Body image disturbance

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.

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

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. 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).

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, and is regarded as difficult to treat. Thus, effective body image interventions could improve the prognosis of patients with ED, as experts have suggested. However, there is no hard evidence that current treatments for body image disturbance effectively reduce eating disorder symptoms. Furthermore, pharmacotherapy is ineffective in reducing body misperception and it has been used to focus on correlated psychopathology (e.g., mood or anxiety disorders). However, to date, research and clinicians are developing new therapies such as virtual reality experiences, mirror exposure, or multisensory integration body techniques, which have shown some extent of efficacy.

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