Body image disturbance

Not to be confused with body dysmorphic disorder.

Body image disturbance
SpecialtyPsychiatry, psychology
SymptomsAltered body self-perception, body uneasiness, body dissatisfaction, body-checking behavior
ComplicationsEating disorders
Usual onsetEarly adolescence
Risk factorsBody dissatisfaction, childhood neglect, childhood abuse
Diagnostic methodEDI-3, body uneasiness test, clinical diagnosis, Visual Size Estimation Task, 3D Morphing
Differential diagnosisBody dysmorphic disorder, obsessive-compulsive disorder
PreventionPositive body image, good self-esteem, healthy eating behaviors
TreatmentPsychotherapy Psychiatric rehabilitation

Body image disturbance (BID) is a common symptom in patients with eating disorders and is characterized by an altered perception of one's own body.

The onset is mainly attributed to patients with anorexia nervosa who persistently tend to subjectively discern themselves as average or overweight despite adequate, clinical grounds for a classification of being considerably or severely underweight.[1] The symptom is an altered perception of one's body and a severe state of bodily dissatisfaction characterizing the body image disturbance. It is included among the diagnostic criteria for anorexia nervosa in DSM-5 (criterion C).[2]

The disturbance is associated with significant bodily dissatisfaction and is a source of severe distress, often persisting even after seeking treatment for an eating disorder,[3][4] and is regarded as difficult to treat.[3][5] Thus, effective body image interventions could improve the prognosis of patients with ED, as experts have suggested.[6] However, there is no hard evidence that current treatments for body image disturbance effectively reduce eating disorder symptoms.[7][8] Furthermore, pharmacotherapy is ineffective in reducing body misperception and it has been used to focus on correlated psychopathology (e.g., mood or anxiety disorders).[9] However, to date, research and clinicians are developing new therapies such as virtual reality experiences,[10][11] mirror exposure,[12] or multisensory integration body techniques,[13][14][5] which have shown some extent of efficacy.

  1. ^ Treasure, J; Zipfel, S; Micali, N; Wade, T; Stice, E; Claudino, A; Schmidt, U; Frank, G; Builk, C; Wentz, E (26 November 2015). "Anorexia nervosa". Nature Reviews Disease Primers. 1 (1): 15074. doi:10.1038/nrdp.2015.74. ISSN 2056-676X. PMID 27189821. S2CID 21580134.
  2. ^ "Feeding and Eating Disorders". Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. 22 May 2013. doi:10.1176/appi.books.9780890425596.dsm10. ISBN 978-0-89042-555-8. Retrieved 1 August 2021.
  3. ^ a b Eshkevari, E; Rieger, E; Longo, M; Haggard, P; Treasure, J (2014). "Persistent body image disturbance following recovery from eating disorders". International Journal of Eating Disorders. 47 (4): 400–409. doi:10.1002/eat.22219. ISSN 1098-108X. PMID 24243423.
  4. ^ Engel, M; Keizer, A (23 November 2017). "Body representation disturbances in visual perception and affordance perception persist in eating disorder patients after completing treatment". Scientific Reports. 7 (1): 16184. Bibcode:2017NatSR...716184E. doi:10.1038/s41598-017-16362-w. ISSN 2045-2322. PMC 5701063. PMID 29170439.
  5. ^ a b Artoni, P; Chierici, M. L.; Arnone, F.; Cigarini, C.; De Bernardis, E.; Galeazzi, G. M.; Minneci, D. G.; Scita, F.; Turrini, G.; De Bernardis, M.; Pingani, L. (2021). "Body perception treatment, a possible way to treat body image disturbance in eating disorders: a case-control efficacy study". Eating and Weight Disorders. 26 (2): 499–514. doi:10.1007/s40519-020-00875-x. ISSN 1590-1262. PMID 32124409. S2CID 211728899.
  6. ^ Bruch, H (1962). "Perceptual and Conceptual Disturbances in Anorexia Nervosa". Psychosomatic Medicine. 24 (2): 187–194. doi:10.1097/00006842-196203000-00009. ISSN 0033-3174. PMID 13873828.
  7. ^ Ziser, K; Mölbert, S; Stuber, F; Giel, K; Zipfel, S; Junne, F (2018). "Effectiveness of body image directed interventions in patients with anorexia nervosa: A systematic review". The International Journal of Eating Disorders. 51 (10): 1121–1127. doi:10.1002/eat.22946. ISSN 1098-108X. PMID 30189104. S2CID 52170683.
  8. ^ Alleva, J; Sheeran, P; Webb, T; Martijn, C; Miles, E (29 September 2015). "A Meta-Analytic Review of Stand-Alone Interventions to Improve Body Image". PLOS ONE. 10 (9): e0139177. Bibcode:2015PLoSO..1039177A. doi:10.1371/journal.pone.0139177. ISSN 1932-6203. PMC 4587797. PMID 26418470.
  9. ^ Ziser, K; Mölbert, S; Stuber, F; Giel, K; Zipfel, S; Junne, F (2018). "Effectiveness of body image directed interventions in patients with anorexia nervosa: A systematic review". International Journal of Eating Disorders. 51 (10): 1121–1127. doi:10.1002/eat.22946. ISSN 1098-108X. PMID 30189104. S2CID 52170683.
  10. ^ Clus, D; Larsen, M; Lemey, C; Berrouiguet, S (27 April 2018). "The Use of Virtual Reality in Patients with Eating Disorders: Systematic Review". Journal of Medical Internet Research. 20 (4): e157. doi:10.2196/jmir.7898. ISSN 1438-8871. PMC 5948410. PMID 29703715.
  11. ^ Porras-Garcia, B; Serrano-Troncoso, E; Carulla-Roig, M; Soto-Usera, P; Ferrer-Garcia, M; Figueras-Puigderrajols, N; Yilmaz, L; Onur Sen, Y; Shojaeian, N; Gutiérrez-Maldonado, J (15 May 2020). "Virtual Reality Body Exposure Therapy for Anorexia Nervosa. A Case Report With Follow-Up Results". Frontiers in Psychology. 11: 956. doi:10.3389/fpsyg.2020.00956. ISSN 1664-1078. PMC 7242758. PMID 32499742.
  12. ^ Cite error: The named reference :17 was invoked but never defined (see the help page).
  13. ^ Keizer, A; Engel, M; Bonekamp, J; Van Elburg, A (2019). "Hoop training: a pilot study assessing the effectiveness of a multisensory approach to treatment of body image disturbance in anorexia nervosa". Eating and Weight Disorders. 24 (5): 953–958. doi:10.1007/s40519-018-0585-z. ISSN 1590-1262. PMC 6751149. PMID 30288723.
  14. ^ Risso, G.; Martoni, R.; Erzegovesi, S.; Bellodi, L.; Baud-Bovy, G. (2020). "Visuo-tactile shape perception in women with Anorexia Nervosa and healthy women with and without body concerns". Neuropsychologia. 149: 107635. doi:10.1016/j.neuropsychologia.2020.107635. PMID 33058922.