Body Image Disturbance in Binge Eating Disorder: A Review

Abstract

Binge eating disorder (BED) is characterized by frequent binge eating without compensatory behaviour and is thus often associated with obesity. Whereas for the eating disorders anorexia nervosa and bulimia nervosa, one of the main diagnostic features is a negative body image, the research criteria for BED do not include body image disturbance. Although several studies have been conducted on the occurrence of body image disturbance in BED, no review has yet summarized and integrated these findings. Therefore, the present paper reviews studies on the cognitive-affective, perceptual and behavioural components of body image. Many of the reviewed studies reveal that individuals with BED display a higher degree of weight and shape concerns than obese persons without BED. Concerning the perceptual component, no evidence exists to date that persons with and without BED differ in terms of the perception of their own body size. While many studies have examined the cognitive-affective body image component, research on the behavioural manifestations of body image disturbance is generally lacking. However, there is first evidence that persons with BED display an enhanced degree of body checking and avoidance. The results of this review indicate that body image disturbance seems to be a symptom of BED but which still requires further exploration.

The impact of early shame memories in Binge Eating Disorder: The mediator effect of current body image shame and cognitive fusion

“…Nonetheless, they provide a useful framework for understanding the factors operating in the vulnerability and persistence of binge eating symptoms in a clinical sample with BED and the function that binge eating may serve for these patients. These findings support the growing evidence that the dimension of body image and its significance for self-evaluation is relevant in BED, bringing this disorder closer to the other established eating disorders (Ahrberg et al, 2011;Dakanalis et al, 2015b;Duarte et al, 2016;Grilo, 2013). Clinically our findings suggest that it is important to assess and address early shame experiences, namely those related to the physical appearance dimension, and to help patients to understand their negative selfevaluations and disordered eating behaviours as strategies they came to adopt as a means to protect them from interpersonal and emotional threats Allan, 2009, 2010;Goss and Gilbert, 2002)).…”

“…These episodes involve emotional distress and shame because of the binging behaviour, as well as concerns about the effects of these episodes on body weight, shape, and self-esteem. However, contrary to the currently established diagnoses of Bulimia Nervosa and Anorexia Nervosa, diagnostic criteria for BED does not require body image concerns for diagnosis (Ahrberg et al, 2011;Dakanalis et al, 2015b;Grilo, 2013).…”

Profiles of body image disturbance and their external correlates

“…In literature specifically considering BID, however, this component is sometimes described as cognitive-affective (Ahrberg et al, 2011;Maïano et al, 2009). This merger is intuitive in the context of a disturbance in body image.…”

“…Because negative evaluation and affect is an inherent and invariable part of BID, considering it as an independent component is unnecessary. Given the precedent of viewing affects and attitudes alongside cognitions in BID (Ahrberg et al, 2011;Maïano, 2009), the present study will consider a joint cognitive-affective component of body image.…”

“…The high prevalence of BID indicates that it is not simply a problem within psychiatric populations. Though BID is related to eating disorders, it is a normative phenomenon that is present in the majority of the population to varying degrees and therefore important to study outside the small portion of the population with eating disorders (Ahrberg, Trojca, Nasrawi, & Vocks, 2011;Rodin et al, 1984;Tantleff-Dunn, 2011;Zanetti et al, 2013). The prevalence of BID is particularly troubling given its association with reduced quality of life and measures of psychopathology (Cash, Phillips, Santos, & Hrabosky, 2004;Vallance, 2011).…”