L. Seidler, Rebecca A. Jones, Caitlin M. McMaster, Susan J. Paxton, Andrew J. Hill, Amy L. Ahern, Sarah P. Garnett, Caroline Braet, Denise E. Wilfley, Louise A. Baur, Natalie B. Lister

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre- and post-intervention or follow-up. Random effects meta-analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female). Interventions ranged from 4 weeks to 18 months, with follow-up of 10 weeks to 36 months post-intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = −0.27; 95% CI −0.36, −0.17; I2 67.1%) and binge eating (49 intervention arms; −0.66; 95% CI −0.76, −0.56; I2 82.7%) post-intervention, both maintained at follow-up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported eating disorder symptoms, not present at baseline, in a subset of participants (0%–6.5%). Overall, behavioral weight management interventions do not increase eating disorder symptoms for most adults; indeed, a modest reduction is seen post-intervention and follow-up. A small subset of participants may experience disordered eating; therefore, monitoring for the emergence of symptoms is important.

Original languageEnglish
Article numbere13561
JournalObesity Reviews
Issue number6
StatePublished - Jun 2023


  • diet intervention
  • disordered eating
  • treatment


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