Trial Outcomes & Findings for Efficacy Trial of a Dissonance Based Eating Disorder Program (NCT NCT03796091)

NCT ID: NCT03796091

Last Updated: 2022-12-09

Results Overview

The Rosenberg Self-Esteem Scale is designed to assess global feelings of self-worth. The RSE includes 10 items (e.g. "I feel that I'm a person of worth'') rated on a four-point scale (1 = strongly disagree, 4 = strongly agree). A total score represents the sum of individual item responses. Scores range from 10 to 40 and higher scores indicate higher levels of self-esteem.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 180 participants
• Primary outcome timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.
• Results posted on: 2022-12-09

Participant Flow

Women aged 15-35 displaying subclinical and clinical eating disorder symptoms were recruited from 2 Midwestern cities and 5 surrounding suburban communities from November of 2018 to March of 2021. All participants were treated in accordance with federal guidelines (Title 45, Code of Regulations Part 46) for the treatment of human participants. The research was approved by an Institutional Review Board at the host institution.

All participants were screened to ensure inclusion criteria were met. Inclusion criteria specified female participants ages 15-34 (postmenarcheal and premenopausal) who were not pregnant. Participant selection was limited to this group to control for the effects of estrogen on cardiac function and in accordance with previous research which suggests dissonance-based programs are most effective when offered solely to females over the age of 15.

Participant milestones

Measure	Educational Brochure Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Overall Study STARTED	60	60	60
Overall Study COMPLETED	40	38	45
Overall Study NOT COMPLETED	20	22	15

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Efficacy Trial of a Dissonance Based Eating Disorder Program

Baseline characteristics by cohort

Measure	Educational Brochure n=49 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=51 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=50 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).	Total n=150 Participants Total of all reporting groups
Age, Continuous	22.48 years STANDARD_DEVIATION 3.63 • n=5 Participants	23.95 years STANDARD_DEVIATION 5.73 • n=7 Participants	21.73 years STANDARD_DEVIATION 4.08 • n=5 Participants	22.75 years STANDARD_DEVIATION 4.65 • n=4 Participants
Sex: Female, Male Female	49 Participants n=5 Participants	51 Participants n=7 Participants	50 Participants n=5 Participants	150 Participants n=4 Participants
Sex: Female, Male Male	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants	1 Participants n=7 Participants	1 Participants n=5 Participants	2 Participants n=4 Participants
Race (NIH/OMB) Asian	0 Participants n=5 Participants	2 Participants n=7 Participants	1 Participants n=5 Participants	3 Participants n=4 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants
Race (NIH/OMB) Black or African American	2 Participants n=5 Participants	2 Participants n=7 Participants	6 Participants n=5 Participants	10 Participants n=4 Participants
Race (NIH/OMB) White	42 Participants n=5 Participants	42 Participants n=7 Participants	38 Participants n=5 Participants	122 Participants n=4 Participants
Race (NIH/OMB) More than one race	4 Participants n=5 Participants	3 Participants n=7 Participants	1 Participants n=5 Participants	8 Participants n=4 Participants
Race (NIH/OMB) Unknown or Not Reported	1 Participants n=5 Participants	1 Participants n=7 Participants	3 Participants n=5 Participants	5 Participants n=4 Participants
Region of Enrollment United States	49 Participants n=5 Participants	51 Participants n=7 Participants	50 Participants n=5 Participants	150 Participants n=4 Participants
Rosenberg Self-Esteem Scale	22.71 units on a scale STANDARD_DEVIATION 4.71 • n=5 Participants	22.50 units on a scale STANDARD_DEVIATION 4.81 • n=7 Participants	22.62 units on a scale STANDARD_DEVIATION 4.07 • n=5 Participants	22.61 units on a scale STANDARD_DEVIATION 4.53 • n=4 Participants
Eating Disorder Examination Questionnaire	4.25 units on a scale STANDARD_DEVIATION 0.8 • n=5 Participants	3.93 units on a scale STANDARD_DEVIATION 1.15 • n=7 Participants	3.96 units on a scale STANDARD_DEVIATION 1.02 • n=5 Participants	4.04 units on a scale STANDARD_DEVIATION 1.00 • n=4 Participants
Body Shape Questionnaire	139.42 units on a scale STANDARD_DEVIATION 23.92 • n=5 Participants	134.37 units on a scale STANDARD_DEVIATION 30.15 • n=7 Participants	134.73 units on a scale STANDARD_DEVIATION 28.32 • n=5 Participants	136.17 units on a scale STANDARD_DEVIATION 27.55 • n=4 Participants
Social Comparison Rating Scale	45.59 units on a scale STANDARD_DEVIATION 17.10 • n=5 Participants	43.83 units on a scale STANDARD_DEVIATION 13.18 • n=7 Participants	43.00 units on a scale STANDARD_DEVIATION 13.80 • n=5 Participants	44.15 units on a scale STANDARD_DEVIATION 14.75 • n=4 Participants
Self-Objectification Questionnaire	10.13 units on a scale STANDARD_DEVIATION 9.75 • n=5 Participants	7.71 units on a scale STANDARD_DEVIATION 13.11 • n=7 Participants	6.32 units on a scale STANDARD_DEVIATION 12.46 • n=5 Participants	8.07 units on a scale STANDARD_DEVIATION 11.91 • n=4 Participants
Ideal Body Stereotype Scale Revised	3.81 units on a scale STANDARD_DEVIATION 0.5 • n=5 Participants	3.82 units on a scale STANDARD_DEVIATION .45 • n=7 Participants	3.76 units on a scale STANDARD_DEVIATION 0.5 • n=5 Participants	3.79 units on a scale STANDARD_DEVIATION .48 • n=4 Participants
State Trait Anxiety Inventory Form Y	58.87 units on a scale STANDARD_DEVIATION 8.42 • n=5 Participants	58.02 units on a scale STANDARD_DEVIATION 7.84 • n=7 Participants	58.70 units on a scale STANDARD_DEVIATION 7.90 • n=5 Participants	58.52 units on a scale STANDARD_DEVIATION 7.84 • n=4 Participants
Positive and Negative Affect Scale - Positive Affect	26.35 units on a scale STANDARD_DEVIATION 5.76 • n=5 Participants	25.53 units on a scale STANDARD_DEVIATION 7.10 • n=7 Participants	25.24 units on a scale STANDARD_DEVIATION 6.46 • n=5 Participants	25.71 units on a scale STANDARD_DEVIATION 6.45 • n=4 Participants
Mean R Wave Amplitude	1.27 mV STANDARD_DEVIATION .36 • n=5 Participants	1.19 mV STANDARD_DEVIATION .31 • n=7 Participants	1.24 mV STANDARD_DEVIATION .37 • n=5 Participants	1.23 mV STANDARD_DEVIATION .35 • n=4 Participants
QTc Prolongation	.38 msec STANDARD_DEVIATION .02 • n=5 Participants	.38 msec STANDARD_DEVIATION .02 • n=7 Participants	.38 msec STANDARD_DEVIATION .02 • n=5 Participants	.38 msec STANDARD_DEVIATION .02 • n=4 Participants
Positive and Negative Affect Scale - Negative Affect	30.15 units on a scale STANDARD_DEVIATION 7.46 • n=5 Participants	29.00 units on a scale STANDARD_DEVIATION 6.88 • n=7 Participants	29.64 units on a scale STANDARD_DEVIATION 6.60 • n=5 Participants	29.59 units on a scale STANDARD_DEVIATION 6.97 • n=4 Participants
Vagal Cardiac Tone - High Frequency Spectral Power	60.08 Normalized units: HF (watts/Hz) STANDARD_DEVIATION 19.56 • n=5 Participants	57.26 Normalized units: HF (watts/Hz) STANDARD_DEVIATION 19.78 • n=7 Participants	61.61 Normalized units: HF (watts/Hz) STANDARD_DEVIATION 5.87 • n=5 Participants	58.51 Normalized units: HF (watts/Hz) STANDARD_DEVIATION 16.90 • n=4 Participants
Sympathetic Cardiac Tone - Low Frequency/High Frequency Spectral Power Ratio	1.02 ratio: LF (watts/HZ) / HF (watts/Hz) STANDARD_DEVIATION 1.55 • n=5 Participants	.99 ratio: LF (watts/HZ) / HF (watts/Hz) STANDARD_DEVIATION .84 • n=7 Participants	.72 ratio: LF (watts/HZ) / HF (watts/Hz) STANDARD_DEVIATION .53 • n=5 Participants	.91 ratio: LF (watts/HZ) / HF (watts/Hz) STANDARD_DEVIATION 1.18 • n=4 Participants

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Rosenberg Self-Esteem Scale is designed to assess global feelings of self-worth. The RSE includes 10 items (e.g. "I feel that I'm a person of worth'') rated on a four-point scale (1 = strongly disagree, 4 = strongly agree). A total score represents the sum of individual item responses. Scores range from 10 to 40 and higher scores indicate higher levels of self-esteem.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Rosenberg Self-Esteem Scale (RSE).	22.71 units on a scale Standard Deviation 4.71	22.50 units on a scale Standard Deviation 4.81	22.62 units on a scale Standard Deviation 4.07

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Rosenberg Self-Esteem Scale is designed to assess global feelings of self-worth. The RSE includes 10 items (e.g. "I feel that I'm a person of worth'') rated on a four-point scale (1 = strongly disagree, 4 = strongly agree). A total score represents the sum of individual item responses. Scores range from 10 to 40 and higher scores indicate higher levels of self-esteem.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Rosenberg Self-Esteem Scale (RSE).	23.55 units on a scale Standard Deviation 4.30	25.45 units on a scale Standard Deviation 4.50	25.08 units on a scale Standard Deviation 4.57

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Rosenberg Self-Esteem Scale is designed to assess global feelings of self-worth. The RSE includes 10 items (e.g. "I feel that I'm a person of worth'') rated on a four-point scale (1 = strongly disagree, 4 = strongly agree). A total score represents the sum of individual item responses. Scores range from 10 to 40 and higher scores indicate higher levels of self-esteem.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Rosenberg Self-Esteem Scale (RSE).	24.55 units on a scale Standard Deviation 4.74	25.55 units on a scale Standard Deviation 4.09	26.60 units on a scale Standard Deviation 4.48

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The 28-item Eating Disorder Examination Questionnaire global score was used to measure eating disorder symptomatology. Participants report symptomatology over the past 28 days on a 7-point Likert scale from 0 (no days) to 6 (everyday). The EDE-Q contains 4 subscales: Restraint, Weight Concern, Eating Concern, and Shape Concern. Subscale scores are calculated by finding the averages of the subscale items. A global score is also calculated by averaging the subscale scores. Scores range from 0 to 6; higher scores indicate higher levels of eating disorder pathology.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Eating Disorder Examination Questionnaire (EDE-Q).	4.25 units on a scale Standard Deviation .8	3.93 units on a scale Standard Deviation 1.15	3.96 units on a scale Standard Deviation 1.02

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The 28-item Eating Disorder Examination Questionnaire global score was used to measure eating disorder symptomatology. Participants report symptomatology over the past 28 days on a 7-point Likert scale from 0 (no days) to 6 (everyday). The EDE-Q contains 4 subscales: Restraint, Weight Concern, Eating Concern, and Shape Concern. Subscale scores are calculated by finding the averages of the subscale items. A global score is also calculated by averaging the subscale scores. Scores range from 0 to 6; higher scores indicate higher levels of eating disorder pathology.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Eating Disorder Examination Questionnaire (EDE-Q).	4.17 units on a scale Standard Deviation .64	2.93 units on a scale Standard Deviation 1.20	3.07 units on a scale Standard Deviation 1.23

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The 28-item Eating Disorder Examination Questionnaire global score was used to measure eating disorder symptomatology. Participants report symptomatology over the past 28 days on a 7-point Likert scale from 0 (no days) to 6 (everyday). The EDE-Q contains 4 subscales: Restraint, Weight Concern, Eating Concern, and Shape Concern. Subscale scores are calculated by finding the averages of the subscale items. A global score is also calculated by averaging the subscale scores. Scores range from 0 to 6; higher scores indicate higher levels of eating disorder pathology.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Eating Disorder Examination Questionnaire (EDE-Q).	3.74 units on a scale Standard Deviation .89	2.73 units on a scale Standard Deviation 1.20	2.78 units on a scale Standard Deviation 1.14

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Body Shape Questionnaire (BSQ) was used to measure body dissatisfaction in the present trial. The BSQ is a 34-item scale. Items are measured on a 6-point Likert scale designed to assess the frequency of negative body-related thoughts (1= never, 6 = always). Individual items are summed to compute an overall score. Scores on this scale range from 34 to 204. Higher scores indicate higher frequency of negative body-related thoughts and higher levels of body dissatisfaction.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Body Shape Questionnaire (BSQ).	139.42 units on a scale Standard Deviation 23.92	134.37 units on a scale Standard Deviation 30.15	134.73 units on a scale Standard Deviation 28.32

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Body Shape Questionnaire (BSQ) was used to measure body dissatisfaction in the present trial. The BSQ is a 34-item scale. Items are measured on a 6-point Likert scale designed to assess the frequency of negative body-related thoughts (1= never, 6 = always). Individual items are summed to compute an overall score. Scores on this scale range from 34 to 204. Higher scores indicate higher frequency of negative body-related thoughts and higher levels of body dissatisfaction.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Body Shape Questionnaire (BSQ).	137.65 units on a scale Standard Deviation 20.91	110.96 units on a scale Standard Deviation 33.39	114.50 units on a scale Standard Deviation 30.96

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Body Shape Questionnaire (BSQ) was used to measure body dissatisfaction in the present trial. The BSQ is a 34-item scale. Items are measured on a 6-point Likert scale designed to assess the frequency of negative body-related thoughts (1= never, 6 = always). Individual items are summed to compute an overall score. Scores on this scale range from 34 to 204. Higher scores indicate higher frequency of negative body-related thoughts and higher levels of body dissatisfaction.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Body Shape Questionnaire (BSQ).	129.51 units on a scale Standard Deviation 23.74	105.19 units on a scale Standard Deviation 32.23	105.29 units on a scale Standard Deviation 28.28

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Social Comparison Rating Scale (SCRS) is an 11-item scale used to assess perception of social rank and social comparison tendencies in the present trial. The scale consists of a series of bipolar adjectives (e.g., inferior/superior) separated by the numbers 1 through 10. For each adjective pair, participants are asked to rank themselves in comparison to others. A score around 60 indicates a person, on average, sees themselves approximately equal to others. Higher scores indicate higher levels of favorable social comparison and higher perceived social rank.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Social Comparison Rating Scale (SCRS).	45.59 units on a scale Standard Deviation 17.10	43.83 units on a scale Standard Deviation 13.18	43.00 units on a scale Standard Deviation 13.80

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Social Comparison Rating Scale (SCRS) is an 11-item scale used to assess perception of social rank and social comparison tendencies in the present trial. The scale consists of a series of bipolar adjectives (e.g., inferior/superior) separated by the numbers 1 through 10. For each adjective pair, participants are asked to rank themselves in comparison to others. A score around 60 indicates a person, on average, sees themselves approximately equal to others. Higher scores indicate higher levels of favorable social comparison and higher perceived social rank.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Social Comparison Rating Scale (SCRS).	51.02 units on a scale Standard Deviation 16.34	51.09 units on a scale Standard Deviation 11.68	47.35 units on a scale Standard Deviation 14.82

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Social Comparison Rating Scale (SCRS) is an 11-item scale used to assess perception of social rank and social comparison tendencies in the present trial. The scale consists of a series of bipolar adjectives (e.g., inferior/superior) separated by the numbers 1 through 10. For each adjective pair, participants are asked to rank themselves in comparison to others. A score around 60 indicates a person, on average, sees themselves approximately equal to others. Higher scores indicate higher levels of favorable social comparison and higher perceived social rank.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Social Comparison Rating Scale (SCRS).	46.28 units on a scale Standard Deviation 17.39	53.39 units on a scale Standard Deviation 10.93	53.18 units on a scale Standard Deviation 15.88

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Self-Objectification Questionnaire (SOQ) is a 10-item self-report inventory designed to assess the relative importance of body competence versus body appearance in sense of self. Participants rank appearance- versus competence-based attributes from 0 to 9 with higher scores representing higher importance. An overall trait self-objectification score is computed by summing competence and appearance ratings and subtracting the sum of competence ratings from the sum of appearance ratings. Resulting scores range from -25 to 25. Higher scores denote higher levels of trait self-objectification.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Self-Objectification Questionnaire (SOQ)	10.13 units on a scale Standard Deviation 9.75	7.71 units on a scale Standard Deviation 13.11	6.32 units on a scale Standard Deviation 12.46

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Self-Objectification Questionnaire (SOQ) is a 10-item self-report inventory designed to assess the relative importance of body competence versus body appearance in sense of self. Participants rank appearance- versus competence-based attributes from 0 to 9 with higher scores representing higher importance. An overall trait self-objectification score is computed by summing competence and appearance ratings and subtracting the sum of competence ratings from the sum of appearance ratings. Resulting scores range from -25 to 25. Higher scores denote higher levels of trait self-objectification.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Self-Objectification Questionnaire (SOQ)	10.40 units on a scale Standard Deviation 9.08	6.70 units on a scale Standard Deviation 11.39	2.35 units on a scale Standard Deviation 13.65

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Self-Objectification Questionnaire (SOQ) is a 10-item self-report inventory designed to assess the relative importance of body competence versus body appearance in sense of self. Participants rank appearance- versus competence-based attributes from 0 to 9 with higher scores representing higher importance. An overall trait self-objectification score is computed by summing competence and appearance ratings and subtracting the sum of competence ratings from the sum of appearance ratings. Resulting scores range from -25 to 25. Higher scores denote higher levels of trait self-objectification.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Self-Objectification Questionnaire (SOQ)	9.80 units on a scale Standard Deviation 8.34	2.81 units on a scale Standard Deviation 12.39	1.78 units on a scale Standard Deviation 12.61

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Ideal Body Stereotype Scale - Revised was used to assess the extent to which participants internalized the cultural feminine thin-ideal. The IBSS-R is a self-report inventory which asks participants to report their level of agreement with 6 statements which indicate what attractive women look like on a 5-point scale ranging from strongly disagree (1) to strongly agree (5). Responses are averaged to compute a total score. Scores ranges from 1 to 5; higher scores indicate higher levels of thin-ideal internalization.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Ideal Body Stereotype Scale - Revised.	3.81 units on a scale Standard Deviation 0.5	3.82 units on a scale Standard Deviation .45	3.76 units on a scale Standard Deviation .5

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Ideal Body Stereotype Scale - Revised was used to assess the extent to which participants internalized the cultural feminine thin-ideal. The IBSS-R is a self-report inventory which asks participants to report their level of agreement with 6 statements which indicate what attractive women look like on a 5-point scale ranging from strongly disagree (1) to strongly agree (5). Responses are averaged to compute a total score. Scores ranges from 1 to 5; higher scores indicate higher levels of thin-ideal internalization.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Ideal Body Stereotype Scale - Revised.	3.76 units on a scale Standard Deviation 0.47	3.39 units on a scale Standard Deviation .69	3.60 units on a scale Standard Deviation .54

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Ideal Body Stereotype Scale - Revised was used to assess the extent to which participants internalized the cultural feminine thin-ideal. The IBSS-R is a self-report inventory which asks participants to report their level of agreement with 6 statements which indicate what attractive women look like on a 5-point scale ranging from strongly disagree (1) to strongly agree (5). Responses are averaged to compute a total score. Scores ranges from 1 to 5; higher scores indicate higher levels of thin-ideal internalization.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Ideal Body Stereotype Scale - Revised.	3.76 units on a scale Standard Deviation .52	3.34 units on a scale Standard Deviation .59	3.46 units on a scale Standard Deviation .40

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The State Trait Anxiety Inventory- Form Y (STAI) is a 20-item self-report measure used to assess level of trait anxiety in the present study. Each item consists of a statement which assesses feelings of anxiety or relaxation on a 4-point scale ranging from 1 (not at all) to 4 (very much so). Responses to individual items are summed to create an overall score. Scores range from 20 to 80. Higher scores indicate higher levels of anxiety.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
State Trait Anxiety Inventory - Form Y.	58.87 units on a scale Standard Deviation 8.42	58.02 units on a scale Standard Deviation 7.84	58.70 units on a scale Standard Deviation 7.90

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The State Trait Anxiety Inventory- Form Y (STAI) is a 20-item self-report measure used to assess level of trait anxiety in the present study. Each item consists of a statement which assesses feelings of anxiety or relaxation on a 4-point scale ranging from 1 (not at all) to 4 (very much so). Responses to individual items are summed to create an overall score. Scores range from 20 to 80. Higher scores indicate higher levels of anxiety.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
State Trait Anxiety Inventory - Form Y.	57.15 units on a scale Standard Deviation 7.39	53.05 units on a scale Standard Deviation 8.22	54.63 units on a scale Standard Deviation 9.31

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The State Trait Anxiety Inventory- Form Y (STAI) is a 20-item self-report measure used to assess level of trait anxiety in the present study. Each item consists of a statement which assesses feelings of anxiety or relaxation on a 4-point scale ranging from 1 (not at all) to 4 (very much so). Responses to individual items are summed to create an overall score. Scores range from 20 to 80. Higher scores indicate higher levels of anxiety.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
State Trait Anxiety Inventory - Form Y.	55.63 units on a scale Standard Deviation 9.45	51.63 units on a scale Standard Deviation 7.00	52.58 units on a scale Standard Deviation 9.71

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Positive and Negative Affect Schedule is a 20-item self-report questionnaire that used to measure positive and negative affect. Items are rated on a 5-point scale ranging from 1 (very slightly) to 5 (extremely) which measures the extent to which the client has experienced that affect over the past week. The 10 positive and 10 negative items are summed separately to create a positive affect score and a negative affect score respectively. Each score ranges between 0 and 50 with higher scores indicating higher positive or negative affect.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Positive and Negative Affect Scale - Positive Affect	26.35 units on a scale Standard Deviation 5.76	25.53 units on a scale Standard Deviation 7.10	25.24 units on a scale Standard Deviation 6.46

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Positive and Negative Affect Schedule is a 20-item self-report questionnaire that used to measure positive and negative affect. Items are rated on a 5-point scale ranging from 1 (very slightly) to 5 (extremely) which measures the extent to which the client has experienced that affect over the past week. The 10 positive and 10 negative items are summed separately to create a positive affect score and a negative affect score respectively. Each score ranges between 0 and 50 with higher scores indicating higher positive or negative affect.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Positive and Negative Affect Scale - Positive Affect	25.54 units on a scale Standard Deviation 6.36	28.57 units on a scale Standard Deviation 5.64	27.82 units on a scale Standard Deviation 6.69

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Positive and Negative Affect Schedule is a 20-item self-report questionnaire that used to measure positive and negative affect. Items are rated on a 5-point scale ranging from 1 (very slightly) to 5 (extremely) which measures the extent to which the client has experienced that affect over the past week. The 10 positive and 10 negative items are summed separately to create a positive affect score and a negative affect score respectively. Each score ranges between 0 and 50 with higher scores indicating higher positive or negative affect.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Positive and Negative Affect Scale - Positive Affect	26.60 units on a scale Standard Deviation 6.44	27.84 units on a scale Standard Deviation 5.85	27.98 units on a scale Standard Deviation 5.26

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Mean R wave amplitude was determined via a 3-lead ECG and was measured in millivolts (mV). The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. A total of 5 minutes and 30 seconds of ECG data were collected to allow for artifact trimming. Artifacts were flagged by experimenters during data collection. Mean R wave amplitude represents ventricular depolarization. Higher magnitudes indicated increased polarity associated with an increased force of ventricular contraction.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Mean R Wave Amplitude	1.27 millivolts (mV) Standard Deviation .36	1.19 millivolts (mV) Standard Deviation .31	1.27 millivolts (mV) Standard Deviation .36

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Mean R wave amplitude was determined via a 3-lead ECG and was measured in millivolts (mV). The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. A total of 5 minutes and 30 seconds of ECG data were collected to allow for artifact trimming. Artifacts were flagged by experimenters during data collection. Mean R wave amplitude represents ventricular depolarization and is measured in millivolts. Higher magnitudes indicated increased polarity associated with an increased force of ventricular contraction.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Mean R Wave Amplitude	1.32 millivolts (mV) Standard Deviation .32	1.19 millivolts (mV) Standard Deviation .24	1.27 millivolts (mV) Standard Deviation .36

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Mean R wave amplitude was determined via a 3-lead ECG and was measured in millivolts (mV). The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. A total of 5 minutes and 30 seconds of ECG data were collected to allow for artifact trimming. Artifacts were flagged by experimenters during data collection. Mean R wave amplitude represents ventricular depolarization and is measured in millivolts. Higher magnitudes indicated increased polarity associated with an increased force of ventricular contraction.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Mean R Wave Amplitude	1.26 millivolts (mV) Standard Deviation .31	1.14 millivolts (mV) Standard Deviation .26	1.12 millivolts (mV) Standard Deviation .26

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

QTc prolongation was measured in msec and was assessed via 3-lead ECG. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. For detection, typical QRS width was set at 80ms and R waves were at least 300ms apart. QTc was corrected with Bazett's formula. QT interval length represents the length of ventricular depolarization and repolarization and is measured in msec.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
QT Interval Length	.38 msec Standard Deviation .02	.38 msec Standard Deviation .02	.38 msec Standard Deviation .02

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

QTc prolongation was measured in msec and was assessed via 3-lead ECG. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. For detection, typical QRS width was set at 80ms and R waves were at least 300ms apart. QTc was corrected with Bazett's formula. QT interval length represents the length of ventricular depolarization and repolarization and is measured in msec.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
QT Interval Length	.38 msec Standard Deviation .02	.39 msec Standard Deviation .01	.39 msec Standard Deviation .01

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
QT Interval Length	.38 msec Standard Deviation .02	.38 msec Standard Deviation .01	.38 msec Standard Deviation .01

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

High frequency spectral power was assessed via heart rate variability (HRV) power spectral analysis of 3-lead ECG data and was reported in normalized units. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. Maximum frequency was set at 0.5 Hz with number of frequencies at 500. LF spectral power ranged from 0.04-0.15 Hz. HF spectral power ranged from 0.15-0.45 Hz. Increased high frequency spectral power represents increased vagal input to the heart.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Vagal Cardiac Tone - High Frequency Spectral Power	60.08 Normalized units: HF (watts/Hz) Standard Deviation 19.56	57.26 Normalized units: HF (watts/Hz) Standard Deviation 19.78	61.61 Normalized units: HF (watts/Hz) Standard Deviation 5.87

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

High frequency spectral power was assessed via heart rate variability (HRV) power spectral analysis of 3-lead ECG data and was reported in normalized units. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. Maximum frequency was set at 0.5 Hz with number of frequencies at 500. LF spectral power ranged from 0.04-0.15 Hz. HF spectral power ranged from 0.15-0.45 Hz. Increased high frequency spectral power represents increased vagal input to the heart.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Vagal Cardiac Tone - High Frequency Spectral Power	60.15 Normalized units: HF (watts/Hz) Standard Deviation 21.20	60.04 Normalized units: HF (watts/Hz) Standard Deviation 23.46	60.58 Normalized units: HF (watts/Hz) Standard Deviation 17.52

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

High frequency spectral power was assessed via heart rate variability (HRV) power spectral analysis of 3-lead ECG data and was reported in normalized units. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. ECG data were analyzed via PowerLab LabChart 8 software. Maximum frequency was set at 0.5 Hz with number of frequencies at 500. LF spectral power ranged from 0.04-0.15 Hz. HF spectral power ranged from 0.15-0.45 Hz. Increased high frequency spectral power represents increased vagal input to the heart.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Vagal Cardiac Tone - High Frequency Spectral Power	51.65 Normalized units: HF (watts/Hz) Standard Deviation 20.56	56.60 Normalized units: HF (watts/Hz) Standard Deviation 22.83	58.81 Normalized units: HF (watts/Hz) Standard Deviation 19.68

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Low frequency to high frequency spectral power was assessed via heart rate variability (HRV) power spectral analysis of 3-lead ECG. This index was reported in normalized units. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. Maximum frequency was set at 0.5 Hz with number of frequencies at 500. LF spectral power ranged from 0.04-0.15 Hz. HF spectral power ranged from 0.15-0.45 Hz. The ratio is designed to assess degree of sympathetic innervation to the heart.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Sympathetic Cardiac Tone - Low Frequency High Frequency Spectral Power Ratio	1.02 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 1.55	.99 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation .84	.72 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation .53

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Low frequency to high frequency spectral power was assessed via heart rate variability (HRV) power spectral analysis of 3-lead ECG. This index was reported in normalized units. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. Maximum frequency was set at 0.5 Hz with number of frequencies at 500. LF spectral power ranged from 0.04-0.15 Hz. HF spectral power ranged from 0.15-0.45 Hz. The ratio is designed to assess degree of sympathetic innervation to the heart.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Sympathetic Cardiac Tone - Low Frequency High Frequency Spectral Power Ratio	1.45 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 3.51	1.05 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 1.17	.85 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 1.02

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

Low frequency to high frequency spectral power was assessed via heart rate variability (HRV) power spectral analysis of 3-lead ECG. This index was reported in normalized units. The ECG signal was acquired via PowerLab 16/35 psychophysiological data acquisition system with a sampling rate of 1000 Hz. Hardware setup included an ECG100C amplifier with a 35Hz LPN filter and a .5Hz HP filter. Maximum frequency was set at 0.5 Hz with number of frequencies at 500. LF spectral power ranged from 0.04-0.15 Hz. HF spectral power ranged from 0.15-0.45 Hz. The ratio is designed to assess degree of sympathetic innervation to the heart.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Sympathetic Cardiac Tone - Low Frequency High Frequency Spectral Power Ratio	1.54 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 1.99	1.86 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 4.64	1.32 ratio: LF (watts/HZ) / HF (watts/Hz) Standard Deviation 2.84

PRIMARY outcome

Timeframe: Baseline assessments occurred after screening and prior to the delivery of any interventions.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Positive and Negative Affect Schedule is a 20-item self-report questionnaire that used to measure positive and negative affect. Items are rated on a 5-point scale ranging from 1 (very slightly) to 5 (extremely) which measures the extent to which the client has experienced that affect over the past week. The 10 positive and 10 negative items are summed separately to create a positive affect score and a negative affect score respectively. Each score ranges between 0 and 50 with higher scores indicating higher positive or negative affect.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Positive and Negative Affect Scale - Negative Affect	30.15 units on a scale Standard Deviation 7.46	29.00 units on a scale Standard Deviation 6.88	29.64 units on a scale Standard Deviation 6.60

PRIMARY outcome

Timeframe: Postintervention assessments were conducted approximately 4 weeks following the baseline assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Positive and Negative Affect Schedule is a 20-item self-report questionnaire that used to measure positive and negative affect. Items are rated on a 5-point scale ranging from 1 (very slightly) to 5 (extremely) which measures the extent to which the client has experienced that affect over the past week. The 10 positive and 10 negative items are summed separately to create a positive affect score and a negative affect score respectively. Each score ranges between 0 and 50 with higher scores indicating higher positive or negative affect.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Positive and Negative Affect Scale - Negative Affect	29.63 units on a scale Standard Deviation 6.67	25.61 units on a scale Standard Deviation 6.99	25.59 units on a scale Standard Deviation 6.89

PRIMARY outcome

Timeframe: Follow-up assessments began approximately 8 weeks after the postintervention assessment.

Population: Mean scores and standard deviations were reported as a function of group and time. Single mean imputation was used to impute all missing scores to reflect a sample size of n=60 per condition (N=180 total) based on participants admitted at the beginning of the trial. The outcome analyses were based on imputed values and therefore, overall number of participants analyzed equals 60 per condition in the outcome analyses.

The Positive and Negative Affect Schedule is a 20-item self-report questionnaire that used to measure positive and negative affect. Items are rated on a 5-point scale ranging from 1 (very slightly) to 5 (extremely) which measures the extent to which the client has experienced that affect over the past week. The 10 positive and 10 negative items are summed separately to create a positive affect score and a negative affect score respectively. Each score ranges between 0 and 50 with higher scores indicating higher positive or negative affect.

Outcome measures

Measure	Educational Brochure n=60 Participants Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 Participants Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Positive and Negative Affect Scale - Negative Affect	28.50 units on a scale Standard Deviation 7.96	24.24 units on a scale Standard Deviation 6.24	25.00 units on a scale Standard Deviation 5.82

Adverse Events

Educational Brochure

Serious events: 1 serious events

Other events: 0 other events

Deaths: 0 deaths

Body Project Traditional

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Body Project Expanded

Serious events: 2 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Measure	Educational Brochure n=60 participants at risk Participants will read an educational brochure from the National Eating Disorder Association and will receive referral resources. Educational Brochure: Participants will read an educational brochure from the National Eating Disorders Association and will receive treatment referral resources.	Body Project Traditional n=60 participants at risk Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project group therapy program (Stice \& Shaw, 2001). Body Project Traditional: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Traditional group therapy program (see Stice \& Shaw, 2001).	Body Project Expanded n=60 participants at risk Participants will complete group therapy for 1-hour per week for 4 weeks consisting of the Body Project Expanded group therapy program (Green et al., 2017). Body Project Expanded: Participants will complete a 1-hour per week group therapy program for 4 weeks consisting of the Body Project Expanded group therapy program (see Green et al., 2017).
Psychiatric disorders Hospitalization	1.7% 1/60 • Number of events 1 • Information regarding adverse events were reported at baseline, postintervention (approximately 4 weeks after treatment initiation) and 2-month follow-up (approximately 8 weeks after treatment conclusion).	0.00% 0/60 • Information regarding adverse events were reported at baseline, postintervention (approximately 4 weeks after treatment initiation) and 2-month follow-up (approximately 8 weeks after treatment conclusion).	0.00% 0/60 • Information regarding adverse events were reported at baseline, postintervention (approximately 4 weeks after treatment initiation) and 2-month follow-up (approximately 8 weeks after treatment conclusion).
Psychiatric disorders Suicidal Ideation	0.00% 0/60 • Information regarding adverse events were reported at baseline, postintervention (approximately 4 weeks after treatment initiation) and 2-month follow-up (approximately 8 weeks after treatment conclusion).	0.00% 0/60 • Information regarding adverse events were reported at baseline, postintervention (approximately 4 weeks after treatment initiation) and 2-month follow-up (approximately 8 weeks after treatment conclusion).	3.3% 2/60 • Number of events 2 • Information regarding adverse events were reported at baseline, postintervention (approximately 4 weeks after treatment initiation) and 2-month follow-up (approximately 8 weeks after treatment conclusion).

Other adverse events

Adverse event data not reported

Additional Information

Dr. Melinda Green

Green Counseling Services PLLC

Phone: 5154508913

Email: drgreen@greencounselingservice.com

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place