Developing a Digital Intervention to Combat Fatphobia and Anti-fat Bias

Introduction: The Body Advocacy Movement (BAM) is an in-person, peer-led, cognitive-dissonance-based eating disorder (ED) prevention program that reduces fatphobia and anti-fat bias. Developing a digital adaptation of BAM has the potential to increase its accessibility and fill a critical gap in existing digital ED interventions, which to date have not specifically targeted anti-fat bias or fatphobia. This study applies a human-centered design approach to inform the development of a digital version of BAM. Methods: Semi-structured interviews were conducted with 31 participants, including 17 college students with elevated ED psychopathology and 14 past BAM participants. College students with elevated ED psychopathology shared experiences with fatphobia and anti-fat bias, how they use mental health technology, and thoughts on digitizing BAM. Past BAM participants shared experiences with BAM, how they use mental health technology, and thoughts on digitizing BAM. Interviews were analyzed using reflexive thematic analysis with a critical realist lens. Results: College students with elevated ED psychopathology described pervasive and harmful experiences of anti-fat bias and fatphobia, coupled with difficulties accessing action-oriented mental health support, underscoring a gap in care that a digital adaptation of BAM could address. Both groups expressed strong interest in a hybrid digital format that combines synchronous and asynchronous components for a balance of social connection and flexibility. Discussion: Findings suggest that a digital adaptation of BAM could address unmet needs in ED prevention by providing accessible, action-oriented content focused on anti-fat bias and fatphobia. Incorporating synchronous social connection within a flexible, interactive framework may promote engagement and impact. A critical next step will involve designing and pilot testing this digital adaptation of BAM to evaluate its feasibility and effectiveness.