Visual mapping of body image disturbance in anorexia nervosa reveals objective markers of illness severity

Abstract

Body image disturbance (BID) is a core feature of eating disorders, for which there are few objective markers. We examined the feasibility of a novel digital tool, “Somatomap”, to index BID related to anorexia nervosa (AN) severity. Fifty-five AN inpatients and 55 healthy comparisons (HC) outlined their body concerns on a 2-Dimensional avatar. Next, they indicated sizes/shapes of body parts for their current and ideal body using sliders on a 3-Dimensional avatar. Physical measurements of corresponding body parts, in cm, were collected for reference. We evaluated regional differences in BID using proportional z-scores to generate statistical body maps, and multivariate analysis of covariance to assess perceptual discrepancies for current body, ideal body, and body dissatisfaction. The AN group demonstrated greater regional perceptual inaccuracy for their current body than HC, greater discrepancies between their current and ideal body, and higher body dissatisfaction than HCs. AN body concerns localized disproportionately to the chest and lower abdomen. The number of body concerns and perceptual inaccuracy for individual body parts was strongly associated with Eating Disorder Examination Questionnaire (Global EDE-Q) scores across both groups. Somatomap demonstrated feasibility to capture multidimensional aspects of BID. Several implicit measures were significantly associated with illness severity, suggesting potential utility for identifying objective BID markers.

Could Avatar Therapy Enhance Mental Health in Chronic Patients? A Systematic Review

“…The use of avatars in treating illnesses has advanced in recent years, offering many possibilities in terms of the pathologies they are geared towards. Although not all the benefits of this kind of intervention are currently known, good results have been obtained in the treatment of anxiety in disorders such as agoraphobia [20] and social phobia [17][18][19], as well as in treating eating disorders [13,14], addictions [15,16], weight control [9][10][11], facial pattern recognition [26][27][28][29][30], and ASD [31][32][33]. Education is another area in which they have been used.…”

“…For example, they have been developed with obesity patients [9][10][11] and to treat mental health diseases such as depressive disorders [12], eating disorders [13,14], addictive disorders [15,16], social anxiety disorders [17][18][19] and agoraphobia [20]. They have also been developed as educational tools in order to enhance healthcare staff performance [21][22][23][24][25].…”

A case of anorexia nervosa whose body image deteriorated after being weighed with classmates at school

“…The European Research Journal 2022 negative presentation of this difference by different environmental factors may lead to eating disorders in the adolescent age group, which is already sensitive to the physical changes occurring in their bodies as body image problems are common in this age group [4][5][6].…”

Sex-dependent Clinical Presentation, Body Image, and Endocrine Status in Long-term Remitted Anorexia Nervosa

“…However, muscularity-focused body image ideals, potentially present in males with AN, may be better captured by the drive for muscularity concept (McCreary & Sasse, 2000), designed as a measure of male body image ideals. Additionally, computer-based body modelling tools have been increasingly applied in AN showing, for example, greater inaccuracy in perception when modelling one’s current body and significantly distorted body image ideals if asked to model one’s desired body (Mölbert et al, 2018; Ralph-Nearman et al, 2021). While deviant body image ideals are generally well characterized in females with AN, little is known about whether these ideals, and especially their sex-specific variations, occur only in the acute state of the disorder or whether they persist into the long-term course of the disease in both sexes.…”