Feasibility, Acceptability, and Preliminary Efficacy of a Peer‐Delivered Group Intervention to Mitigate Risk of Disordered Eating Among Pregnant Individuals: A Pilot Randomized Controlled Trial

OBJECTIVE: Pregnancy and postpartum are high-risk periods for body dissatisfaction and disordered eating, which adversely affect the wellbeing of pregnant people and their children. The Pregnant Body Project (PBP) is a peer-led intervention based on an empirically supported eating disorder prevention program, adapted to address the unique context and risks of pregnant individuals who have a prior history of disordered eating. METHOD: Pregnant individuals with a history of disordered eating (N = 65) were randomized to a 6-week virtual peer-led PBP group (n = 32) or an active time- and dose-matched health education control (n = 33). Participants completed measures of feasibility, engagement, acceptability, satisfaction, and clinical outcomes (e.g., disordered eating) at pre- and post-test. Descriptive statistics summarize primary implementation outcomes. Secondary clinical outcomes were analyzed using linear mixed effects models with time, treatment group, and their interaction, estimated using full information maximum likelihood under an intent to-treat approach. RESULTS: Recruitment, retention, and data collection met or exceeded preregistered thresholds. Program completion (88%) and homework completion (88%) indicated strong engagement, and PBP participants' average ratings for satisfaction, appropriateness, and acceptability were above the midpoint. Group leaders demonstrated high fidelity and competency. While not statistically significant, small effect sizes favored PBP for improvements in eating disorder symptoms and body image satisfaction (between group d = -0.10 to -0.26; within group d = -0.13 to -0.46). DISCUSSION: Findings support the feasibility and acceptability of a virtual, peer-led intervention tailored to pregnant individuals with a history of disordered eating. These findings provide a foundation for a larger-scale hybrid effectiveness-implementation trial.