Body image in women with anorexia nervosa
A key symptom of anorexia nervosa (AN) is an overestimation of body size compared to control subjects, with women with AN consistently overestimating their own body size and having a markedly thinner ideal body size than control subjects. Body image distortion has been shown to be one of the most persistent of all the eating disorder symptoms, the severity of which seems to predict the long-term treatment outcome. Furthermore, this persistence predicts the rate of relapse which may be as high as 40% over the first 12-months post-discharge from treatment.
To treat this feature of AN and reduce relapse rates, we have developed a novel training program to recalibrate people’s concept of what constitutes a normal body size away from an unhealthy thin ideal back towards the healthy body size preferences seen in control participants. In a pilot study, the program successfully recalibrated the body size preferences of women with AN and reduced their body size and eating disordered concerns. We are now starting a full randomized control trial of the training in collaboration with the Eating Disorder Service of the Lincoln Partnership NHS Trust. This training program has the potential to be a valuable cost-effective adjunctive treatment for AN, which may be used together with more traditional talking therapies (e.g. CBT, mindfulness).
Understanding Body Image Distortion in Men
Perceptual body image distortion (BID) is often characterized by altered self-perceptions and has been assessed in the past using a variety of scales. However, due to the link between BID and eating disordered pathology, research within female populations has taken precedence. Consequently, body shape measurement scales employed within male populations are far less developed and are severely limited by poor imagery. Male body shape derives from a complex interaction between three attributes: adiposity, muscle mass and muscle tone. Therefore, there is a need to develop biometrically accurate, ecologically valid images with which to measure men’s estimates of body size and shape. To do this, we are combining 3D body shape scanning technology with state of the art body composition measurements (bio-impedance) to generate the required high quality, CGI stimuli. Using these images in conjunction with psychophysical techniques and a battery of psychometric measures, we are investigating the perceptual, psychological and social dimensions of male body image, in health and disease.
The Cross-cultural Perception of Body Image and the Influence of the Media
While evidence strongly suggests that media exposure drives the preference for a slim female body, the ubiquitous nature of the media via TV, print and electronic devices in Western countries means that experiments manipulating media exposure often face the problem of ceiling effects (i.e. individuals already have so much media exposure, that additional exposure has little or no effect on their body perception). However, in parts of Nicaragua there still exists considerable variation in TV access: some villages have no mains electricity and thus very limited potential for TV access, while other villages are connected to the national grid and therefore have relatively high media access. This situation allows us to make cross-sectional and longitudinal comparisons of the relative impact of TV on people’s preferences for ideal body size and shape.
Development of the MapMe body image scales of known weight status for 4-5 and 10-11 year old children
Parents have an important role to play in childhood obesity prevention, yet their ability to recognise unhealthy weight status in children is limited. Parents tend to use visual assessments when determining child weight status and so typically underestimate child size. We have developed a visual tool to aid more accurate assessment of child weight status with visual images of known weight status for children, based on UK criteria. Sex- and age-specific body image scales of known weight status were created for 4-5 and 10-11 year old children according to British growth reference (UK90) criteria. The body image scales have potential in combatting the childhood obesity epidemic via use by the public, health professionals and the scientific community. The scales have been tested in a trial to assess their impact on parental recognition of whether a childhood is overweight, and they improve parental action to maintain healthy weight in their child and child weight status.