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Cited by 37Eating Disorders and BehaviorsBody Image and Dysmorphia StudiesNutrition, Health and Food Behavior

Perceptive Body Image Distortion in Adolescent Anorexia Nervosa: Changes After Treatment

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Dalhoff, Anke W., Romero Frausto, Hugo, Romer, Georg, Wessing, Ida·2019·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2019.00748PMC PMC6803517
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Abstract

One key symptom of anorexia nervosa (AN) is body image distortion (BID). For example, AN patients who are asked to perform body size estimation tasks tend to overestimate their body size; this is thought to indicate a distortion of the perceptive component of body image. Although BID is an important treatment objective, only few treatment approaches explicitly target body image, and even fewer target the perceptive component. Moreover, very little is known about how patients’ perceptive body image changes after treatment and related weight gain. Consequently, we investigated changes of the perceptive BID in adolescent AN patients at the beginning (T1) and the end (T2) of inpatient treatment using a body size estimation task. A total of 38 AN patients performed the test for Body Image Distortion in Children and Adolescents (BID-CA) within the first two weeks of inpatient treatment and at the end of treatment. The results were compared to 48 healthy control (HC) participants performing the same task once. At T1, AN patients overestimated their body size more than HC, i.e. a total overestimation of 33 % in AN patients vs. 11 % in HC. At T2, AN patients overestimated their arm size to the same degree that they did at TI, but overestimations for the thigh and waist were reduced, and their overestimations for the waist no longer differed from the HC group. Thus, after treatment, AN patients were partly able to more realistically estimate their body size. Several factors may have influenced the observed changes in body size estimation, including task repetition, deliberate adjustment, growing into their preexisting perceptive body image through weight gain, as well as targeted and non-specific psychotherapeutic treatment. In conclusion, the perceptive BID in adolescent AN patients is persistent but also modifiable. Although diverse factors presumably play a role in changing BID, these findings suggest that AN patients may benefit from targeted treatment of BID.

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  • Body image satisfaction or lack thereof profoundly impacts emotional state, behavioral patterns, and overall quality of life, setting foundation for psychological resilience or vulnerability.

    “Body image satisfaction—or the lack thereof—profoundly impacts one’s emotional state, behavioral patterns, and overall quality of life, setting a foundation for either psychological resilience or vulnerability [166].”

    From Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors (2024) · cites this paper as [166]

    The Introduction (page not provided) says negative feelings about the body can motivate restrictive eating in anorexia nervosa and that body image distortion is associated with the disorder’s outcomes. This supports a link to emotional experience and behavior in that clinical setting, but the paper does not establish the claim’s broad effects on quality of life or psychological resilience across people generally. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • As Western media penetrate non-Western societies, ideals of thinness and muscularity become global aspirations, impacting body perception and leading to increased body dissatisfaction and mental health issues.

    “For instance, as Western media penetrate non-Western societies, the ideals of thinness and muscularity become global aspirations, impacting how individuals in these cultures perceive their bodies. This shift can lead to increased body dissatisfaction and related mental health issues in cultures where such problems were previously less prevalent [166].”

    From Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors (2024) · cites this paper as [166]

    The Introduction discusses body dissatisfaction in anorexia nervosa, and the Discussion addresses changes in body-size perception after treatment; neither addresses Western media entering non-Western societies. Searches for Western media, globalization, thinness and muscularity ideals, and cultural changes found no passage supporting the claimed causal link. (LLM, conf=0.76)

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Authors
Dalhoff, A. W., Romero Frausto, H., Romer, G., & Wessing, I.
Affiliations
University Hospital Münster (DE)
Corresponding author
Wessing, Ida
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2019-10-15
Volume
10
Pages
748-748
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2019.00748
PMC
PMC6803517
OpenAlex
W2980530286
Cited by
37
References
33
Citations by year
2026: 7 · 2025: 2 · 2024: 10 · 2023: 5 · 2022: 7 · 2021: 4 · 2015: 2
FWCI
3.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Deutsche Forschungsgemeinschaft
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
anorexia nervosa, body image distortion, body size estimation, adolescents, inpatient care, weight gain, body image therapy

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