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Eligible randomised controlled trials (RCTs) reported quantitative outcomes (e.g., ED psychopathology, body dissatisfaction, dieting behaviors) following universal secondary-school interventions addressing weight, shape, or eating concerns and another psychological risk factor in non-clinical adolescents aged 11\u201318. Results were synthesized narratively, and study quality was evaluated using the Cochrane Risk of Bias (RoB-2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen RCTs were included. Eleven studies were conducted in Europe, most participants were female and in middle adolescence. Overall, most universal school-based ED interventions produced some immediate improvement in ED symptoms or well-being but effects were generally small or rarely sustained at follow-up. There were no significant changes in BMI. However, the high risk of bias limits the confidence of findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These improvements were short term, and their effects were mostly small. Future research would benefit from adopting active comparison groups and longer follow-ups. Whilst core ED psychopathology in addition to the risk factors of body image dissatisfaction, dieting, self-esteem, and social media appear consistent factors to include in universal interventions, further understanding of the most effective risk factors to target in this population is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40337-026-01712-9","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:15:01Z","timestamp":1787318101000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of universal secondary school-based interventions addressing the psychological risk factors of eating disorders in adolescents: a systematic review"],"prefix":"10.1186","volume":"14","author":[{"given":"Melissa","family":"Stock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"issue":"1","key":"1712_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/eat.10234","volume":"35","author":"L Abascal","year":"2004","unstructured":"Abascal L, Brown J, Winzelberg A, Dev P, Taylor C. 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