Use of Peer-Based Interventions in the Field of Eating Disorders

Eating disorders have high rates of comorbidity, mortality, and relapse. Many individuals with eating disorders experience barriers to accessing care, in part due to lack of specialized eating disorder providers and services. In recent years, peerbased interventions have proliferated in other fields of mental health, and there is an emerging body of literature examining their efficacy for individuals with eating disorders. Peer-based interventions involve the provision of services to individuals experiencing a particular diagnosis or stressor by other individuals who have a shared lived experience of that diagnosis or stressor. “Peers” in peerbased interventions can be individuals of similar age and developmental stage delivering preventative interventions or individuals who have experienced and recovered from an eating disorder delivering supportive or other interventions to those with a current eating disorder. Randomized controlled trials (RCTs) of preventative interventions delivered to at-risk female samples (i.e., college sororities) by same-age peers suggest efficacy for reduction in eating disorder risk factors like body dissatisfaction, and there is some evidence for benefits to peers as well. Qualitative, observational, and cross-sectional studies of peer mentorship delivered by recovered peers to individuals with a current eating disorder suggest high levels of acceptability and positive impact on quality-of life-related outcomes, engagement/treatment adherence, and some clinical outcomes. While there is a dearth of RCTs testing peer mentorship, results from existing studies are also suggestive of positive effects on engagement and select symptoms. The eating disorders field will benefit from additional, large, quantitative, and controlled studies to further inform the utility of peer mentorship for individuals with eating disorders. Additional research directions, such as the importance of clear definitions of “peers, ” clear descriptions of peer roles and interventions, and consistent outcomes measures, to further the existing knowledge base, are also discussed.