Body Image Disturbance and Binge Eating

Abstract

Body image disturbance is one of the diagnostic criteria for anorexia and bulimia nervosa, but not for binge-eating disorder (BED). Nevertheless, a disturbed body image is also present in patients with BED. In particular, the cognitive-affective component of body image disturbance, which encompasses overvaluation of shape and weight, body dissatisfaction, and dysfunctional body-related information processing, is more pronounced in individuals with BED than in weight-matched controls. There is no evidence regarding a perceptual body image disturbance, and findings on body-checking and avoidance behaviors are inconclusive with respect to whether these characteristics are associated with BED rather than with obesity. However, not only BED, but also other eating disorders, which feature binge eating behavior, i.e., bulimia nervosa and the binge eating/purging subtype of anorexia nervosa, are characterized by dysfunctions in these body image facets. In sum, body image disturbance might be a worthwhile treatment target, and initial research has illustrated the efficacy of body image-related interventions in patients with BED or binge eating behavior. However, future studies are warranted to investigate the add-on effects of body image-related interventions to existing state-of-the-art treatments and to identify subgroups of individuals with BED or binge eating who benefit the most from these treatments.