Etiology And Prevention Of Eating Disorders, Obesity, And Substance Use

Etiology And Prevention Of Eating Disorders, Obesity, And Substance UseEric Stice, Ph.D. Oregon Research InstituteEric Stice, Ph.D. Oregon Research Institute

04/15/23 RiverMend Health, LLC 2

13% of adolescent girls/young women meet criteria for an eating disorder

Marked by distress, impairment, medical problems, and increased obesity, depression, substance abuse, and mortality

Over 80% never seek treatment and treatments only effective for 40-50% of pts

Prevention seemed like an ideal solution

Based on multiple prospective studies we determined that pursuit of the unrealistic thin-ideal is at the head waters of a cascade of risk processes that predict eating disorders

As most educational eating disorder prevention programs were ineffective, we use persuasion principles from social psychology to create a program in which young women talk themselves out of a linchpin risk factor for eating disorders


Body project has reduced risk factors, eating disorder symptoms, and eating disorder onset (60% over 3-yr follow-up) in efficacy and effectiveness trials conducted by multiple labs

Can be delivered by clinicians, peer-leaders, and Internet

Being disseminated in 16 countries by universities, high schools, non-profits (NEDA), for-profits (Dove), states (NY), national governments (Iceland), and eating disorder treatment centers (ERS)


70% of US adults overweight or obese Obesity causes 300,000 deaths in the US Medical costs exceed $150 billion

annually Unfortunately, obesity prevention and

treatment interventions are ineffective Initiated novel brain imaging studies to

elucidate neural vulnerability factors that predict future weight gain (e.g., first team to administer food in the scanner)


Greater reward region response to palatable food cues predicts future weight gain (Chouinard et al., 2010; Demos et al., 2012; Stice et al., 2010; Yokum, Ng, & Stice, 2011; Yokum, Gearhardt, Harris, Brownell, & Stice, submitted) and substance use onset (Stice et al., 2013)


Relation between greater reward region response to food cues and future weight gain is stronger for youth with a genetic propensity for greater DA signaling capacity in reward circuitry (replicate x 3)


Greater reward region (amygdala, midbrain, ventral pallidum, and nucleus accumbens) response to milkshake tastes predicts future weight gain (Geha et al., 2010; Stice et al., in prep; Sun et al., 2013)

Greater caudate volume predicts wt gain too, as well as substance use onset


Women who gained weight showed a reduction in striatal response to milkshake taste vs women who were weight stable or weight losers (Stice et al., 2010)


Piloting a prevention program that trains people to use cognitive reappraisal strategies (Hollmann et al., 2011; Kober et al., 2010; Siep et al., 2012; Yokum & Stice, 2013) to reduce responsivity of reward and attention regions and increase activation of inhibitory regions in response to food images

Use of these procedures should reduce craving for high-fat/sugar foods when confronted with food cues or unhealthy foods


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Etiology And Prevention Of Eating Disorders, Obesity, And Substance Use