The Thinner the Better: Self‐Esteem and Low Body Weight in Anorexia Nervosa

Brockmeyer, Timo; Holtforth, Martin Grosse; Bents, Hinrich; Kämmerer, Annette; Herzog, Wolfgang; Friederich, Hans‐Christoph

doi:10.1002/cpp.1771

Cited by 39 publications

(31 citation statements)

References 62 publications

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“…Recovered AN patients do not significantly differ from controls in important elements of social functioning, in terms of empathy, emotional recognition, or social conformity according to one study (Morris et al, 2013). Self-liking was found to not significantly differ between sustained weight-restored AN and acutely ill AN (Harper et al, 2017), whereas self-esteem was lower than healthy controls in both recovered AN (Brockmeyer et al, 2013) and BN patients (Daley et al, 2008).…”

Section: Quality Of Life and Positive Mental Healthmentioning

confidence: 76%

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Tomba

Tecuta

Crocetti

et al. 2019

Intl J Eating Disorders

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Objective: In psychiatry, the presence of residual symptoms after treatment is linked to the definitions of remission and recovery. To identify the presence of residual eating disorder (ED) symptoms and associated non-ED clinical features in remitted and recovered EDs, the current systematic review with meta-analysis was performed.Method: A systematic review was conducted on residual ED symptoms and non-ED clinical features including comorbid psychopathology, neurophysiological functioning, cognitive functioning, and quality of life in ED patients considered remitted or recovered. To examine residual ED symptoms, meta-analyses were performed while considering age, study quality, remission, and recovery criteria strictness as moderators.Sensitivity, publication bias, and heterogeneity analyses were also conducted. Results: The 64 studies selected for the systematic review underscored the presence of residual ED symptoms in anorexia nervosa (AN) and bulimia nervosa (BN), and impairments and deficits in the additional features examined. From the 64 studies, 31 were selected regarding residual ED symptoms in AN for meta-analysis. Large effect sizes indicated that remitted/recovered AN patients reported significantly lower body mass index (Hedges' g = −0.62[−0.77, −0.46]) and significantly greater symptomatology in terms of ED examination-questionnaire (Hedges'g = 0.86 [0.48,1.23]) and ED inventory (Hedges' g = 0.94[0.64,1.24]) than healthy controls, independently of remission and recovery criteria strictness, age, and study quality. Discussion: The presence of residual ED symptoms in AN is quantitatively supported, whereas the presence of residual ED symptoms in BN should be further investigated. Data on binge-eating disorder are missing. Future research should use consistent, multicomponent, and standardized comparable indicators of recovery. ResumenObjetivo: En psiquiatría, la presencia de síntomas residuales después de tratamiento está ligado a las definiciones de remisión y recuperación. Para identificar la presencia de síntomas residuales del trastorno de la conducta alimentaria (TCA) y características clínicas no de TCA asociadas en pacientes remitidos y recuperados de TCAs, se realizó la presente revisión sistemática con meta-análisis.

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Section: Quality Of Life and Positive Mental Healthmentioning

confidence: 76%

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Tomba

Tecuta

Crocetti

et al. 2019

Intl J Eating Disorders

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“…We favor the neural compensation hypothesis because outpatient treatment of AN typically includes individual psychotherapy and cognitive therapies that focus on self-perception, body-image, mentalization, and self-esteem (Lazaro et al , 2011; Brockmeyer et al , 2013; Watson and Bulik, 2013; Hay et al , 2014; Kelly et al , 2014), all constructs related to social self-evaluations. One area that differed during reflected third person evaluations compared to direct first person evaluations in the recovered women was the dACC, a region that has been directly related to the difficulty of a task (Shenhav et al , 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Although weight-restoration is essential for recovery from AN, more than half of adult patients relapse after treatment (Steinhausen, 2002; Keel and Brown, 2010). Therapies that consider body-image, identity, and self-esteem are typically utilized after weight-restoration but the specific cognitive, physiological, and emotional changes that result in sustained recovery have not been clearly identified (Murphy et al , 2010; Lazaro et al , 2011; Brockmeyer et al , 2013; Watson and Bulik, 2013; Hay et al , 2014; Kelly et al , 2014). Utilization of functional magnetic resonance imaging (fMRI) tasks to characterize specific neurocognitive problems in self-perception in AN may improve our ability to understand the disease and design targeted treatments.…”

Section: Introductionmentioning

confidence: 99%

Neural differences in self-perception during illness and after weight-recovery in anorexia nervosa

McAdams¹,

Jeon–Slaughter

Evans

et al. 2016

Social Cognitive and Affective Neuroscience

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Anorexia nervosa (AN) is a severe mental illness characterized by problems with self-perception. Whole-brain neural activations in healthy women, women with AN and women in long-term weight recovery following AN were compared using two functional magnetic resonance imaging tasks probing different aspects of self-perception. The Social Identity-V2 task involved consideration about oneself and others using socially descriptive adjectives. Both the ill and weight-recovered women with AN engaged medial prefrontal cortex less than healthy women for self-relevant cognitions, a potential biological trait difference. Weight-recovered women also activated the inferior frontal gyri and dorsal anterior cingulate more for direct self-evaluations than for reflected self-evaluations, unlike both other groups, suggesting that recovery may include compensatory neural changes related to social perspectives. The Faces task compared viewing oneself to a stranger. Participants with AN showed elevated activity in the bilateral fusiform gyri for self-images, unlike the weight-recovered and healthy women, suggesting cognitive distortions about physical appearance are a state rather than trait problem in this disease. Because both ill and recovered women showed neural differences related to social self-perception, but only recovered women differed when considering social perspectives, these neurocognitive targets may be particularly important for treatment.

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“…Concerning BDD, Phillips and colleagues pointed out that the relationship of symptom severity with self-esteem was largely mediated by the level of depression . Furthermore, in AN, a direct association of self-esteem with changes in weight has been found (Brockmeyer et al, 2012;Hoffmeister et al, 2010). A thorough comparison of self-esteem across both disorders including a control for depression level is missing.…”

mentioning

confidence: 95%

A Comparison of Self-Esteem and Perfectionism in Anorexia Nervosa and Body Dysmorphic Disorder

Hartmann

Thomas

Greenberg³

et al. 2014

Journal of Nervous &Amp; Mental Disease

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Previous studies have identified phenotypic similarities between anorexia nervosa (AN) and body dysmorphic disorder (BDD), which share the common feature of negative body image. Studies comparing endophenotypes that may cut across both disorders-as suggested by the National Institute of Mental Health's Research Domain Criteria-are limited. Sixty-nine individuals (AN, n = 24; BDD, n = 23; mentally healthy controls [MHCs], n = 22) completed diagnostic interviews and self-reports assessing self-esteem and perfectionism. Clinical groups showed greater perfectionism in almost all subdimensions as well as poorer self-esteem compared with MHCs, with no clinical group differences when controlling for level of depression. Depression was a mediator of the relationship between symptom severity and self-esteem in both clinical groups. Comparable low self-esteem and greater perfectionism in AN and BDD corroborated existing etiological models and previous studies. Depression was a significant contributor to negative self-esteem in both disorders.

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The Thinner the Better: Self‐Esteem and Low Body Weight in Anorexia Nervosa

Cited by 39 publications

References 62 publications

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Neural differences in self-perception during illness and after weight-recovery in anorexia nervosa

A Comparison of Self-Esteem and Perfectionism in Anorexia Nervosa and Body Dysmorphic Disorder

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