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Effects of a cognitive dissonance intervention on Weight and Shape Concern among women of higher weight: An ORBIT Phase 2 pilot trial
Abstract   Open access   Peer reviewed

Effects of a cognitive dissonance intervention on Weight and Shape Concern among women of higher weight: An ORBIT Phase 2 pilot trial

KayLoni L. Olson, Natalie G. Keirns, Tina Chen, Meghan L Butryn, A. Rani Elwy, Shira I. Dunsiger, Rebecca Puhl, J Graham Thomas and Rena R Wing
Annals of behavioral medicine, v 60(Supplement_1), pp S237-S237
01 Apr 2026
DOI: https://doi.org/10.1093/abm/kaag012#page=S237
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https://doi.org/10.1093/abm/kaag012#page=S237View
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Abstract

Randomized controlled trial Obesity
High weight and shape concern (WSC) is common among women initiating weight loss treatment and linked to poorer treatment outcomes. Yet, evidence-based WSC interventions do not exist for this population. In preliminary work guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, we iteratively modified an existing evidence-based WSC program developed for young women (the Body Project) for use among adult women with WSC who want to lose weight. The Body Project uses cognitive dissonance to challenge and resist thin beauty ideals. In the current study we conducted a randomized pilot trial (ORBIT Phase 2) to determine if the modified Body Project (mBP) produces a clinically significant signal on WSC compared to a time-matched and social contact control. Adult cisgender women (25-70 yrs) with high BMI (≥25kg/m2) and WSC (Eating Disorder Examination-Questionnaire: EDEQ shape concern≥4.25; weight concern≥4) were recruited in small groups of 5-10 and randomly assigned to the mBP or a control condition focused on myths and facts about obesity (CON). Both conditions were group-based and delivered remotely in four, weekly, 60-minute meetings. Participants completed the EDE-Q at baseline and end of treatment. Clinically significant improvement in WSC (remission) was defined as no longer meeting EDEQ inclusion criteria for either EDEQ subscale. The final sample included n=65 women across eight cohorts who were randomized to mBP (n=32) and CON (n=33). Participants (M age=46, SD=12.8; M BMI=31.7, SD=4.5) were racially/ethnically diverse: 42% Non-Hispanic White; 26% Black; 12% Hispanic/Latina, 9% multiracial; 8% Asian; 1.5% Native Hawaiian/Pacific Islander; 1.5% Hispanic Black. A total of n=57 (88%) women completed the post-treatment assessment (94% of mBP and 85% of CON). Among completers, 57% of mBP vs 36% of CON participants met remission criteria after treatment. An additional 13% of mBP vs 7% of CON participants met remission criteria on one subscale. Among CON, 57% of participants continued to have clinically significant WSC at post-treatment vs 30% of mBP participants. Consistent with the goals of the ORBIT Phase 2 pilot trial, these preliminary results suggest the brief mBP can produce clinically meaningful change in WSC compared to a rigorous control that accounted for both time and social contact. An important next step is evaluating if targeting WSC with the mBP can improve weight loss when combined with weight loss treatment.

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