Strategic Priorities for Advancing Eating Disorder Risk Reduction: A Narrative Review.

Despite decades of advances in treatment, eating disorders continue to impose substantial individual and societal burden, underscoring the need for earlier and more effective risk reduction. Prevention research has expanded considerably, producing a wide range of approaches that target modifiable risk factors, build individual coping skills, intervene within schools and families, leverage digital delivery formats, and, increasingly, consider policy and structural levers. Although many programs demonstrate small-to-moderate improvements in established risk factors, population-level impact has been limited. Effects are often modest, implementation is inconsistent, and scalability remains constrained. This narrative review synthesizes contemporary eating disorder risk reduction efforts across four interconnected dimensions that shape impact: mechanisms targeted, level of focus (from individual to population), personalization and cultural adaptation, and delivery and scalability. Across these domains, critical gaps emerge, including narrow mechanistic focus, imprecise risk stratification, underrepresentation of diverse populations, and limited integration of implementation science and economic and policy evaluation. This review argues that advancing eating disorder risk reduction requires a shift from efficacy-focused intervention development toward coordinated, multilevel, and implementation-informed strategies that prioritize precision, equity, system integration, and policy engagement. Such reorientation is essential if eating disorder risk reduction is to achieve meaningful and sustained population-level impact. Drawing on these findings, this review outlines a set of strategic priorities for advancing eating disorder risk reduction at scale.