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SMILE body project: protocol for a randomized controlled trial of an online eating disorder prevention program in young women with psychiatric disorders

Abild CB, Stice E, Stice E, Byrial P, Telléus GK, Clausen L

Eating and weight disorders : EWD, 2026

300 participants

Abstract

Aim: Young women with psychiatric illness have an increased susceptibility for eating disorders (ED); however, no prevention initiatives have been tested for this group. The Body Project ED prevention program has produced promising effect on ED symptoms, body satisfaction, and future ED onset; however, no studies have investigated this specific vulnerable group. In SMILE Body Project, we adapted the Body Project manual to a psychiatric population. In this protocol paper, we describe the randomized controlled trial (RCT) to evaluate the efficacy of the SMILE Body Project.

Methods: This is an ongoing RCT including 300 young women between 15 and 30 years with a psychiatric illness and subjective body dissatisfaction, starting May 2025. Participants are randomized to either online Body Project groups or an active control arm based on expressive writing exercises. The primary aim is to test if SMILE Body Project significantly reduces the incidence of ED in women with psychiatric illness after 2 years compared to controls. The secondary aim is to explore changes in ED symptoms, psychiatric symptoms, QoL, and predictors such as psychiatric symptoms and time spent on social media.

Results: We expect that SMILE Body Project will effectively reduce the incidence of ED diagnosis compared to controls. In addition, we anticipate new knowledge on how time spent on social media affects body image in women with psychiatric illness.

Conclusions: If SMILE Body Project proves efficacious, it…

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: 300 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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