Efficacy of the Intervention Against the Stigmatization of Men With Eating Disorders in Primary Healthcare (iSMEsH): Results From a Randomized Waitlist-Controlled Study
Abstract
Objective: Eating disorders (EDs) in men are underdiagnosed and undertreated, partly due to stigma hindering help-seeking. This randomized waitlist-controlled study tested the efficacy of the iSMEsH online anti-stigma intervention targeting German general practitioners (GPs) and medical students. The program aimed to reduce stigmatizing attitudes toward men with EDs and improve knowledge and self-efficacy in managing ED symptoms.
Method: A total of 292 participants (130 GPs, 162 medical students) were randomly assigned to immediate intervention or waitlist control. The intervention consisted of six video-based, on-demand modules co-developed with men who have lived experience of an ED, combining education and contact-based strategies. Outcomes included cognitive stigma (knowledge), affective stigma (biased attitudes), and behavioral stigma (treatment self-efficacy), assessed at three timepoints.
Results: The iSMEsH anti-stigma intervention significantly increased knowledge of male-specific ED presentations and enhanced treatment self-efficacy in both GP and medical student populations. Effects on affective stigma were less consistent.
Discussion: Findings support the efficacy of the iSMEsH anti-stigma intervention in improving knowledge and treatment self-efficacy regarding EDs in men among healthcare professionals. Effects on affective stigma were limited and may require longer follow-up periods to be comprehensively captured. The intervention shows promise as a scalable…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 292 participants or records.
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