Intervenção preventiva em distúrbios de imagem corporal, transtorno alimentar e dismorfia muscular: um ensaio clínico controlado randomizado com homens adultos brasileiros cisgênero gays/bissexuais

Abstract

Body dissatisfaction is a global issue, acknowledged as a risk factor for eating disorders (EDs) and muscle dysmorphia (MD). Body image disturbances, EDs, and MD significantly impact physical health and psychosocial functioning, in addition to having a chronic course, relapse, and high treatment costs. Cisgender gay/bisexual men show higher symptomatology of EDs and MD compared to their heterosexual counterparts. However, few preventive programs have been empirically developed and evaluated to help cisgender gay/bisexual men with ED symptoms. Furthermore, to date, no preventive program has been developed focusing on reducing MD symptoms and increasing body appreciation in adult cisgender gay/bisexual men. Thus, the aim of this study was to evaluate the efficacy of the intervention PRIDE Body Project as a proposal to reduce risk factors for the development of EDs and MD, as well as to increase body appreciation in adult Brazilian cisgender gay/bisexual men. A randomized controlled trial was conducted with 149 men, aged 18 to 30 years, of any color, race, or ethnicity. Participants were randomized into two groups: dissonance-based condition (DB; n = 74) and assessment-only condition (AOC; n = 75). The DB condition participated in two sessions of approximately 120 minutes each, with a oneweek interval between them. The AOC received no intervention. The variables investigated were: appearance-ideal internalization, drive for muscularity, self-objectification, body appreciation, ED and MD symptoms. A set of instruments with validity and reliability indicators were applied at baseline, post-intervention, and at four, 24, and 52 weeks of followup. The results showed a high adherence and acceptance rate of the intervention. Significant effects of the intervention on the variables of appearance-ideal internalization (p < 0.05; Cohen's d between groups = -0.34 – -0.76), drive for muscularity (p < 0.05; d = -0.38 – -0.64), body appreciation (p < 0.05; d = -0.31 – -0.81), ED symptoms (p < 0.05; d = -0.33 – -0.61) and MD (p < 0.05; d = -0.35 – -0.92) were observed at the four, 24, and 52-week of followups. For the self-objectification variable, significant effects were observed post-intervention, and at four, 24, and 52 weeks of follow-up (p < 0.05; d = -0.31 – -0.76). The results confirm the acceptance and efficacy of the intervention PRIDE Body Project in reducing risk factors for the development of EDs and MD in Brazilian cisgender gay/bisexual men, as well as increasing body appreciation. It is suggested that this intervention be widely implemented in academic, clinical, and epidemiological settings.