A novel \u2018practical body image\u2019 therapy for adolescent inpatients with anorexia nervosa: a randomised controlled trial

Hannah Biney,Jessica Grant,John F Morgan,Matt Hutt,Rachel Matthews,J Hubert Lacey,Sarah Astbury,Sarah White,Amanda Haines,Nicola Malone

doi:10.1007/s40519-020-00997-2

Abstract

PurposeTo determine the potential effectiveness of a novel 10-week manualised Practical Body Image therapy (PBI) with mirror exposure (ME), when used as an adjuvant to an intensive treatment package (TAU) in adolescent inpatients with Anorexia Nervosa (AN). To evaluate the effectiveness of ME in an adolescent population.MethodsUsing a randomised control design, 40 girls aged 11–17 years with AN were assigned to PBI with TAU (n = 20) and TAU alone (n = 20). Both groups completed self-report measures of body image at week 1 and week 10 of the study to measure the potential effectiveness of PBI. The PBI group completed measures at week 7 to evaluate the ME component.Results31 participants completed the study; 16 TAU, 15 PBI. PBI participants had greater improvement in all outcomes than TAU participants. Medium effect sizes were seen for self-reported weight concern, body image avoidance in terms of clothing and body image anxiety. ME produced effect sizes in self-reported body image avoidance in terms of clothing and grooming that were greater than 0.40, n = 14.ConclusionThe findings demonstrate that PBI supports an intensive inpatient treatment package and addresses elements of negative body image. PBI was beneficial for addressing body image dissatisfaction with improvements in weight concerns, body image avoidance and physical appearance trait anxiety following the ME component. The magnitude of the effect sizes is comparable to previous studies. Positive qualitative feedback indicated the intervention was acceptable to users. PBI is a promising new adjuvant treatment for AN.EMB RatingLevel I: randomized controlled trial.

Highlights

Introduction and aimsA core diagnostic feature of Anorexia Nervosa (AN) is body dissatisfaction, defined as ‘a disturbance in the way in which body weight or shape is experienced with undue influence of body weight or shape on self-evaluation or persistent lack of recognition of the seriousness of current low body weight’ [1]
The aim of this study was to evaluate the potential effectiveness of Practical Body Image therapy (PBI) which uses cognitive behaviour therapy (CBT) approaches and mirror exposure (ME) to improve body image in adolescents with a diagnosis of AN, when used as an adjuvant to an array of therapies in an inpatient unit
Weight for height and BMI was collected for all participants at T1 and T3, and for PBI participants at T2

Summary

Introduction

Introduction and aimsA core diagnostic feature of Anorexia Nervosa (AN) is body dissatisfaction, defined as ‘a disturbance in the way in which body weight or shape is experienced with undue influence of body weight or shape on self-evaluation or persistent lack of recognition of the seriousness of current low body weight’ [1]. [≥ 90% of healthy weight] Introduce programme and complete time 1 Body Image questionnaires. Using a timeline of body image events to explore how negative body image developed, identify negative beliefs about their body and explore perception and ideal body shape using photographs of different body shapes and sizes. Investigate perception of their body weight and size using a 2D drawing task of their body outline and 3D drawing task of 2-3 body parts. Outing to try on avoided clothes and explore clothes sizes and to take photographs at healthy weight for survey.

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Conclusion