Culturally adapted body image program for Mexican university women: feasibility, acceptability, and cultural relevance in a Pilot RCT protocol

Background: Eating disorders (EDs) and body dissatisfaction (BD) are common among young women in Mexico, yet the evaluation of culturally adapted prevention programs remains limited. Early work implementing a dissonance-based intervention with Mexican university students reported encouraging changes in BD and thin-ideal internalization. Building on this initial evidence, there is a clear need for a randomized design to examine the feasibility and implementation of culturally adapted prevention efforts in this context. Methods: This single-center, two-arm pilot RCT will recruit 30 female university students aged 18–25 years in Northeastern Mexico. Participants will be randomized 1:1 to the Body Image Program (BIP) or a waitlist control. Intervention groups will receive two 120-minute in-person sessions over consecutive weeks. Assessments will occur at baseline (week 0), post-intervention (week 2), and follow-up (week 6). Waitlist participants will be offered the BIP after the final follow-up. Primary outcomes are feasibility and acceptability (recruitment ≥70%, retention ≥80%, adherence ≥70%, satisfaction ≥4/5) and ED symptoms (ED-15). Secondary outcomes include BD (BSQ-8), body appreciation (BAS-2), social physique anxiety (SPAS-7), thin-ideal internalization (SATAQ-4), and appearance comparisons (PACS). Analyses will use linear mixed-effects models under an intention-to-treat framework, reporting standardized effect sizes with 95% confidence intervals. Conclusions: This protocol describes a pilot randomized trial of a culturally adapted body image program in a Mexican university setting. The study will provide feasibility data to guide a fully powered RCT and contribute to the development of culturally relevant prevention strategies in Latin America. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT07193043.