Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: A longitudinal study

Calugi, Simona; Ghoch, Marwan El; Conti, Maddalena; Grave, Riccardo Dalle

doi:10.1016/j.brat.2018.04.001

Cited by 55 publications

(50 citation statements)

References 30 publications

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“…Similar tendencies were observed not only among patients with AN but, also, among women with high BD. These results support the increasing evidence in favor of the critical role that the FGW might display not only in AN [ 6 , 8 , 9 , 10 ] but, also, in healthy women with body concerns. Indeed, several studies have reported high prevalence of FGW among adult women [ 2 , 57 ] and young women between 16 to 25 years old [ 58 ].…”

Section: Discussionsupporting

confidence: 88%

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Porras-García

Ferrer-García

Serrano‐Troncoso

et al. 2020

JCM

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Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery.

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Section: Discussionsupporting

confidence: 88%

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Porras-García

Ferrer-García

Serrano‐Troncoso

et al. 2020

JCM

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“…Network analyses have identified 'feeling fat' as among the most central eating disorder (ED) symptoms in clinical samples of adults (Christian et al, 2020;Elliott et al, 2020) and children/adolescents (Goldschmidt et al, 2018). These results are consistent with research indicating that 'feeling fat' predicts both ED symptom severity (Linardon et al, 2018) and treatment outcome (Calugi et al, 2018). In non-clinical samples, 'feeling fat' has been associated with eating pathology and body dissatisfaction, as well as other factors relevant for EDs including perfectionism, low self-esteem, perceived pressure to be thin, and the tendency to engage in social comparison (Lam et al, 2002;Mehak & Racine, 2019;Streigel-Moore et al, 1986;Tiggeman, 1996).…”

supporting

confidence: 69%

Exposure to thin and non-thin bodies elicits ‘feeling fat’: Validation of a novel state measure

Wilson¹,

Mehak²,

Racine³

2020

Preprint

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‘Feeling fat’ refers to the subjective experience of being overweight and relates to severity of eating pathology. Despite research suggesting that ‘feeling fat’ fluctuates across contexts, this construct is almost exclusively assessed in terms of frequency or as a trait. Examining state ‘feeling fat’ in response to external stimuli can inform us of the nature of this construct. A community sample of women (N = 290) viewed affective images and images of women at different body weights. Self-Assessment Manikin (SAM) valence and arousal rating scales as well as a novel SAM ‘feeling fat’ scale were rated for each image. Theoretically-related constructs (i.e., trait ‘feeling fat’, thin-ideal internalization, body dissatisfaction, eating pathology) were measured. Body images elicited greater state ‘feeling fat’ than affective images, with images of thin-ideal non-conforming bodies producing higher state ‘feeling fat’ than thin-ideal conforming bodies. Positive correlations were observed between state ‘feeling fat’ in response to thin-ideal conforming images and all variables of interest, whereas associations between these variables and ‘feeling fat’ in response to thin-ideal non-conforming images were small and often non-significant. The development of a state measure of ‘feeling fat’ allows for the investigation of triggers of this bodily experience and will facilitate future research.

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“…"Feeling fat" has been measured inconsistently. Striegel-Moore et al (1986) crafted a 7-item scale, Cooper et al (2007) asked participants to describe "feeling fat" in a semi-structured interview, and T A B L E 1 Proposed mechanisms of "feeling fat" and suggested multimethod measurement strategies Heart rate variability Electrodermal activity Heart beat perception task; two-step water load test; laboratory measurement of body mass index; body fat estimation (e.g., caliper method, DEXA scan), clothing size recent research has used a single item from the Eating Disorder Examination-Questionnaire (e.g., Calugi et al, 2018;Linardon et al, 2018;Mehak & Racine, 2019). Unfortunately, researchers have overlooked validated measures of "feeling fat."…”

Section: Psychometric Measurement Of Feeling Fatmentioning

confidence: 99%

Understanding “feeling fat” and its underlying mechanisms: The importance of multimethod measurement

Mehak

Racine

2020

Intl J Eating Disorders

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“Feeling fat,” the somatic sensation of being overweight that does not entirely correlate with one's actual weight, is recognized clinically as a maintenance factor in eating disorders. Occurring amidst Western internalized thin ideals and weight stigma, “feeling fat” is wide‐reaching and also reported by those with subclinical and absent eating pathology. However, empirical study of “feeling fat” is limited. Regarding proposed mechanisms, “feeling fat” may (a) reflect the displacement of negative affect onto the body, (b) represent one element of a cognitive distortion related to the imagined consumption of fattening food, and/or (c) be a function of impaired interoceptive awareness. However, the relative and/or joint contributions of these mechanisms to “feeling fat” are unclear. Regarding measurement, retrospective assessment with single items has been the norm. Innovative measures of “feeling fat” will expand our understanding of this construct. Ecological momentary assessment can clarify the transitory nature of this experience, and physiological measures can allow for assessment of somatic elements of “feeling fat. Multi‐method and implicit measurement strategies of ‘feeling fat’” may clarify the mechanisms underlying this experience. Further research with improved measurement techniques may also benefit eating disorder treatment by highlighting new treatment foci (e.g., cognitive distortions, interoceptive awareness).

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Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: A longitudinal study

Cited by 55 publications

References 30 publications

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Exposure to thin and non-thin bodies elicits ‘feeling fat’: Validation of a novel state measure

Understanding “feeling fat” and its underlying mechanisms: The importance of multimethod measurement

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