Primary prevention of bulimia nervosa, which is part of the strategy to prevent obesity and other eating disorders, focuses on:[52]Fletcher A, Bonell C, Sorhaindo A. You are what your friends eat: systematic review of social network analyses of young people's eating behaviours and bodyweight. J Epidemiol Community Health. 2011 Jun;65(6):548-55.
http://www.ncbi.nlm.nih.gov/pubmed/21427455?tool=bestpractice.com
[58]Treasure J, Sepulveda AR, MacDonald P, et al. The assessment of the family of people with eating disorders. Eur Eat Disord Rev. 2008 Jul;16(4):247-55.
http://www.ncbi.nlm.nih.gov/pubmed/18240125?tool=bestpractice.com
[59]Sharpe H, Schober I, Treasure J, et al. Feasibility, acceptability and efficacy of a school-based prevention programme for eating disorders: cluster randomised controlled trial. Br J Psychiatry. 2013 Dec;203(6):428-35.
http://www.ncbi.nlm.nih.gov/pubmed/24115345?tool=bestpractice.com
[60]Golden NH, Schneider M, Wood C; et al. Preventing obesity and eating disorders in adolescents. Pediatrics. 2016 Sep;138(3).
http://pediatrics.aappublications.org/content/early/2016/08/18/peds.2016-1649
http://www.ncbi.nlm.nih.gov/pubmed/27550979?tool=bestpractice.com
Increasing self-esteem
Improving media awareness
Strengthening the family
Decreasing the emphasis on weight and shape at home, at school, and in society
Decreasing pressure for people to conform to the ideals of the media.
Regular healthy low-pressure eating at home, at school, and in society is important, as is educating parents and coaches about unhealthy weight loss behaviors.[57]Carl RL, Johnson MD, Martin TJ; Council on Sports Medicine and Fitness. Promotion of healthy weight-control practices in young athletes. Pediatrics. 2017 Sep;140(3): e20171871.
https://publications.aap.org/pediatrics/article/140/3/e20171871/38384/Promotion-of-Healthy-Weight-Control-Practices-in?autologincheck=redirected
http://www.ncbi.nlm.nih.gov/pubmed/28827381?tool=bestpractice.com
However, teaching children about eating disorders is unhelpful as a preventive strategy.[5]Furnham A, Davidson L. Sex differences in beliefs about bulimia nervosa. Soc Psychiatry Psychiatr Epidemiol. 2012 Jan;47(1):67-77.
http://www.ncbi.nlm.nih.gov/pubmed/21057770?tool=bestpractice.com
[61]Mond JM, Arrighi A. Gender differences in perceptions of the severity and prevalence of eating disorders. Early Interv Psychiatry. 2011 Feb;5(1):41-9.
http://www.ncbi.nlm.nih.gov/pubmed/21272274?tool=bestpractice.com