Examining Body Image Distortion Related to Anorexia Nervosa – Nature Reviews Disease Primers




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Note: BID is Body Image Distortion and AN is Anorexia Nervosa.

“Findings from an increasing number of functional MRI (fMRI) studies . . . provide valuable insights into the neural basis of BID in AN. Unfortunately, we felt that these issues were not entirely addressed by the Primer, making it difficult to understand the ‘reasonably consistent’ (Ref. 7) evidence produced by this research. The review summarized that the ‘affective’ component of BID in AN is related to alterations of the prefrontal cortex, the insula and the amygdala and that the ‘perceptive’ component of BID is related to alterations of the parietal lobes (which have roles in spatial and body representations, body ownership and other features requiring multisensory integration) or, more accurately, the posterior parietal regions (which are involved in visuospatial processing). A deficit in parietal cortex-mediated functions in AN is also underscored by findings from neurocognitive studies. Although both extant neuroimaging and behavioural data suggest that two components of body image (the estimation of one’s own body size and the attitude towards one’s own body in terms of an emotional evaluation) are disturbed in individuals with AN, these aspects might have been described in more detail in the Primer. In fact, although two (widely accepted) body-image components can be distinguished, this does not imply that they are independent. Indeed, experimental evidence supports a direct (unidirectional) link between how we perceive and how we feel about our body. The aforementioned specific neural bases of the affective component of BID in AN also support an altered emotional response to unpleasant (for example, self-distorted fat image) stimuli. Furthermore, in the few available fMRI studies based on a word paradigm (that is, tasks using ‘fat’, ‘thin’ and ‘neutral’ words), a variation in amygdala response was absent — making the involvement of this brain region less clear but suggesting the greater relevance of self-perception and the mechanism of body-image construction (see below). There is the need to take into account these (and other convergent) clues and the considerable room for improvement that remains from the first-line prevention and psychotherapeutic interventions, currently described in the Primer (for example, the Body Project and enhanced cognitive–behavioural therapy), and targeting the ‘affective’ body-image component. Thus, we would suggest that it is now time to consider the development of intervention strategies that target the perceptive component.”


Article discussing recent reviews of research into Anorexia Nervosa and related body-image issues through brain scans and other available data.


  • Antonios Dakanalis, Santino Gaudio, Silvia Serino, Massimo Clerici, Giuseppe Carrà & Giuseppe Riva


  • Body-image distortion in anorexia nervosa


  • Nature Reviews Disease Primers (Journal)


  • April 21, 2016


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