Secondary prevention related to eating disorders among school-age children and teenagers
This is a scoping review about secondary prevention of eating disorders in school-aged children and adolescents in schools and primary health services. It is based on Arksey and O’Malley’s methodological framework for scoping review and includes 34 scientific publications from between 2016 and February 2025. The purpose is to identify, describe and summarise knowledge about schools’ and primary health services’ responsibility for and work with the prevention of anorexia, bulimia and binge eating disorder. The scoping review also provides an overview of legal, political and professional documents that regulate and guide these services’ work with such secondary prevention.
The included publications were developed in the USA, Australia, Germany, Japan, Singapore, Cyprus, the UK, France, Sweden and Norway. There are 20 publications on conditions and measures that can influence whether eating disorder risk and symptoms become clinical eating disorders. 14 of them concern conditions that can influence whether clinical eating disorders are detected, diagnosed and treated at an early stage. The results show that secondary prevention based on cognitive dissonance theory and acceptance and commitment therapy are among the topics explored. The same applies to digital prevention in schools, support measures for parents and systematic weight measurement work for earlier detection of anorexia. Some studies concern aspects of the services that can influence whether eating disorders are detected and treated at an early stage. The use of former patients’ experiences as a resource is also thematised.
Low competence in these services is highlighted in some studies as an obstacle to early detection. Low funding and long waiting times are also described as obstacles. Digital guidance has been tested to make competence available locally in terms of early intervention. The importance of staff knowing about referral options, and about maintaining regular appointments with the children/youth until treatment starts, is also highlighted. However, prevention research is still in its infancy and more research is needed: on prevention based on acceptance and commitment therapy, cognitive dissonance-based prevention among children and adolescents under 15, prevention among boys, gender minorities and those who do not live at home, on the relationship between prevention of obesity and eating disorders – and on prevention in different phases of the process where risk becomes symptoms of clinical illness.