Approach and avoidance bias for thin‐ideal and normal‐weight body shapes in anorexia nervosa

Abstract

Objective The two studies aimed to examine implicit affective evaluations of thin‐ideal and normal‐weight body shapes in women with anorexia nervosa (AN), taking identification with body shapes into account. Method In study 1, approach–avoidance bias for thin‐ideal and normal‐weight bodies was assessed in 40 women with AN and 40 healthy women by using an Approach‐Avoidance Task and female avatar bodies with a standard face as stimuli. In study 2, 39 women with AN and 38 healthy women underwent a similar task but identification with bodies was manipulated by presenting bodies once with the participant's own face and once with another woman's face. Results In study 1, patients with AN did not differ from healthy participants in their automatic approach–avoidance tendencies towards thin‐ideal and normal‐weight bodies. In study 2, no definite approach bias for a thin self and no avoidance bias for thin other women or for a normal‐weight self were found. However, as compared to healthy women, those with AN showed a less positive implicit evaluation of thin other women, and an implicit preference for thin bodies depicted as themselves over thin bodies depicted as another woman. Conclusions The findings suggest that intra‐sexual competition for being slim is increased in AN.

Implicit bias to food and body cues in eating disorders: a systematic review

“…No differences in startle responses to thin female bodies were found between females with AN, BN, and controls in the study by Friederich et al [43], a finding confirmed by Brockmeyer et al [48] who found no differences between patients with AN and healthy controls in the implicit evaluation of emaciated bodies in an AAT. Interestingly, after replacing the face on body stimuli by the participant's own face, patients with AN displayed an implicit bias for that manipulated body over the one carrying the standard face [48].…”

“…We included n = 18 eligible studies that examined implicit bias to body cues in ED cohorts, including n = 5 studies that examined food and body cues and were already presented in "Studies investigating implicit biases in clinical (ED) cohorts: food cues" [34,35,39,42,43]. No differences in startle responses to thin female bodies were found between females with AN, BN, and controls in the study by Friederich et al [43], a finding confirmed by Brockmeyer et al [48] who found no differences between patients with AN and healthy controls in the implicit evaluation of emaciated bodies in an AAT. Interestingly, after replacing the face on body stimuli by the participant's own face, patients with AN displayed an implicit bias for that manipulated body over the one carrying the standard face [48].…”

Implicit approach‐avoidance tendencies toward food and body stimuli absent in individuals with anorexia nervosa, bulimia nervosa, and healthy controls

“…They only found differences between adult patients with AN and HCs when the participants' own faces were positioned onto the avatars' bodies. Brockmeyer et al (2020) suggested that identification may be a crucial component of biased body evaluation. The findings of the present study support this conclusion.…”

“…With regard to body stimuli, there is sparse evidence in clinical samples. In two studies, Brockmeyer et al (2020) assessed approach-avoidance biases toward thin and normal weight bodies in AN patients compared to HCs.…”

“…With regard to low-calorie stimuli, no differences in response times were expected. Our study was planned and designed before the study by Brockmeyer et al (2020) was published. Therefore, we expected that individuals with AN and BN would show an approach bias toward thin bodies (i.e., they would be faster when pulling than pushing thin bodies).…”